01/21/2022
TECHNICAL NOTE - GUIDANCE FOR VACCINATION AGAINST COVID-19 IN EXERCISERS AND ATHLETES
TECHNICAL NOTE OF THE EXERCISE AND SPORT MEDICINE SOCIETY - RJ
GUIDANCE FOR VACCINATION AGAINST COVID-19 IN EXERCISERS AND ATHLETES
January/2022
Writing team:
CLAUDIO GIL SOARES DE ARAUJO (Guest Editor)
MARCO AURELIO MORAES DE SOUZA GOMES (President of SMEERJ)
FABIO PERALTA MATHIAS (Scientific Director – SMEERJ)
SMEERJ, through this TECHNICAL NOTE, reinforces its role and its responsibility to inform the population and, in particular, athletes, exercisers and all those who deal with the various forms of human movement. The purpose of this TECHNICAL NOTE is to provide guidance on vaccination against COVID-19 in physically active individuals and serves to complement other information available in the literature on the relationship between COVID-19 and physical activity, exercise and sport.1,2
Concern about the risks of adverse effects of vaccines against COVID-19 in terms of health and, in particular, sports performance, has been recurrent in the media and among some athletes. Some articles that circulate in newspapers and on social networks go so far as to link vaccination with cases of myocarditis and sudden death in athletes, which constitutes a serious case of misinformation.3 However, several societies and institutions in various parts of the world ,4 have already approved and consider the various vaccines safe and attested that the cases of clinically relevant adverse reactions are, in their almost totality, not only extremely rare, but that they disappear spontaneously, without the need for medical intervention, in a few hours or a few days.
There is, to date, no scientific evidence that vaccines may be more adverse for athletes than for the general population,5,6 and it is even expected that athletes who will participate in the Winter Olympic Games in February 2022 , are vaccinated.7 In the very rare cases of myocarditis reported - 24 cases in 1 million in the general population -8 in patients immunized with m-RNA vaccines, the clinical course was almost always rapid and benign, and certainly at a much lower incidence than that resulting from SARS-Cov2 infection in athletes and physically active individuals.9
On the other hand, the risks arising from COVID-19 are very variable, with many individuals not presenting any clinical manifestations, while others have more complex or severe clinical evolutions, which, unfortunately, can lead to death, even in healthy and young individuals. There is currently no scientific doubt that the chances of contracting COVID-19 and, especially, of progressing poorly are significantly higher in individuals who do not have adequate vaccination coverage.10
Therefore, considering the current evidence, SMEERJ emphatically advises in favor of complete vaccine coverage for COVID-19, including a booster dose, in all those who do physical activity, exercise and sport, unless there is a formal and clearly documented medical contraindication. It is also expected that elite athletes engage in the collective sense and relevance of the current pandemic in the context of public health and act as disseminators of these guidelines.
In addition, we reinforce the importance of regular exercise as a way to strengthen the immune system, to allow preventing, treating and even rehabilitating patients affected by SARS-Cov2 and other diseases, even non-communicable ones.
References 1. Araújo CGS. Physical Activity, Exercise and Sports and Covid-19: What Really Matters. Int J Cardiovasc Sci 2021;34(2):113-5.
2. McKinney J, Connelly KA, Dorian P, et al. COVID-19-Myocarditis and Return to Play: Reflections and Recommendations From a Canadian Working Group. Can J Cardiol. 2021 Aug;37(8):1165-74.
3. https://www.medicinadoesporte.org.br/informe-da-sbmee-sobre-eventos-de-morte-subita-em-atletas-vacinados-contra-a-covid-19/ (acessado em 19/01/2022)
4. https://www.ema.europa.eu/en/human-regulatory/overview/public-health-threats/coronavirus-disease-covid-19/treatments-vaccines/vaccines-covid-19/safety-covid-19-vaccines (acessado em 19/01/2022).
5. Narducci DM, Diamond AB, Bernhardt DT, Roberts WO. COVID Vaccination in Athletes and Updated Interim Guidance on the Preparticipation Physical Examination During the SARS-Cov-2 Pandemic. Clin J Sport Med. 2022 Jan 1;32(1):e1-e6.
6. Hull JH, Wootten M, Ranson C. Tolerability and impact of SARS-CoV-2 vaccination in elite athletes. Lancet Respir Med. 2022 Jan;10(1):e5-e6.
7. https://olympics.com/athlete365/entourage/beijing-2022-information-for-athletes-entourage/ (acessado em 19/01/2022).
8. Witberg G, Barda N, Hoss S, et al. Myocarditis after Covid-19 Vaccination in a Large Health Care Organization. N Engl J Med. 2021 Dec 2;385(23):2132-9.
9. Martinez MW, Tucker AM, Bloom OJ, et al. Prevalence of Inflammatory Heart Disease Among Professional Athletes With Prior COVID-19 Infection Who Received Systematic Return-to-Play Cardiac Screening. JAMA Cardiol. 2021 Jul 1;6(7):745-52.
10. Abdul Taib NA, Baha Raja D, et al. Characterisation of COVID-19 deaths by vaccination types and status in Malaysia between February and September 2021. Lancet Reg Health West Pac. 2022 Jan;18:100354.
The following specialists in Exercise and Sports Medicine also supported and contributes to the content of this technical note :
ADILSON COSTA CAMARGO DE CASTRO
ADRIANO FONSECA DE MORAES
ALEXANDRO SOUZA COIMBRA
CARLOS BRUNO REIS PINHEIRO
CLAUDIO GIL SOARES DE ARAUJO
FABIO PERALTA MATHIAS
GUILHERME DE VIEIRA GIORELLI
JOAO FELIPE FRANCA
LUIZA CATHARINA BRUSASCO GRANDINI
MARCO ANTONIO ALVES AZIZI
MARCO AURELIO MORAES DE SOUZA GOMES
MATEUS FREITAS TEIXEIRA
NATALIA MOURAO
PAULA BARBOSA BAPTISTA MOREIRA
REINALDO MARTINS DE OLIVEIRA JUNIOR
RICARDO DE ANDRADE OLIVEIRA
ROBERTO LOHN NAHON
SERAFIM BORGES
This TECHNICAL NOTE should be cited as:
Araújo CG, Gomes MA, Mathias FP et al. ORIENTATION ABOUT COVID-19 VACCINATION IN EXERCISERS AND ATHLETES: Technical note of Sociedade de Medicina do Exercício e do Esporte do Rio de Janeiro; 21 January 2022
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