Editor's note: Since this article was published, Villa manager Steven Gerrard has tested positive for COVID and will miss the club's next two games.
Steven Gerrard is worried, and so are his players. The Aston Villa manager is taking almost hourly bulletins on how badly his squad has been affected by positive COVID-19 cases and whether he will have enough players -- 13 outfield players and a goalkeeper -- to meet the minimum requirement to fulfil a Premier League fixture.
Villa were forced to postpone last Saturday's game against Burnley just over two hours before kick-off because of a COVID outbreak at the club, and they may be severely depleted against Chelsea on Sunday, but the impact goes behind simply having a fixture called off. Footballers are just as concerned about the virus and the vaccination process, as well as the long-term effects of both, as everyone else.
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"We had a situation at the weekend where one of the players was reluctant to get out of his car because he had some symptoms and he's got a young family, and you can totally understand his view in his situation," Gerrard said at a news conference this week. "This is a guy who's got a young family, it is Christmastime, and that's the situation everyone is in. No one wants to get this virus. Everyone wants to protect their own families.
"Thankfully he was tested after and he didn't have a situation, but that player would not have been available for me on the day, and these are the little situations that people don't see. We've got a major responsibility to listen to the players and deal with every situation as it comes your way."
The Premier League is experiencing a COVID-19 crisis. Six of 10 fixtures were postponed last weekend due to outbreaks at a host of clubs, three games slated for Dec. 26 have already been called off, a record high of 90 positive results among players and staff were recorded during the most recent testing period (the previous high was 42) and, in official data released by the league earlier this week, it was revealed that only 77% of players among the 20 clubs have been fully vaccinated.
Perhaps the starkest statistic of all was that 16% of Premier League players have not received a single dose of the vaccine. The most recently released vaccination figures from other major European leagues show the Premier League to be lagging some distance behind their competitors. In Italy, Serie A has recorded 98% of players being fully vaccinated, Ligue 1 have reported 95% in France, while Germany's Bundesliga and Spain's LaLiga both have 92% of players fully vaccinated.
It is a similar story of high uptake in U.S. sports. The NFL reported on Dec. 15 that 94.6% of players are fully vaccinated, while the NBA reported 97% full vaccination rates when figures were released in mid-November. In October, the NHL reported that just four players out of the entire league had not been vaccinated. While Europe as a whole is suffering infection spikes because of the omicron variant, the Premier League is the only major league dealing with a raft of COVID-19-related postponements.
So how has the richest and most high-profile league in world football found itself in a situation where games are being called off so regularly because of COVID-19 outbreaks and surprisingly low vaccination rates?
ESPN has spoken to players, managers and senior figures to find out what is going wrong -- and why -- and whether things will get better in the months ahead.
With additional reporting and information from Gab Marcotti, Rob Dawson, Tom Hamilton, Julien Laurens and James Olley
Vaccines are not mandatory in the Premier League, but there are consequences for those who choose not be vaccinated. They must eat, change and travel separately from their fully vaccinated teammates and, if they are in close contact with a positive case, must isolate for seven days. Even if they are fully fit and not infected, the rules are clear -- isolation for seven days, no training and no availability for selection.
This issue is a major factor in the recent spate of postponements. Sources have told ESPN that those clubs that have successfully vaccinated all, or the vast majority, of their players are becoming increasingly angry with those teams with several unvaccinated players.
Here's why: If a club has four players test positive and have six unvaccinated players, they have 10 players ruled out because of COVID-19 and are almost certain to have their game postponed. But if a club with a 100% vaccination rate has four players test positive, none of their vaccinated teammates must isolate, so the game goes ahead. That's good in the sense that it avoids fixture congestion down the line, but not so good if those four players are your captain, best midfielder and two leading goal scorers.
As of now, those players are still paid by their clubs while unavailable because of not taking the vaccine. In Germany, Bayern Munich have announced wage cuts for unvaccinated players who cannot play, so that is an avenue that remains open to Premier League clubs, although sources have told ESPN there are no moves at this stage to consider wage cuts.
Klopp, Southgate fight misinformation
The Premier League, and English football in general, is some distance behind when it comes to players being vaccinated. In the English Football League (EFL) -- Championship, League One and League Two -- 25% players have told the league and their clubs that they do not intend to get the vaccine.
"The EFL continues to strongly encourage players and staff at clubs to get fully vaccinated and obtain a booster jab if eligible to do so," Dr. Richard Higgins, the EFL's medical adviser, said. "We know that getting double jabbed and boosted now will reduce the risk of getting seriously ill or dying from COVID-19, reduce the risk of catching or spreading COVID-19 amongst teammates and loved ones, while helping protect against COVID-19 variants including omicron."
