COVID-19 is wreaking havoc on NFL, NBA and NHL. Can booster shots save the season(s)?

Despite player populations that are overwhelmingly vaccinated, COVID-19’s second winter has decimated North American sports leagues at a level not seen since the industry restarted in 2020.

From the NFL reporting a single-day high in cases, to the NHL’s Calgary Flames forced to postpone three games and the Chicago Bulls postponing two games after 10 players entered COVID-19 protocols, every active league is seeing its regular season – and, in the NFL’s case, playoff push – imperiled by the pandemic.

Tuesday marked the first anniversary since a New York critical-care nurse became one of the first Americans to receive the COVID-19 vaccine, and in the 12 months since, sports leagues re-wrote safety protocols and urged their players to get vaccinated once they became widely available last spring.

Entering the teeth of this winter, the effort was largely a success: The NFL reports nearly 95% of its players vaccinated, the NHL has just one unvaccinated holdout and the NBA also exceeds 97%, despite high-profile holdouts such as Brooklyn Nets guard Kyrie Irving and Detroit Red Wings forward Tyler Bertuzzi.

Yet the past week has resulted in more postponements and players in protocol than even navigating through an unvaccinated 2020-21 winter.

Monday, the NFL reported its highest day of positive COVID-19 tests over two seasons of the pandemic, according to the NFL Network, with 36 players and one staffer forced into protocols. The hits kept coming across all sports on Tuesday:

• Eight Cleveland Browns – including five key players – were placed on the COVID-19 list. Wednesday, quarterback Baker Mayfield and head coach Kevin Stefanski were added to the list; Mayfield will miss Saturday's game against the Las Vegas Raiders unless he produces two negative tests before then.
• Los Angeles Rams receiver Odell Beckham Jr. tested positive for COVID-19 one day after two other key Rams – tight end Tyler Higbee and cornerback Jalen Ramsey – were scratched from a key Monday night game against Arizona due to positive tests.
• The Calgary Flames, who had three of their games postponed, have nine players in protocol. Two recent opponents - the Boston Bruins and Carolina Hurricanes - also reported cases, and Tuesday night's Carolina-Minnesota Wild game was postponed as the number of Hurricanes players in protocol rose to six. Wednesday, the Flames added seven more players and staffers to its COVID-19 list, bringing the total to 16.
• The Los Angeles Lakers canceled a Tuesday practice ahead of a trip to Dallas after guard Talen Horton-Tucker tested positive for COVID-19. They join the Bulls, Nets and Charlotte Hornets as clubs suffering COVID-related setbacks in recent days.

With the winter not yet arrived and the money portion of the NFL season – the playoffs – fast approaching, why the rash of positive tests? And what can be done to slow the spread in the frequent-test, highly-vaccinated sports environment?

Fortunately for the leagues involved, the answers to both questions are related.

Will Humble, director of the Arizona Public Health Association, says the rash of breakthrough cases can very likely be traced to waning immunity among vaccinated players – particularly NBA players who might have been fully immunized as far back as March or April. That’s increasingly likely for those who received the less effective Johnson & Johnson vaccine, which was popular among athletes because of its one-shot regimen.

And waning immunity begets a simple solution: Booster shots.

“The evidence is really clear that circulating antibodies start dropping off dramatically after eight months,” Humble said, “especially Johnson & Johnson, followed by Pfizer and then Moderna. Those early, vaccinated athletes now have antibody tiders that are a lot lower than they were a few months ago.”

A study by a quintet of Veterans Affairs and public health officials showed that from February 2021 to October 2021, vaccine antibodies declined from 88% to 48%, with the steepest curve for the Johnson & Johnson vaccine – which bottomed out at 13% at the eight-month mark. Fortunately, says Humble, performance of T cells remain robust in providing protection against perilous health outcomes.

In the wake of its Monday outbreak, the NFL mandated booster shots for all tier 1 and 2 employees who work closely with players, including coaches who already agreed to a vaccine mandate.

The league cannot impose a vaccine mandate on players and can only strongly encourage them to receive booster shots. Yet with league testing frequency ramping up as community spread increases with the highly contagious omicron variant, the likelihood is far greater for asymptomatic players to test positive.

And with a majority of NFL teams in playoff contention – followed by a month worth of playoffs culminating in the Feb. 13 Super Bowl – the consequences for a rash of positives will only increase.

“If you’re a playoff team you damn well better make sure everyone has their booster shot,” says Humble. “Because with this frequency of testing, you can’t afford what happened to the Rams last night to happen in the playoffs. It’s inexcusable to let that happen to a key player when a booster could have solved that.”

While the booster shot may not be a silver bullet, both peer-reviewed and anecdotal data indicate it will be a crucial weapon to maintain immunity.

The newly discovered omicron variant, meanwhile, poses another potential crisis for frequently-tested athletes.

While just one person in the sports league environment – a Washington Football Team staffer – was confirmed to test positive for omicron, it has the characteristics to decimate a roster even if it proves not as damaging to one’s health as the delta variant.

Humble, while stressing that data is still emerging, says omicron is proving highly contagious, much more than delta, particularly for those unimmunized and previously infected with COVID-19. But it’s also not shown to escape immunity via vaccination any more than previous variants. And a preliminary study released Tuesday in South Africa – where the variant was first discovered – shows it to be less virulent, although more contagious, than the delta variant.

That’s great news in the U.S., where just 70% of the population is fully vaccinated and states such as New Mexico and Arizona are once again hovering close to crisis standards of care due to rising hospitalization rates.

The contagious piece of it is not as encouraging for immunized athletes, who are more frequently tested even when asymptomatic. A positive test in the NBA, for one, requires a 10-day isolation period or consecutive negative tests at least 24 hours apart, followed by a health screening.

Even if asymptomatic, these detours are enough to derail a season. And that’s why the booster may prove to be the 2022 MVP in several leagues.

“If you get the booster, the huge increase in antibody types overwhelms the virus,” says Humble, who notes a Johnson & Johnson vaccine followed by a Pfizer or Moderna booster has proved a particularly effective combination.

“After the booster, you’re as protected against omicron as you were against delta.”

Contributing: Mike Brehm, Jeff Zillgitt