International travel and the elite athlete

Vaccination status of elite athletes in the German Armed Forces: a retrospective descriptive overview

Purpose

Vaccination of athletes is an effective preventive intervention to maintain athletic performance. Data reporting the vaccination status of elite athletes are limited. Aim of this study was to provide an overview about the vaccination status in elite athletes who were affiliated to the German Armed Forces.

Materials and Methods

Six hundred seventy athletes were included in this retrospective cross-sectional study. Statistical analysis was performed using McNemar's test, φ coefficient and logistic regression.

Results

The 0.3% of all included athletes had a complete vaccination status as recommended by the German Standing Commission on Vaccination when they started their career. Regarding the different kinds of vaccination, there was a range from 3.0% (influenza) to 69.6% (mumps, measles, rubella). Although a valid vaccination status is mandatory for soldiers, only 6.3% of the athletes had a valid one at the time of data collection. During the observation period, only few athletes worsened their vaccination status. Specific differences could be seen for different kinds of sports. Swimmers and sleigh drivers were almost completely below average. The vaccination status among Taekwondo Fighters and Fencers were almost entirely above average. Worse vaccination status was found for vaccinations that required more frequent repetition. The vaccination status was comparable for vaccinations that are available as combination vaccines.

Conclusion

Although a complete vaccination status was mandatory, there were vaccination gaps. It seems necessary to be more stringent in the prevention of vaccination gaps. Athletes, physicians, and sports associations should cooperate to find an effective way to get optimum prevention.

Influenza Vaccination Practices and Perceptions Among Young Athletes: A Cross-Sectional Study in Greece

BACKGROUND

Influenza vaccination among athletes is a crucial area in sports medicine. This descriptive, cross-sectional study aims to explore the vaccination practices and intentions regarding influenza vaccines among young athletes.

METHODS

A structured, questionnaire-based study was conducted among students from the National School of Sports in Greece. The survey was conducted over the period of April to May 2023. Overall, 138 participants participated in the study.

RESULTS

More than half of the participants had received a flu vaccine in the past, but only 12.3% were vaccinated against influenza for 2022-2023. The main reasons seemed to be the lack of time (40.6%) and the idea that influenza does not lead to any serious health threats for the participants (36.2%). The main factor that affected their decision to get the flu vaccine or not was the need for more information regarding influenza vaccination (79%).

CONCLUSIONS

The recent study showed low vaccination coverage among people of young age participating in sports activities. The qualitative views of the participants highlighted the significance of the lackof a well-organized information program provided by health professionals and coaches.

Assessment of Vaccination Status in Professional Football Players in Low Categories in Greece

BACKGROUND

There are limited data on the vaccination practices of footballers in low professional categories in Greece and Europe. The aim of this study was to investigate the vaccination practices followed by the medical staff of the low professional football categories in Central Greece.

METHODS

A questionnaire was developed and included questions on the vaccination practices of football players. The participants were chief medical officers of the fifteen low-category football teams in Central Greece. Overall, 10 out of 15 chief medical officers participated (response rate: 67%).

RESULTS

All participants recommended only the tetanus monovalent vaccine in cases with deep trauma of athletes. Influenza, pneumococcal vaccine, and Hepatitis A and B vaccines were not recommended by the medical officers. This was also the case for measles, mumps, rubella (MMR) vaccine and meningococcal vaccine with strains A, C, Y, W. Participants reported the lack of specific guidelines for vaccination in professional footballers.

CONCLUSIONS

The recent study showed poor vaccination practices in low categories of professional football teams in Central Greece. The qualitative view of the respondents revealed the importance of the absence of guidelines on vaccination of football players.

Safety and Impact on Training of the Influenza Vaccines in Elite Athletes Participating in the Rio 2016 Olympics

OBJECTIVE

The aim of the study was to evaluate the safety and tolerance of influenza vaccines for the northern and southern hemispheres in Polish elite athletes participating in the Rio 2016 Olympics.

DESIGN

Prospective, observational, cohort study.

SETTING

Institutional level.

PARTICIPANTS

Ninety-seven athletes vaccinated only with the northern hemisphere vaccine; 98 athletes received the southern hemisphere vaccine alone, whereas 39 athletes were vaccinated with both vaccines.

INTERVENTIONS

The athletes were vaccinated with a trivalent, inactivated influenza vaccine recommended for the northern hemisphere 2015/2016 and then with the vaccine recommended for the southern hemisphere 2016. Athletes kept a diary of adverse events and effects (if any) on training for 6 days after vaccination.

MAIN OUTCOME MEASURES

The percentage of general and local adverse events, number of lost or modified training sessions.

RESULTS

Significantly more local adverse events (pain and redness) were found in the group immunized with the vaccine for the northern hemisphere. There were no differences in the frequency of general adverse events and influence on training between groups. Of total 273 athletes who had 1911 training days during 6 days after vaccination, 6 athletes (2.2%) lost 13 training days (0.7%) and 16 athletes (5.9%) had to modify 34 (1.7%) training days within first 2 days after vaccination.

