Vaccination in Elite Athletes
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REVIEW ARTICLE
Vaccination in Elite Athletes Barbara C. Ga¨rtner • Tim Meyer
Ó The Author(s) 2014. This article is published with open access at Springerlink.com
Abstract Public health vaccination guidelines cannot be easily transferred to elite athletes. An enhanced benefit from preventing even mild diseases is obvious but stronger interference from otherwise minor side effects has to be considered as well. Thus, special vaccination guidelines for adult elite athletes are required. In most of them, protection should be strived for against tetanus, diphtheria, pertussis, influenza, hepatitis A, hepatitis B, measles, mumps and varicella. When living or traveling to endemic areas, the athletes should be immune against tick-borne encephalitis, yellow fever, Japanese encephalitis, poliomyelitis, typhoid fever, and meningococcal disease. Vaccination against pneumococci and Haemophilus influenzae type b is only relevant in athletes with certain underlying disorders. Rubella and papillomavirus vaccination might be considered after an individual risk–benefit analysis. Other vaccinations such as cholera, rabies, herpes zoster, and Bacille Calmette–Gue´rin (BCG) cannot be universally recommended for athletes at present. Only for a very few diseases, a determination of antibody titers is reasonable to avoid unnecessary vaccinations or to control efficacy of an individual’s vaccination (especially for measles, mumps, rubella, varicella, hepatitis B and, partly, hepatitis A). Vaccinations should be scheduled in a way that possible side effects are least likely to occur in periods of competition. Typically, vaccinations are well tolerated by elite athletes, B. C. Ga¨rtner (&) Institute for Microbiology and Hygiene, Saarland University, Faculty of Medicine and Medical Center, Building 43, 66421 Homburg/Saar, Germany e-mail: [email protected] T. Meyer Institute of Sports and Preventive Medicine, Saarland University, Saarbru¨cken, Germany e-mail: [email protected]
and resulting antibody titers are not different from the general population. Side effects might be reduced by an optimal selection of vaccines and an appropriate technique of administration. Very few discipline-specific considerations apply to an athlete’s vaccination schedule mainly from the competition and training pattern as well as from the typical geographical distribution of competitive sites.
Key Points Risk–benefit analysis of vaccination in elite athletes differs significantly from that of the general population, providing the rationale for specific vaccination guidelines Risk of infection is higher in athletes due to worldwide traveling and close contact with teammates or opponents. Moreover, consequences of infection are more serious, since even mild infections might be relevant for individual performance Adverse reactions could be reduced by selecting the optimal vaccine, the optimal time point for vaccination and the correct vaccination technique
1 Introduction Prevention of infection is a key issue in the healthcare of athletes. Exposu
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