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Minnesota vs. Buffalo Prediction: Josh Allen's Health Looms Large for Matchup of Division Leaders

Vikings have won six in a row while banged-up Bills looking to bounce back from last week's painful loss.

Sunday's game between the Minnesota Vikings and Buffalo Bills has the makings of a Super Bowl preview that is by far the best game of the week. How much the game lives up to the hype will depend greatly on one ligament in Josh Allen's right elbow.

The MVP front-runner has missed practice all week after suffering an injury to his ulnar collateral ligament, which when torn requires dreaded Tommy John surgery. Fortunately, due to the mechanics of throwing a football, quarterbacks can make a much quicker return from such injuries than pitchers, who are generally sidelined for a year or more.

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For now, Allen remains day-to-day, if not hour-to-hour. Bills head coach Sean McDermott is mum but hopeful that his quarterback will be able to play — this would be his first absence since another UCL injury in 2018. If not, Buffalo will turn to veteran Case Keenum, who has made just two starts in the last three seasons.

Allen's elbow wasn't the only bad news last week; dropping a game to the Jets was literally adding insult to injury. The Bills still remain the AFC's No. 1 seed thanks to a head-to-head win over the 6-2 Chiefs, although six three-loss teams are breathing down their neck should they fall to the Vikings.

Minnesota, meanwhile, moved to 7-1 last week, although the Vikings haven't faced many big tests. Their 6-0 record in one-score games is unsustainable, and the only teams they've faced that currently have a winning record are the undefeated Eagles, who beat them by 17 points, and the Dolphins.

Can Buffalo maintain its grip on the AFC with a big question mark at quarterback? Or will the Vikings finally add a signature win to their impressive first season under head coach Kevin O'Connell?

Minnesota (7-1) at Buffalo (6-2)

Kickoff: Sunday, Nov. 6 at 1 p.m. ET
TV: FOX
Live Stream: fuboTV (Start your free trial)
Spread: Bills -3.5
Tickets: As low as $158 on SITickets.com*

Three Things to Watch

1. What will the Bills get out of their quarterback?
So much of this game will hinge on Allen's health that it's almost foolhardy to project what will happen without knowing whether he'll play. Simply put, Allen is the MVP front-runner, while Keenum, a former Viking, can at best play a caretaker role.

If Allen does play, he won't be at 100 percent, although that didn't stop him from chucking a ball 69.3 yards, the longest in the NFL over the last six years, after injuring his elbow. Arm strength has never been an issue for him, although accuracy with a sore elbow is worth monitoring considering he already leads the league in turnover-worthy plays.

The Vikings could be in a good position to slow Allen, too, since they're one of the least blitz-happy teams in the league. Despite only sending an extra pass rusher 15.1 percent of the time (29th), they rank 17th with a 22.2 percent pressure rate.

If the Bills need to turn to Keenum, that will significantly shrink their playbook. Also, crucially, it will take away the threat of the quarterback run. The Bills rank 13th in the league in rushing offense (124.3 ypg), but Allen is the leading rusher at 49.0 yards per game and 6.3 yards per carry.

2. Stefon Diggs vs. Justin Jefferson
Very few sports trades work out well for both teams, but the trade that sent Diggs to Buffalo for the first-round pick that wound up being Jefferson has paid off better than each team could have expected. Diggs has truly unlocked Allen's potential, while Jefferson looks like potentially the best young receiver in the league.

This will be the first time these teams meet up since the trade, and while this game won't be a referendum on who won — both teams are thrilled — both players will be key to watch.

Diggs will have even more pressure on him if Keenum is starting. He'd likely be working with tighter windows and more errant passes, but Diggs is one of the best contested-catch receivers in the game, tying for third among WRs and TEs in ESPN's Analytics' new Catch Score metric. Expect to see cornerback Patrick Peterson shadowing him for most of the game; the veteran is having a resurgent season with opponents only completing 52.2 percent of their passes toward him, 232nd among 255 qualified defenders.

Buffalo, on the other hand, is less well-equipped to stop Jefferson. The Bills have struggled to stop No. 1 receivers all season with Tre'Davious White sidelined, although their pass defense has been a top-10 unit as a whole. Rookie cornerback Kaiir Elam is questionable with an ankle injury, and his absence would make that challenge even greater.

3. Can Minnesota expose a beat-up Buffalo defense?
White and Elam aren't the only key defenders missing from the Bills' defense. Buffalo is still without star safeties Jordan Poyer and Micah Hyde, as well as edge rusher Greg Rousseau, and may be missing a pair of key linebackers.

The Bills could not stop the run last week (174 yards on 34 carries) with Matt Milano out, although he returned to practice this week. However, fellow linebacker Tremaine Edmunds is now sidelined with a groin injury. He would be an equally tough loss.

Super Bowl contenders can only take so many injuries — just look at the 2021 Ravens — and this defense may be reaching its breaking point. Dalvin Cook is a far bigger threat as a runner than James Robinson and Michael Carter last week, so the Vikings have a chance to really break this game open.

Final Analysis

Almost all of the key factors are pointing to the Vikings in this game. Without Allen playing, they should probably be favored (and could be by kickoff based on Allen's status). But until he's ruled out, a banged-up Allen at home should be enough to win and hand Minnesota its first one-score loss of the season.

Prediction: Bills 20, Vikings 17

*Price as of publication.