Key result
Professional athletes are linked to ~6-fold higher risk of inadequate rubella immunity versus matched controls.
Why the study?
Multiple outbreaks of vaccine-preventable viral diseases have occurred in professional sports, but no established protocol for vaccination or immunity screening exists for professional athletes.
Does the prevalence of inadequate immunity to measles, mumps, rubella, and varicella differ between professional athletes and an age-matched general population?
Cross-Sectional (n=98)
Does the prevalence of inadequate immunity to measles, mumps, rubella, and varicella differ between professional athletes and an age-matched general population?
One-third of professional athletes studied had inadequate immunity to at least one of four common vaccine-preventable viruses, highlighting the need for screening programs.
BACKGROUND: Multiple outbreaks of vaccine-preventable viral diseases have occurred in professional sports in recent years. Currently, there is no established protocol for vaccination or immunity screening for professional athletes. HYPOTHESIS: There are significant differences in the prevalence of inadequate immunity dependent on age, sport, country of birth, and participation in collegiate sports. STUDY DESIGN: Cross-sectional cohort study. LEVEL OF EVIDENCE: Level 4. METHODS: A sample of Major League Baseball (MLB) and National Basketball Association (NBA) players were screened for serologic evidence of immunity to measles, mumps, rubella, and varicella prior to the 2015 and 2016 seasons. The results were designated as adequate (immune) or inadequate (equivocal or nonimmune) based on laboratory criteria. Comparison with an age-matched control group was performed using data from the National Health and Nutrition Examination Survey (NHANES). RESULTS: A total of 98 athletes (62 MLB, 36 NBA) were screened. The prevalence of inadequate immunity for any virus was 35.5% in MLB players and 33.3% in NBA players. There was a significantly greater risk of inadequate immunity to rubella (risk ratio, 6.38; P < 0.01) and varicella (risk ratio, 4.21; P < 0.01) in athletes compared with the age-matched NHANES population. Our analysis did not reveal differences in rates of immunity based on sport, country of birth (US born vs international), or participation in college athletics. There was a lower rate of inadequate immunity to varicella with increasing age (odds ratio, 0.72; P = 0.05). CONCLUSION: One-third of athletes studied had inadequate immunity to 1 of the 4 viruses tested. Younger players had a significantly greater risk of inadequate immunity to varicella. Birth outside the US and lack of participation in college athletics were not found to influence immunity rates. CLINICAL RELEVANCE: These results can inform the development of future screening programs to prevent outbreaks of viral infections in professional athletes.
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Conway et al. (2018) conducted a cross-sectional in Inadequate immunity to vaccine-preventable viral diseases (n=98). Professional athlete status (MLB and NBA) vs. Age-matched NHANES population was evaluated on Inadequate immunity to rubella (RR 6.38, p=<0.01). Professional athletes had a significantly greater risk of inadequate immunity to rubella (RR 6.38; P<0.01) and varicella (RR 4.21; P<0.01) compared with an age-matched NHANES population.
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