NHL Commissioner Gary Bettman let out a faint cough and assured those seated at least 6 feet away it was allergies, not COVID-19. He had tested negative for the coronavirus three times in the previous week.

It allowed the fully vaccinated 69-year-old the opportunity to underscore the message that the virus is still part of the NHL and other professional sports leagues 19 months into the pandemic.

U.S. sports have successfully forced more athletes and staff to get vaccinated than many other industries, in part because the threat of losing pay is so severe. Yet, the outliers have and will continue to get more attention and generate outrage from fans who want to see stars play.

Basketball’s Kyrie Irving and Bradley Beal, football’s Kirk Cousins, Cole Beasley and Chase Young, baseball’s Chris Sale and hockey’s Tyler Bertuzzi have all held out, with varying degrees of outspoken skepticism. Monday, the NHL suspended San Jose’s Evander Kane 21 games for submitting a fake vaccination card and Washington State University fired football coach Nick Rolovich for failing to comply with a state government vaccine mandate, providing two more reminders of the impact the coronavirus is still having on professional and college sports.

They’re in the shrinking minority.

Major League Baseball, in the middle of its postseason, reports 87.4% of players and key staff are fully vaccinated. The NFL through six weeks of its season is at 94%, with 133 active players who have not had at least one dose. NBA Commissioner Adam Silver said Monday his league is at 96% with the chance for that number to tick up. Bettman noted last week the NHL had only four unvaccinated players among more than 700 — well over 99% fully vaccinated.

“If given grades, those are A-pluses,” said former women’s basketball player Iciss Tillis, who is now a labor and employment attorney at the law firm Hall Estill. “It’s been really interesting to watch the transition over the past year and a half go from extreme skepticism to, I guess, people being able to see friends and family go ahead and get the vaccine first and sort of see how they react to it.”

None of those leagues has a full mandate, but all imposed rules treating differently players who are fully vaccinated. In addition, some cities and states put further requirements on players and coaches, especially those at state universities such as Rolovich. Daily coronavirus testing, mask wearing and restrictions on movement made more players choose to be vaccinated — as did the threat of losing pay.

Golden State Warriors forward Andrew Wiggins decided to get a COVID-19 vaccine to be eligible to play. The NHL’s agreement to go to the Olympics requires all participants to be fully vaccinated, which could lead New Jersey Devils goaltender Mackenzie Blackwood to change his mind as well.