White House COVID-19 Task Force, Dr. Fauci Press Conference Transcript April 12

Andy: (00:00) ... 120 million Americans, including over 72 million who have been fully vaccinated. 46% of adults have had at least their first shot and 28% of adults are now fully vaccinated across the US. We've made significant progress also in vaccinating Americans over the age of 65. 78% have now had at least their first shot. By this time next week, all adults across the country will be eligible for their vaccine. Andy: (00:36) This means that there has never been a better time than now for seniors and those eligible to get their shots. Make an appointment today, and if you have someone in your life, particularly a senior who has not gotten a shot yet, reach out and see what help they need. All this is happening because of the accelerated pace of the country's vaccination program. In the last seven days alone, the US has reported administering nearly 22 million shots. That's more than 8% of the adult population in a single week. Andy: (01:17) While we're pleased with this pace, we are making even more doses available for administration. Over the last three weeks, we've sent out nearly 90 million total doses. Now, even with uneven supply from Johnson & Johnson, we are distributing vaccines applied to vaccinate well more than 3 million people per day. In fact, on Saturday, we reported 4.6 million shots, which is a record. We're administering shots at a record pace and we're adding millions more each week, and we're continuing to work with states to ensure that each and every dose gets administered. Andy: (02:02) To provide even more capacity to administer all the vaccine supply we have, we are accelerating our efforts to put more vaccinators in the field and add more vaccination sites. On this front, we're excited to announce today a new federally run mass vaccination site in Central Point, Oregon. On March 29, the president set a goal of adding at least a dozen new mass vaccination sites by April 19. Today, I can report that we are on track to meet the president's goal this week ahead of schedule. Andy: (02:38) By next week, we will have opened a total of 36 mass vaccination sites with a combined capability of administering 124,000 shots per day. We're also increasing the number of pharmacies participating in the retail pharmacy program and working with community health centers to increase the number administering shots. The president set a goal on March 29 of expanding the pharmacy program to nearly 40,000 pharmacies participating by next Monday, April 19. Already, there are roughly 30,000 pharmacies in the program and we're on track to have nearly 40,000 by Monday. Andy: (03:23) To date, we've deployed 8,500 federal personnel as vaccinators or to support vaccinations. This includes 4,400 active duty troops, and that number will grow to 6,000 active duty troops in the coming week. All of this work will help meet the president's goal of ensuring that at least 90% of Americans have a vaccine site within five miles of where they live by this coming Monday. At the same time, we're working with states to ensure that they're ordering the full amount available to them and efficiently distributing those vaccines to the places that need them. Andy: (04:05) We want states to be ordering and administrating shots as soon as doses are made available. From the start, we've been closely tracking the data on the state of the pandemic and vaccination effort in each state and territory. In states like Michigan, where we are seeing troubling metrics, we are taking action by deploying resources in four critical areas, shots in arms, personnel, testing, and therapeutics. On shots in arms, we're working with states to accelerate the number of shots in arms. Andy: (04:39) This means working with states, making sure that they're ordering up to their cap, using what they order efficiently, and utilizing best practices to meet the goals of speed and equity. On personnel, we've offered a surge federal personnel, including CDC response teams to help with case investigations and contact tracing efforts, particularly for outbreaks in congregate settings. We've also sent more FEMA personnel to administer shots in arms across the State of Michigan. On testing, we're increasing the number of diagnostic tests sent to the state, assisting the state with setting up more testing sites and helping pilot innovative approaches as part of the state's testing programs to monitor school sports. Andy: (05:26) On therapeutics, we're pre prepared to send additional therapeutic capacity to the state as well. I want to close by reminding every American that we all need to do our part, and if we do, better days are ahead. We are working with states, tribes and territories to accelerate the number of shots in arms we're administering, and we need Americans to do their part. Wear a mask, socially distance, and get vaccinated when it's your turn. With that, let me turn it over to Dr. Wilensky. Dr. Walensky: (05:59) Thank you, Andy. I'm glad to be back with you all today, and as is my usual, I will start with the data. Over the weekend, the CDC reported 75,000 cases and 81,000 cases of COVID-19 each day. As such, CDC's most recent data show that seven-day average for new cases has increased about 3% over the prior seven day period to over 66,000 cases daily. Hospital admissions also continue to increase. The most recent seven day average, a little over 5,300 admissions per day is a 6.6% increase from the prior seven-day period. Dr. Walensky: (06:40) Deaths