Editor’s note: The guidance in this article has been updated since the time of publication. Please visit Return to Sports and Physical Activity. For the latest news on COVID-19, visithttp://bit.ly/AAPNewsCOVID19.
The AAP is recommending that pediatricians ask patients during sports exams if they have had the COVID-19 vaccine or SARS-CoV-2 infection. Updated preparticipation history and physical exam forms now have a section for COVID-19 information.
The changes give pediatricians a starting point to discuss vaccination and the opportunity to document the history in the patient’s medical record. The recommendations are included in the updated interim guidance on returning to sports and physical activity.
The Academy also has signed onto a statement with physician groups, sports medicine groups, high school and college associations, and the U.S. Olympic and Paralympic Committee that urges all medical providers to ask about COVID-19 vaccine at all sports preparticipation evaluations. The statement also encourages all youth sport and athletic associations to spread the message to their communities about vaccinating athletes to prevent “widespread disease, hospitalizations and deaths due to COVID-19” and to help “keep students in the classroom, athletes in the game, and athletic teams on the field, while protecting our communities.”
The groups are calling on all athletes who are eligible and do not have contraindications to be vaccinated against COVID-19 as soon as possible because it takes several weeks to reach full immunity.
Kick off the discussion
COVID-19 vaccine should be a topic of discussion for all pediatricians, said Susannah M. Briskin, M.D., FAAP, a member of the AAP Council on Sports Medicine and Fitness Executive Committee. “Make sure you discuss it at every visit regardless of the reason of why the individual is coming in.”
When talking with her patients who are athletes, Dr. Briskin explains how the vaccine can minimize disruption to their training and games. Once athletes are fully vaccinated, the AAP recommends following transmission mitigation recommendations as described by the Centers for Disease Control and Prevention for vaccinated people.
“I try to explain to people that their child is less likely to get COVID-19 if they have the vaccine, and they’re more likely to be able to be involved in their sports without interruption if they’ve been vaccinated,” she said.
Questions have been added to the history form, including “Have you had COVID-19?” and “Have you been immunized for COVID-19?” (If yes, the patient checks whether they have had one or two doses.)
A section on the physical examination form asks whether the patient has received the COVID-19 vaccine, if the vaccine was administered at that visit and whether it was the first or second dose.
Both forms include a disclaimer clarifying that athletes who have a current preparticipation physical evaluation (per state and local guidance) on file should not need to complete another history form.
Dr. Briskin said the updated forms create a prompt for pediatricians to ask patients who have had COVID-19 infection about possible medical issues associated with post-infection complications and to confirm that the patient has appropriate medical clearance before returning to physical activities. If eligible for vaccination, she tells patients they should get it right away.
Pediatricians also can remind families and athletes about higher-risk activities such as shared transportation, shared meals and playing indoor sports.
“I try and discuss with families if they’re at all hesitant, but if their child is doing an indoor sport, they may really want to consider getting the vaccination done because there is a significant increase (in risk from) being indoors as opposed to being outdoors,” she said.
According to a summary of publicly reported data, there were 71,726 confirmed COVID-19 cases in children the week ending July 29 compared to 38,654 confirmed cases in the week ending July 22. Children account for about 19% of new cases.
