Letters to the Editor

Administering COVID-19 Vaccines During Preparticipation Physical Examinations


Am Fam Physician. 2021 Oct ;104(4):331-332.

Published online September 15, 2021.

To the Editor: During the SARS-CoV-2 pandemic, youth and interscholastic sports contacts have led to multiple outbreaks in and across communities. Breaking this chain of transmission is an essential public health measure for stopping the pandemic. Representatives from 12 medical and sports organizations, including the American Academy of Family Physicians, the American Academy of Pediatrics, and the American Medical Society for Sports Medicine (AMSSM), worked together with the White House COVID-19 Response Team to develop a consensus statement detailing the importance of COVID-19 vaccination for all athletes who are eligible to receive the vaccine and who do not have contraindications as an important tool to keeping “…students in the classroom, athletes in the game, and athletic teams on the field, while protecting our communities.”1 The representatives recognized the critical role of primary care physicians in improving vaccine acceptance. The preparticipation physical examination (PPE) provides an excellent opportunity to promote or administer a COVID-19 vaccine.

Last year, the AMSSM published interim guidance on PPE during the SARS-CoV-2 pandemic,2 which was summarized in an American Family Physician Community Blog.3 In August 2021, they released updated interim guidance to address the administration of the COVID-19 vaccine during the PPE and to discuss vaccine hesitancy, timing, and guidance on specific athlete populations (including athletes who are immunocompromised and individuals with other medical conditions).4 The guidance provides information about reducing disparities in outcomes in medically underserved and marginalized populations, the rare complication of myocarditis following vaccination, and other possible vaccine-related adverse effects. Although the medical home is considered the best place for a PPE, the guidance also addresses the possibility of incorporating a mass vaccination program with a mass PPE program. However, the vaccine should not be delayed until after the sports or competition season, and exercise around the time of vaccination may improve immune function and response to the vaccine.

Physicians are encouraged to use the updated COVID medical history form and COVID physical evaluation form when performing PPEs.5

Author disclosure: No relevant financial affiliations.


show all references

1. American Academy of Family Physicians. Sports and medical organizations encourage COVID -19 vaccine conversations be part of all sports physicals. August 3, 2021. Accessed August 25, 2021. https://www.aafp.org/news/media-center/statements/covid-vaccine-sports-physicals.html...

2. Diamond AB, Narducci DM, Roberts WO, et al.; American Medical Society for Sports Medicine. Interim guidance on the preparticipation physical exam for athletes during the SARS-CoV-2 pandemic. Accessed August 25, 2021. https://journals.lww.com/cjsportsmed/Documents/Interim%20Guidance%20PPE%20COVID.pdf

3. Lin K. American Family Physician Community Blog. Preparticipation physical exam and return to sports during the COVID-19 pandemic. September 14, 2020. Accessed August 25, 2021. https://afpjournal.blogspot.com/2020/09/preparticipation-physical-exam-and.html

4. Narducci DM, Diamond AB, Bernhardt DT, et al.; American Medical Society for Sports Medicine. COVID vaccination in athletes and updated interim guidance on the preparticipation physical examination during the SARSCov2 pandemic. Accessed August 25, 2021. https://www.amssm.org/Content/pdf-files/COVID19/Interim_COVID_vaccines-8-4-2021.pdf

5. American Academy of Pediatrics. Preparticipation physical evaluation (PPE). Accessed August 25, 2021. https://www.aap.org/en/patient-care/preparticipation-physical-evaluation/

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This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.



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