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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.
Copyright © 2021 American Academy of Pediatrics