It is a similar message from the Premier League, which said in a statement that it "continues to work with clubs to encourage vaccination among players and club staff, as well as promoting the Government's public health vaccination messaging to clubs and the wider public."
In September, the Premier League commissioned a video message by Jonathan Van-Tam, the United Kingdom's deputy chief medical officer, which was distributed to all players, urging them to listen to the science and get vaccinated, but almost one-fifth of the league's eligible players continue to be sceptical enough to choose not to receive the vaccine.
As in society in general, the COVID-19 vaccine has become a divisive issue. Social media has played a part in entrenching opposing positions and prompting hostility towards those on both sides of the debate who have gone public with their opinion.
When Wigan Athletic player Charlie Wyke suffered a cardiac arrest while training with the League One team in November, it was widely claimed on social media that the 28-year-old had recently been vaccinated. Those reports proved to be baseless, with the club issuing a statement saying, "With Charlie's approval, we can confirm that Charlie has not received a COVID-19 vaccination and Charlie's collapse was not related to any COVID-19 vaccination."
Multiple sources at Premier League clubs and friends of players have told ESPN that reports of some cases of myocarditis (heart inflammation) following vaccination have led to a reluctance among players to receive their vaccine, as has the collapse of Denmark midfielder Christian Eriksen during Euro 2020, even though it has since been confirmed that the player had not been vaccinated at the time.
Comments made by singer Nicki Minaj on Twitter in September about the vaccine being linked to impotency -- debunked by medical experts including Dr. Anthony Fauci, chief medical adviser to President Joe Biden -- have also been cited to ESPN as a factor in some players choosing not to be vaccinated.
Liverpool manager Jurgen Klopp has been one of the most outspoken against misinformation about the vaccine, using his programme notes ahead of last week's Premier League game against Newcastle to urge people to get the vaccine.
"I won't apologise for the view I hold on the vaccination, no matter how unpopular it might make me in certain sections of society," Klopp wrote. "If I come across friends or people I care about in my life away from football and they tell me they haven't had a jab yet, I do my best to encourage them to listen to experts. It's never a case of 'Listen to me.' It's always 'Listen to those who know'.
"Ignore those who pretend to know. Ignore lies and misinformation. Listen to people who know best. If you do that, you end up wanting the vaccine and the booster. The 'stick to football' abuse so misses the point."
Yet the vast majority of those within the game are reluctant to go on the record with their views on the vaccination. When England manager Gareth Southgate fronted a campaign to urge young people to get the vaccine during the summer, he was targeted by so-called anti-vaxxers.
"That's probably the one [issue] I've received the most abuse over," said Southgate, who previously had to deal with public criticism after missing the decisive penalty during a Euro 96 shootout defeat against Germany.
"I'm probably going to keep out of that argument for the time being. I'm not the one who has to open some of that mail and some of those emails, because my poor secretary has dealt with quite a lot of that. That is the reality."
Jordan Henderson, the Liverpool captain, has admitted that players can find themselves "caught up" in the social media maelstrom of COVID-19 and vaccinations.
"There's a lot things flying around on social media and you can get caught up in it a little bit," Henderson told Talksport. "For us, it's about listening to the people who are experts on it. The doctors, the medical experts who know exactly what the best way forward is."
But there are others who are less inclined to take the vaccine. One recently retired player who's still involved in the game has spoken to ESPN on condition of anonymity about why so many players have chosen not to vaccinate.
"The most important tool a footballer has is his body," the retired player said. "And to have reached Premier League level, they will have made sacrifices, been extremely disciplined and even selfish at times in order to ensure that nothing they do will compromise their body. That amounts to what they put into their body and they will have researched everything from nutrition to supplements and any medical treatment they have.
"That is one reason why so many have chosen not to be vaccinated, but there are other factors such as players being extremely single-minded and not wanting to be dictated to by others -- doctors, club management, politicians, etc. -- as to what they should do."
It is the vaccine-hesitant players, rather than those with a vehemently anti-vaccination position, whose minds the clubs are attempting to change their minds. Sources have told ESPN that the experience of Bayern Munich's Joshua Kimmich is being used to gently point vaccine-hesitant players towards a change of heart.
Kimmich, 26, has not played since Nov. 6 having tested positive for COVID-19. The Germany international admitted that he had not been vaccinated and is now not expected to play again until next month at the earliest after revealing that he suffered damage to his lungs as a result of being infected. Kimmich told ZDF that "fears and concerns" had prevented him from being vaccinated, but that he now regrets his decision.
The recently retired player added, "You also have to bear in mind that a player's club may be urging them to be vaccinated, but in six months' time, that club could move them on, so why do something that could potentially be detrimental to your body in the long term for a club that might not even employ you beyond the end of the season?
