Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through D-quality evidence.

Class
Qualifying studies
Minimum requirements
A
Systematic review or meta-analysis of human trials
 
B
RDBPC human trials
2+ studies and/or 1 study with 50 + subjects
C
RDBPC human trials
1 study
D
Non-RDBPC human or In-vivo animal trials
 

This template, which outlines an adjunctive therapy approach for individuals receiving vaccines, aims to enhance immune responses and reduce side effects through targeted supplementation. Key supplement ingredients include vitamin D, probiotics, multivitamins, and omega-3 fatty acids. These ingredients may help to modulate immune responses, improve antibody production, and reduce post-vaccination adverse effects such as pain and gastrointestinal symptoms, making them valuable additions to vaccination strategies, particularly for individuals with micronutrient deficiencies or those seeking enhanced immunogenicity. (Calder 2022)(Davidson 2011)(Fateh 2023)(Gualtieri 2023)

Vitamin D

600–2,500 IU per day, at least two weeks before and after the vaccination period

  • Vitamin D3 supplementation significantly increased IgG levels and reduced post-vaccination side effects, especially in those with higher body mass index (BMI). (Fateh 2023)
  • Participants in the intervention group showed a significant increase in 25-hydroxy vitamin D levels and experienced fewer side effects after the second vaccine dose compared to the first. (Fateh 2023)
Vitamin D in the Fullscript catalog

Probiotics

Lactobacillus rhamnosus GG, at least 10^10 CFU per day, for at least two weeks before and after the vaccination period

  • In a study of 39 subjects, Lactobacillus GG (LGG) was well tolerated and improved immunogenicity against the H3N2 strain of influenza, with 84% of LGG recipients achieving protective titers compared to 55% in the placebo group. LGG shows potential as an adjuvant to enhance influenza vaccine response, particularly for certain strains, warranting further research in specific populations. (Davidson 2011)
  • LGG may be an effective adjuvant to vaccines by enhancing immunomodulatory responses, potentially improving vaccine efficacy. Its ability to boost immune function has demonstrated promising results, making it a valuable adjunct in optimizing patient outcomes during immunization. (Gorelov 2018)
Probiotics in the Fullscript catalog

Multivitamin

Containing at least 5 mg of zinc and 200 mcg of selenium, take daily ongoing

  • A review of 6,700 publications highlights that micronutrients such as folate, selenium, zinc, iron, and vitamins A, D, and B12 support T- and B-lymphocyte function, potentially enhancing vaccine efficacy and safety. Micronutrient supplementation before and after vaccination may boost antibody responses, reduce adverse effects, and improve outcomes, particularly in patients with micronutrient deficiencies. (Torshin 2021)
  • Micronutrient supplementation, particularly with vitamins A, D, and E and trace elements such as zinc, iron, and selenium, has been associated with enhanced immune responses and improved vaccine efficacy. Addressing micronutrient deficiencies could serve as a safe, cost-effective strategy to boost immunogenicity and reduce the incidence and severity of respiratory diseases, complementing vaccination efforts globally. (Calder 2022)
Multivitamins in the Fullscript catalog

Omega-3 fatty acids

1.6 g per day of EPA and 1.1g per day of DHA, at least two weeks before and after the vaccination period

  • Omega-3 polyunsaturated fatty acids (PUFAs), such as EPA and DHA, have been shown to improve immune responses to diphtheria and tetanus vaccines in pregnant women, increasing Th1-associated cytokines and IgG titers. (Gualtieri 2023)
  • Research suggests that omega-3 PUFAs could be integrated into food premixes to enhance vaccine efficacy and safety, with ongoing updates required due to evolving research. (Gualtieri 2023)
  • Significant associations were found between reduced side effects and supplementation with omega-3s during the vaccination cycle. Patients taking omega-3s at the start and those taking vitamin supplements at the end of the cycle were more likely to experience no side effects compared to those who didn’t supplement. (Gualtieri 2023)
Omega-3 fatty acids in the Fullscript catalog

Disclaimer

The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

View protocol on Fullscript
References
  1. Calder, P. C., Berger, M. M., Gombart, A. F., McComsey, G. A., Martineau, A. R., & Eggersdorfer, M. (2022). Micronutrients to support vaccine immunogenicity and efficacy. Vaccines, 10(4), 568. https://doi.org/10.3390/vaccines10040568 
  2. Davidson, L. E., Fiorino, A., Snydman, D. R., & Hibberd, P. L. (2011). Lactobacillus GG as an immune adjuvant for live-attenuated influenza vaccine in healthy adults: a randomized double-blind placebo-controlled trial. European Journal of Clinical Nutrition, 65(4), 501–507. https://doi.org/10.1038/ejcn.2010.289 
  3. Fateh, H. L., Kareem, G., Rezaeian, S., Moludi, J., & Kamari, N. (2023). The effect of VIT-D supplementation on the side effect of BioNTech, Pfizer vaccination and immunoglobulin G response against SARS-COV-2 in the individuals tested positive for COVID-19: a randomized control trial. Clinical Nutrition Research, 12(4), 269. https://doi.org/10.7762/cnr.2023.12.4.269 
  4. Gorelov, A. V., Kanner, Е. V., Maximov, M. L., Ermolaeva, A. S., Voznesenskaya, A. A., & Dadasheva, K. N. (2018). Lactobacillus rhamnosus GG: clinical aspects of the use from the perspective of evidence-based medicine. Meditsinskiy Sovet = Medical Council, 17, 66–73. https://doi.org/10.21518/2079-701x-2018-17-66-73 
  5. Gualtieri, P., Trombetta, D., Smeriglio, A., Frank, G., Alibrandi, A., Leggeri, G., Marchetti, M., Zingale, I., Fanelli, S., Stocchi, A., & Di Renzo, L. (2023). Effectiveness of nutritional supplements for attenuating the side effects of SARS-COV-2 vaccines. Nutrients, 15(8), 1807. https://doi.org/10.3390/nu15081807
  6. Torshin, I. (2021). Computational systematics of nutritional support of vaccination against viral and bacterial pathogens as prolegomena to vaccinations against COVID-19. medRxiv (Cold Spring Harbor Laboratory). https://doi.org/10.1101/2021.09.10.21263398