COVID Vaccination in Athletes and Updated Interim Guidance on the Preparticipation Physical Examination During the SARS-Cov-2 Pandemic

Abstract

The American Medical Society for Sports Medicine (AMSSM) convened an expert panel to address the current evidence, knowledge gaps, and recommendations surrounding the COVID vaccination in athletes during the SARS-CoV-2 pandemic. The group held a series of meetings beginning in July 2021 and reviewed the available literature while using an iterative process and expert consensus to finalize this guidance statement. This document is intended to provide clinicians with suggestions on how to incorporate the COVID vaccination during the preparticipation physical examination for athletes in all levels of training and competition. The statement is not intended to address treatment, infection control principles, safety, ethical discussion, or public health issues related to SARS-CoV-2. The AMSSM task force acknowledges the clinical uncertainty, evolving public health objectives, and the limited data currently available to create this guidance statement.

Tolerability and impact of SARS-CoV-2 vaccination in elite athletes

“…As vaccination policies for SARS-CoV-2 have evolved to include younger, active populations, 1 evidence of vaccine hesitancy in some groups has emerged. 2 For athletic individuals, a key concern relates to the potential effect of vaccine-associated side-effects on sporting participation; 3 , 4 even brief interruptions to training can affect athletic performance.…”

COVID-19 and elite sport: Cardiovascular implications and return-to-play

“…The most notable case here relates to Novak Djokovic, who was unable to participate in the 2022 Australian Open and was subsequently deported by the Australian Government for not adhering to laws around vaccination. Despite the development and widespread administration of efficacious COVID-19 vaccines, 61 waning immunity, 62 athlete hesitancy, 63 and the risk of sustained transmission and emerging variants 64 will undoubtedly lead to spikes in the transmission that need to be considered with the development and introduction of screening/testing procedures that prioritize athlete welfare over commercial and business needs. Counterintuitively, the relaxing of mandatory social distancing, wearing of face coverings and the removal of access to free testing in western societies means that sports science and medicine practitioners will result in governing bodies and sports organizations having to develop, implement and uphold protocols that protect athletes, coaches, and spectators against the continued risk of infection and long-term sequelae.…”

Coronavirus disease 2019 and the young heart: prevention, treatment, and return to play

“…Despite these findings, rates of vaccination in this population remain suboptimal. As annual and preparticipation physical examinations are one of the most common reasons for athletes to see their primary care physicians, these visits provide opportunities to educate families and provide COVID-19 vaccination [ 10 ]. The AAP has revised sports preparticipation history and physical examination forms to include questions regarding COVID-19 history and COVID-19 vaccination status and continues to encourage all eligible children and adolescents to receive the COVID-19 vaccine [ 8 ].…”