"A lot of players I've spoken to have seen Sergio Aguero retire because of a heart condition and then Victor Lindelof complain of problems while playing for Manchester United. We don't know what has happened in those cases, but players who haven't been vaccinated are concerned about what they aren't being told.
"They see all of their performance data now, when they are at high intensity, when they are in the red zone, and their view is that they don't want to put anything into their body which could jeopardise their health and put themselves at risk."
The Premier League is now committed to publishing vaccination rates at the end of every month, starting in January, so the progress, or lack thereof, will be closely scrutinised in the months ahead.
Team unity leads to fewer COVID-19 cases?
Wolverhampton Wanderers have had a 100% COVID-19 vaccination rate among players and staff at Molineux. On Monday, Bruno Lage and his squad all received their booster jabs.
"Everyone in our building is fully vaccinated, which is the right thing to do, especially with the increase in positive cases in the Premier League and wider society," Lage said. "We have a responsibility to keep ourselves and others safe, so when the players and staff were offered the booster jab, it was a simple decision for us."
As the Premier League statistics prove, other clubs have not been as successful. ESPN is aware of two leading clubs who have struggled to convince their players to be vaccinated, with sources saying they are paying the price for being relaxed about vaccine uptake until infection rates began to surge in recent weeks.
"Our manager wanted to know the squad's vaccination status back in October and the club flipped out, saying they were wary of violating right-to-privacy rules," one Premier League player told ESPN. "Then we did the survey, but to be honest, it's just people saying yes or no. Nobody asked to see my vaccination certificate."
One club official gave a blunt assessment of some clubs' failure to vaccinate successfully, telling ESPN, "Footballers have everything done for them now, to the point that you couldn't be certain they can even tie their own shoelaces, so if you leave something as important as having a vaccine up to them, the reality is that they are unlikely to get it done unless somebody else arranges it for them."
At Wolves, however, sources have said that a combination of a tightly knit squad, trust in the medical staff and, crucially, the caution of the club's owners, the Shanghai-based Fosun Group, who had learned key health measures during outbreaks of SARS and avian flu in China in 2004 and 2013 respectively, have all contributed to the club successfully vaccinating every member of the squad and backroom team.
At the outset of the pandemic, chairman Jeff Shi imposed social distancing and hand-washing measures within the squad and a work from home mandate for non-playing staff before those measures became UK government policy. As a result, Wolves have been ahead of the curve throughout the pandemic.
Former coach Nuno Espirito Santo was a strong advocate of the vaccine and, with the support of club doctor Matt Perry, persuaded the squad to be receive their first vaccine late last season.
"The players and staff, as well as their families, all had the vaccine together one evening," a Wolves source told ESPN. "Since then, they have had the second vaccine and then the booster and we are 100% vaccinated as a club."
One source has told ESPN that, by receiving their first vaccine before the summer, Wolves began their vaccination journey before the anti-vax campaign gathered pace in late summer and, as a result, the players had their own experience of the jab to guide them, rather than campaigns on social media. Other clubs, meanwhile, are playing catch-up at a time when the virus is resurgent and the anti-vax campaign has become increasingly vociferous.
But even if a player chose to receive his first vaccine today, he would have to wait at least three months before being classed as fully vaccinated by having a second dose, and three more months before having a booster.
So those clubs with a sizeable group of unvaccinated players have a problem that will now be an issue for the remainder of the season. There is also a growing weight of opinion within the game which points to unvaccinated players being pushed out of the picture at some clubs. For instance, Klopp and Gerrard have both said that they will not sign new players if they are unvaccinated.
"I think it will be influential, definitely, in who clubs sign," Klopp said. "If a player is not vaccinated at all, he is a constant threat for all of us. He doesn't want to be a threat. It is not that he thinks: 'I don't care about the others.'
"But he is [a threat] and we have to find different scenarios. He has to change in a different dressing room, he has to eat in a different dining room, he has to sit in a different bus, he has to drive in a different car. From an organisational point of view, it gets really messy."
Chelsea manager Thomas Tuchel has warned against a "hunt" for unvaccinated players, however. "I don't want to get involved in pointing fingers and starting the hunt for non-vaccinated people," he said. "We cannot force people to get vaccinated and I will not change my opinion on that. I will not get involved. I am vaccinated. I took the decision for me. And that's it."
The reality in the Premier League is that all players remain able to make their own choice on whether to be vaccinated against COVID-19. Equally, they are also expected to be sensible when away from clubs and to adhere to health and safety precautions at a time when society in England is largely free of restrictions, with no social distancing measures in place.
Sources have told ESPN that mandatory vaccines are highly unlikely to be imposed by the Premier League and that persuasion, supported by scientific evidence, is the way forward. But every COVID-related postponement will only sharpen the focus on the Premier League's vaccination numbers.