In New COVID-19 Guidance, NCAA Updates Definition of Fully Vaccinated to Include Booster

The NCAA medical advisory group is changing its definition of a fully vaccinated individual as someone who has received the COVID-19 booster shot if they are eligible, sources tell Sports Illustrated, a significant move that will trigger a rush from universities to get their players and staff boosted.

The new definition only applies to previously vaccinated individuals who are eligible for the booster. Athletes are eligible if they are within two months from getting the single shot Johnson and Johnson; five months from the last Pfizer shot; and six months from the last Moderna shot. Athletes who are not eligible for the booster but are vaccinated are still considered fully vaccinated. Those athletes who have tested positive for COVID-19 in the last 90 days are also immunized and receive the benefits of a fully vaccinated athlete.

The new protocols are only recommendations or “considerations,” NCAA documents say. Conferences and schools can choose whether to follow them or create their own guidelines based on their local health department guidance. Many conferences, especially at the Power 5 level, have already created their own policies, many of them matching the latest CDC guidance. It’s unclear how those leagues will treat booster-eligible athletes who have not had the booster. Are they considered fully vaccinated or unvaccinated?

The recommended NCAA protocols for those fully vaccinated are more relaxed than those who are unvaccinated. Vaccinated athletes are not required to quarantine as close contacts and are exempt from regular COVID-19 testing. Those considered unvaccinated are regularly tested and, if deemed a close contact, must quarantine for at least five days. The reasons behind many of the postponed or canceled games over the last month often trace back to such issues.

The latest changes are part of the NCAA medical advisory group’s new re-socialization guidelines expected to be released to schools on Thursday. The new protocols are a response to the surging omicron variant, which represents 95.4% of new COVID-19 cases in the United States last week, according to the latest estimate report released by the CDC on Tuesday. The variant is moving across the U.S. as well as college sports, having forced the cancellation of six bowls games and more than 200 men’s and women’s basketball games.

According to feedback from the NCAA to college administrators, officials are not, as of now, contemplating a cancellation of winter championships nor are they examining a waiver modification in qualifying for championships as was the case last year. March Madness is roughly two months away, and the college football national championship game between Alabama and Georgia is scheduled for Monday in Indianapolis. Both the Bulldogs and the Tide have confirmed publicly that they are more than 90% boosted.

Because of the speed in which omicron spreads, officials believe cases will begin to sharply decline in the next two-to-three weeks. Physicians are still not seeing COVID-19 transmission during games, NCAA chief medical officer Brian Hainline told administrators.

With its change regarding the booster, the NCAA medical group is stretching beyond even the CDC, which does not yet require the booster shot to deem people fully vaccinated. However, the CDC strongly encourages booster shots for those eligible. According to the NCAA’s new guidance, those who have gotten the booster are considered fully vaccinated immediately. There is not an immunization period as there was with previous vaccines.

While the new NCAA guidance strengthens the definition of a fully vaccinated person, it reflects the state of the pandemic with a relaxation of some protocols.

For instance, those vaccinated or unvaccinated who test positive for COVID-19 can return to athletic activity without a mask as long as they produce a negative test after their five days of isolation. This is a significant change that may avoid more game cancellations, and it is a policy that differs from CDC guidelines.

The CDC recommends COVID-19 positives mask up for five days after leaving isolation. Unvaccinated close contacts must quarantine for five days, but in a new change, they are eligible to return to athletic activity unmasked with a negative test.

The changes are in response to the COVID-19 pandemic inching closer to what’s being described as an “endemic,” a disease that regularly lives among a population, such as the flu. In interviews last month, several physicians suggested that medical task forces across college sports were exploring ways to relax guidelines given the state of the pandemic and that the NCAA itself was in communication with the CDC.

“Conversations are being had,” said Jeremy Cauwels, a member of the NCAA advisory group and the chief physician at Sanford Health in South Dakota. “That’s the hard part—truly understanding when somebody is no longer infectious. The CDC doesn’t differentiate between a 70-year old and a college athlete. That’s some of the work the NCAA is trying to do: Can we say there is a standard of safety that may be shorter for a vaccinated college athlete than your average 70-year old?”

There is another issue. With any COVID-related changes, universities remain at the mercy of their local health departments, some of which are more risk-averse and might not approve relaxing protocols.

In its new recommendations, the NCAA is leaving the door ajar for some schools and conferences to do away completely with surveillance testing if their local community’s COVID-19 rates are at a manageable or low number. But if a team has what is termed “sustained transmission,” the team should consider testing all close contacts immediately, even if they are vaccinated and boosted. Sustained transmission is defined as three or more positives on a team of 50 or fewer players, or 5% percent for a team of more than 50.