CONCLUSIONS

Athletes tolerated influenza immunization well. If they are going to travel to the other hemisphere during the influenza season, the use of the second influenza vaccine should be advised. Athletes should anticipate modification of trainings for 2 days after vaccination.

Vaccination practices and influenza in professional football players in Greece

BACKGROUND

There is limited data on vaccination practices for professional footballers globally.

AIMS

To record vaccination practices employed by medical staff of individual football teams of the Super League Greece, and absenteeism of footballers related to influenza illness.

METHODS

A brief questionnaire was distributed to chief medical officers (CMOs) of the sixteen teams of the Super League Greece. Participants were asked to report vaccines they recommended for footballers. In addition, the questionnaire included questions on new cases of influenza and absenteeism due to influenza. Descriptive statistics (absolute and relative frequencies) were used for the presentation of the results.

RESULTS

Overall, 87% of the CMOs recommended seasonal influenza vaccine, 62% hepatitis B vaccine and 50% pneumococcal vaccine. Fourteen CMOs (87%) reported that the occurrence of seasonal influenza in the 2016-17 northern hemisphere season ranged from one to five cases, while two medical officers (12%) reported zero workdays lost due to influenza.

CONCLUSIONS

Our survey shows considerable variation in vaccination practices of CMOs of the Super League Greece. The results of this survey should stimulate further evaluation of vaccination policy and influenza-related absenteeism in footballers.

Immunizations in Athletes

Context:

Immunizations are a cornerstone of preventive care and an important consideration for team physicians caring for athletes.

Evidence Acquisition:

A PubMed search was performed from August 2016 through May 2017 as well as a website review of the Centers for Disease Control and Prevention, World Health Organization, and Immunization Action Coalition.

Study Design:

Clinical review.

Level of Evidence:

Level 4.

Results:

By keeping abreast of diseases endemic to nations to which athletes may be traveling as well as the vaccination status of the athletes, team physicians can provide appropriate advice regarding immunization and prevention of disease.

Conclusion:

There are a host of regularly updated reliable websites to assist the team physician in these recommendations.

Gastrointestinal Prophylaxis in Sports Medicine

Context:

Because sports participation at all levels often requires international travel, coaches, athletic trainers, and team physicians must effectively protect athletes from gastrointestinal infections. Traveler’s diarrhea is the most common travel-related illness and can significantly interfere with training and performance.

Evidence Acquisition:

A review of relevant publications was completed using PubMed and Google Scholar.

Study Design:

Clinical review.

Level of Evidence:

Level 5

Results:

Enterotoxigenic and enteroaggregative Escherichia coli are the most common bacterial causes of traveler’s diarrhea. Traveler’s diarrhea generally occurs within 4 days of arrival, and symptoms tend to resolve within 5 days of onset. There are several prophylactic agents that physicians can recommend to athletes, including antibiotics, bismuth subsalicylate, and probiotics; however, each has its own unique limitations. Decision-making should be based on the athlete’s destination, length of stay, and intent of travel.

Conclusion:

Prophylaxis with antibiotics is highly effective; however, physicians should be hesitant to prescribe medication due to the side effects and risks for creating antibiotic-resistant bacterial strains. Antibiotics may be indicated for high-risk groups, such as those with a baseline disease or travelers who have little flexible time. Since most cases of traveler’s diarrhea are caused by food and/or water contamination, all athletes should be educated on the appropriate food and water consumption safety measures prior to travel.

Canadian Academy of Sport and Exercise Medicine position statement: athletes at high altitude

Many sports incorporate training at altitude as a key component of their athlete training plan. Furthermore, many sports are required to compete at high altitude venues. Exercise at high altitude provides unique challenges to the athlete and to the sport medicine clinician working with these athletes. These challenges include altitude illness, alterations in training intensity and performance, nutritional and hydration difficulties, and challenges related to the austerity of the environment. Furthermore, many of the strategies that are typically utilized by visitors to altitude may have implications from an anti-doping point of view.This position statement was commissioned and approved by the Canadian Academy of Sport and Exercise Medicine. The purpose of this statement was to provide an evidence-based, best practices summary to assist clinicians with the preparation and management of athletes and individuals travelling to altitude for both competition and training.

Effect of airline travel on performance: a review of the literature

The need for athletes to travel long distances has spurred investigation into the effect of air travel across multiple time zones on athletic performance. Rapid eastward or westward travel may negatively affect the body in many ways; therefore, strategies should be employed to minimise these effects which may hamper athletic performance. In this review, the fundamentals of circadian rhythm disruption are examined along with additional effects of airline travel including jet lag, sleep deprivation, travel at altitude and nutritional considerations that negatively affect performance. Evidence-based recommendations are provided at the end of the manuscript to minimise the effects of airline travel on performance.