Photo: Trinity School of Durham and Chapel Hill
All athletes ages 12 and older should be vaccinated in order to stay safe, preserve in-school learning and prevent youth sports teams from shutting down, according to U.S. Secretary of Education Miguel Cardona, Centers for Disease Control and Prevention officials, and other leading health experts.
“If we don’t send kids onto a football field without a helmet, why would we send them into competition without vaccination?” Cardona said Friday in a webinar hosted by the National Federation of State High School Associations (NFHS) for its members.
As the delta variant swept across the country this summer, unvaccinated adolescents were hospitalized with COVID-19 at 10 times the rate of fully vaccinated adolescents, according to the CDC. The CDC study found that vaccines were “highly effective” at preventing serious illness in youth ages 12 to 17, the only pediatric age group for which vaccines are approved.
Last week, North Carolina’s department of health and human services said 45% of all COVID-19 clusters in the state’s middle and high schools stemmed from sports teams. Outbreaks were associated with youth sports teams in 2020 and early 2021, so it’s no surprise this issue has returned, health experts said.
Cardona, a father of two kids who play sports, said seeing games get canceled in 2020 “broke our hearts.” He noted that the SEC, NFL and other leagues have implemented rules that penalize teams with low vaccination rates. He praised the state of Hawaii, New York City, Fairfax County, Virginia and others for vaccination mandates for students to play school sports.
“What’s right is not always popular, but as leaders, we have to make the right decisions,” Cardona said.
The most powerful messenger to entice more young athletes to get vaccinated may be young athletes themselves, Cardona said.
“Students listen to students best,” he said. “When you have the captain of the team talking about it, and you have all the senior players talking to students and saying, ‘Listen, this is my last shot here,’ it matters as a team to take care of one another. … It’s really important we frame it that way: You’re helping your team out. No one wants to be the kid where you have half the team quarantining because of them.”
Unlike when vaccines were unavailable, the average daily rate of COVID-19 cases per 100,000 is now higher among children and adolescents ages 5-11 and 12-17 than adults, according to the CDC. The rate of pediatric COVID-19 admissions is highest in states with the lowest vaccination rates, especially the regions of Washington D.C./Mid-Atlantic, Atlanta/Southeast, and Dallas/South Central. Hispanic children account for the highest percentage of COVID-19 deaths among children and adolescents.
Fully vaccinated people who are exposed to COVID-19 do not have to quarantine at home but should get tested within three to five days, said Capt. Erin Sauber-Schatz, team lead of the CDC’s Division of Injury and Prevention. Being vaccinated not only prevents serious illness or death, but also supports in-person learning and extracurricular activity participation.
“We’re focused in to make sure students can stay in-person learning, and then hopefully sports and extracurricular activities can also be protected,” said Sauber-Schatz, a former diver and mom of a 12-year-old baseball player.
Last month, Fairfax County (Virginia) Public Schools – the 11th-largest school district in the country – announced students must be vaccinated to play winter and spring high school sports. The rule goes into effect Nov. 8. Fairfax County said 10 other counties in Virginia have since announced a similar vaccination requirement.
“This message needs to go national,” said Dr. Scott Brabrand, Fairfax County superintendent. “Our national leaders and policymakers need to call for mandatory vaccinations for all athletes right now. This is a no-brainer. It preserves the instructional integrity of our students and it preserves the athletic integrity for our athletics and programs.”
The NFHS recently launched a campaign called “Don’t Miss Your Shot” to encourage eligible students to get vaccinated so they don’t miss any competitions this school year.
In college sports, 90% of athletes from the five major conferences (ACC, SEC, Big Ten, Pac-12, Big 12) are vaccinated. Of the 69 schools from those conferences, more than half have instituted vaccine mandates. Vaccination rates are also high in pro sports – WNBA (99%), NHL (98%), MLS (greater than 95%), NFL (93.5%), MLB (87%), and NBA (85%).
High school athletes are uniquely vulnerable because of travel and other high contact time periods, said Dr. Cameron Wolfe, an infectious disease specialist who chairs the ACC’s medical advisory team.
“When you move a team together, you’re moving them in close proximity,” Wolfe said. “It’s not just the on-field transmission. We saw almost none of that. It’s how they go to the locker rooms, or how they move on buses, or in meal sessions. All of that is intensely close.”
Wolfe cautioned that being vaccinated doesn’t mean other mitigation efforts simply go away, such as masking and distancing. “But it’s so much harder to make athletics move forward without vaccination,” he said.
The American Medical Society for Sports Medicine (AMSSM) supports vaccination mandates for athletes 12 and older. Last month, AMSSM joined with organizations such as the American Academy of Pediatrics, National Athletic Trainers’ Association, NFHS, NCAA and U.S. Olympic and Paralympic Committee urging all medical providers to ask athletes about COVID-19 vaccinations at all sports physicals.
While less than a dozen youth athletes are identified as having died from COVID-19, one in seven infected kids have persistent symptoms known as long COVID, said Dr. Jason Matuszak, a sports medicine doctor and AMSSM board member.
“These things matter,” Matuszak said. “This is time away from the classroom, or exposure to teachers and coaches who died because of exposure through extracurricular activities. The implications of the disease remain profound. … The number of outbreaks that occurred in spring and winter last year could be a drop in the bucket to what we’ll face this fall and winter.”
While there are still occasional examples of outbreaks in pro and college sports that involve vaccinated people, health experts said all of these are associated with unvaccinated individuals to some degree. Dr. Robby Sikka, chair of the COVID Sports and Society Workshop, said getting youth athletes vaccinated is the best strategy to keep them playing sports because contact tracing is not necessary for vaccinated youth who are only exposed to the virus.
“That’s a positive to be able to play with minimal disruption to athletes,” said Sikka, noting that vaccinated individuals spread less virus and are less contagious than unvaccinated people.
Health experts also stressed there’s a psychological incentive to have youth athletes vaccinated. Wolfe noted how despondent COVID-positive North Carolina State University baseball players became after their diagnosis in June caused the Wolfpack to forfeit a shot at the national title.
“The public stigma was awful for the kids,” Wolfe said. “If I could avoid that again, I would do that in a heartbeat.”
Said Sikka: “If someone gets COVID and they pass it along, there’s a social consequence that has a psychological impact on your team. I’ve seen it in the NBA where one player blames another player for getting the virus. Those social effects can really, really damage kids. When you level the playing field by vaccinating everybody, you allow sports to continue in their natural state.”
Email Jon Solomon at jon.solomon@aspeninstitute.org.