Do NSAIDS or Executing Exercise Decrease Local Erythema, Site Swelling & Pain After INoculation

The study will evaluate the efficacy and immunologic effects of a non-pharmacological
exercise intervention (push-ups) compared to an oral NSAID (ibuprofen) and a blinded oral
placebo to decrease local injection site inflammation symptoms of delayed pain, erythema, and
edema and any impact on serologic antibody immune response after influenza vaccine receipt. A
healthy military cohort will be randomly assigned to either perform push-ups consistent with
their army physical fitness score, or to take a blinded oral medication which will be an
NSAID (ibuprofen) or an oral placebo. The study will require three visits for assessment: on
the day of vaccine receipt, 48-72 hours later and 21 -28 days later. The assessment visits
will include injection site inspection, an injection site photograph, completion of symptom
diaries and a validated pain scale and a laboratory blood specimen at the first and third
visit to measure antibody level changes. The exercise participants will also be required to
provide 1-2 fingerstick blood samples to evaluate for lactate, which is a byproduct of
anaerobic exercise to measure if level of exercise effort achieved anaerobic metabolism. The
study will evaluate if either of the interventions impacted perceived delayed pain, physical
signs of inflammation or antibody response as measured by serology.

Inclusion Criteria:

Must:

1. Be Active Duty Service Members.

2. at least 18 years of age or older.

3. Be requiring and eligible for inactivated influenza vaccine receipt.

4. Be willing and able to complete the study protocol requirements.

5. Have a current Flu Screening Form with medical clearance to receive the influenza
vaccination.

Exclusion Criteria:

Must Not:

1. Have already received influenza vaccine for the current season.

2. Have received any type of vaccine in the previous 72 hours.

3. Be on a medical profile resulting in current profile exemption from Physical Training
of Upper 2 or Upper 3. (Upper extremity injury or illness)

4. Have preexisting symptoms of injury or infection or other local symptoms that would
interfere with site assessment.

5. Be pregnant.

6. Have a history of allergy, intolerance, stomach bleeding or other medical exclusion
for ibuprofen.

7. Have a history of stroke or coronary artery disease, such as uncontrolled high blood
pressure or abnormal heart beat.

8. Has taken any topical or oral pain medications from the following medication classes
in the past 24 hours prior to the start of the study: oral acetaminophen, opioids,
tramadol, nonsteroidal anti-inflammatory drug (NSAID) or acetylsalicylic acid (ASA) or
topical pain relievers or counterirritants of menthol, methyl salicylate, camphor
menthols, and capsaicins.

9. Have any chronic or acute illness or treatment causing immunological suppression such
as current oral steroid therapy, malignancy or chemotherapy or lung disease. (not
including controlled asthma)

10. Currently participating in any other study