Advisory on COVID-19 from SMAC (Sport Medicine Advisory Committee): October 21, 2021


Please Note: The SMAC COVID-19 Advisory will no longer be released bi-weekly and will be issued ‘as required’. Please continue to request information via the SMAC CMOs and/or members of the COVID-19 Task Force.

Review of Tokyo Games

Having returned from the Tokyo Olympic and Paralympic Games it is worthwhile to reflect on the success from both the sporting and medical fronts. A detailed debrief of the Tokyo quinquennial experiences was conducted by OTP on October 13-14, 2021.

In terms of COVID we are very happy to report that there were no cases within the Canadian teams at both the Olympic and Paralympic Games. In the Games environment there were a total of 863 cases and 25 hospitalized cases.

In terms of vaccination the numbers are not complete, but 90% of all Canadian Olympic and 87% of all Canadian Paralympic athletes had been vaccinated and 92% of all Canadian Olympic and 91% of all Canadian Paralympic staff team members were vaccinated. Estimates are that 80% of all international athletes attending the Olympics were vaccinated.

As well the number of non-COVID illnesses at the Games was extremely low with 3 upper respiratory illnesses at the Olympics and none at the Paralympics and no Gastrointestinal (GI) cases. This is a result of all the preventive measures put in place for COVID which included wearing of masks, social distancing and likely most importantly washing of hands. These measures should continue to be implemented for Beijing 2022 as well as future Games.

Many National Olympic Committees and Paralympic Committees, including the Canadian Olympic Committee and Canadian Paralympic Committee, have declared that all team members going to Beijing 2022 will be required to be fully vaccinated.

Vaccine Questions

Is mixing and matching vaccinations safe?

In combination with the above preventive measures in place at the Tokyo Games and recommended by public health experts, vaccines remain very effective for prevention and decreasing symptoms of COVID-19. Recent studies have shown that mixing and matching of vaccinations are very effective as well (see information below).


Can I access other countries with a mixing and matching vaccination history?

There have recently been issues with some countries not accepting mixing and matching of vaccinations for purposes of travel or being allowed to access facilities and restaurants as an example. This is a rapidly evolving issue that is being addressed at the federal government level. It is important that NSOs check with the destination country for restrictions.

Recently the USA has stipulated that Canadians will be permitted with a mixing and matching vaccination history (e.g., Pfizer and Astra Zeneca) or two viral vector vaccinations (e.g., Astra Zeneca).

Should an athlete or staff member get a third dose if they had two viral vector vaccinations (e.g., Astra Zeneca)?

If an athlete or staff has received a complete vaccination of two doses of Astra Zeneca, they do not require a third dose of vaccine unless they are immunocompromised, and a third dose is recommended by their provincial health officer.

If an athlete or staff member received a vaccine not licenced in Canada (e.g. Sputnik) then a third dose of a mRNA vaccine is recommended.

Should an athlete or staff member get a third dose of a mRNA vaccination if they received mixed and matched vaccinations?

Mixing and matching vaccinations is very effective, and a third dose is not required from a medical perspective. Some countries (unlikely to be required for travel to Beijing) are requiring a third dose of mRNA (Pfizer or Moderna) prior to entry for individuals with a mixing and matching vaccination history. This will require a third dose for the purpose of travel to these specific countries.

Where in Canada can I get a mRNA booster?

Different provinces provide a third dose or booster for the purpose of travelling to other countries which may not accept Canada’s mixing and match approach. Based on the advice of the National Advisory Committee for Immunization (NACI) provinces are providing third doses for immunocompromised individuals.

This Table provides an update of provincial access to a third dose in Canada for immunocompromised individuals and those needing a third dose for travel.

Further Questions

Further information about COVID-19 may be obtained from your NSO Chief Medical Officer or Team Physician, or the Chief Medical Officers of the Sport Medicine Advisory Committee.

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