decreased 5.2% to a seven day average of 684 per day. Vaccinations continue to increase, with the most recent seven day average of over 3 million vaccines delivered daily and a record high day on Saturday, as Andy mentioned, of 4.6 million doses administered in just one day. We are now 82 days into the 100 day mark and have administered more than 166 million vaccinations towards the president's goal of 200 million vaccinations in the first 100 days. Dr. Walensky: (07:16) I want to reflect for just a moment on this tremendous progress. While we still celebrate how far we have come and our collective efforts, we also have to hold ourselves accountable. Today, CDC is releasing two reports in the morbidity and mortality weekly report that underscore the need to address health inequities in our country, including in our vaccination efforts. The first report details trends and racial and ethnic disparities in COVID-19 hospitals across this country. Looking at data from March through December, 2020, we confirmed the preliminary findings that were published last year. Dr. Walensky: (07:57) People from racial and ethnic minority groups are disproportionately affected by COVID-19, including being at increased risk for hospitalization. Within each region of the country, the proportion of patients hospitalized with COVID-19 was highest for Hispanic and Latino individuals. The largest disparities occurred early in the pandemic during April through July of 2020. Although these disparities have become less pronounced over time, as recently as December, 2020, there were disparities among racial and ethnic groups in all four regions of the country, with the largest disparity among Hispanic and Latino patients in the West. Dr. Walensky: (08:39) Similarly, the second publication looked at emergency department visits for COVID-19 from October through December, 2020. Data from 13 States show Hispanic and American-Indian and Alaska native individuals were 1.7 times more likely, and black individuals, 1.4 times more likely to seek care in emergency departments for COVID-19 related illness in comparison to white individuals. This information and the ongoing surveillance data we see daily from states across the country underscore the critical need and an important opportunity to address health equity as a core element in all of our public health efforts. Dr. Walensky: (09:21) These disparities were not caused by the pandemic, but they were certainly exacerbated by them. The COVID-19 pandemic and its disproportional impact on communities of color is just the most recent and glaring example of health inequities that threaten the health of our nation. At CDC, we have a critical role to play in addressing health equity. We have made new and expanded investments in racial and ethnic minority communities and other disproportionately effected communities around the country to provide the foundation and resources to help address disparities to COVID-19, and importantly, to create the infrastructure to address the other health conditions. Last week, CDC ... Dr. Walensky: (10:03) ... address the other health conditions. Last week, CDC launched a new website, Racism and Health, which serves as a platform for greater education and dialogue about these critical issues. There, we articulate that racism is a serious public health threat that directly affects the well-being of millions of Americans and the health of our entire nation. We must acknowledge the disparities that exist and commit to an equitable distribution of vaccines, particularly to those communities that have been hardest hit by the virus. Dr. Walensky: (10:34) Looking at the data available, the total number of vaccines administered, Black and African-American individuals make up about 12% of the US population and are just 8.4% of those receiving at least one dose of the vaccine. And 18% of the country identifies as Hispanic or Latino, yet they make up only 10.7% of those receiving vaccinations. We must do better and we will do better, and here's how. Dr. Walensky: (11:04) Last month CDC provided $3 billion to support efforts to increase vaccine uptake by expanding COVID-19 programs and ensuring greater equity and access to vaccines. We made more than $300 million in funding, available to strengthen the work of community health workers nationwide, bolstering their efforts to prevent and control COVID-19 among populations of high-risk, and serving as trusted messengers to overcome concerns and vaccine hesitancy. These actions are in addition to the $2.25 billion CDC made available for testing efforts in communities at high risk and who are underserved across the country. We will continue to support and expand these efforts, ensuring that as we do this work we'll build bridges with communities that allow for ongoing engagement to improve long-standing health disparities, such as blood pressure management, mental health, childhood vaccination, and diabetes control. Our work to address these disparities will not be easy, but I know that together we can meet this challenge. Thank you. I'll now turn things over to Dr. Fauci. Dr. Fauci: (12:18) Thank you very much, Dr. Walensky. I'd like to spend a few minutes now talking about the concept of breakthrough infections. Can I have the first slide? Dr. Fauci: (12:27) I think it would be important to put this into perspective with some definitions. A breakthrough infection or a vaccine failure is when a person contracts an infection despite being vaccinated against it. We see this with all vaccines. In clinical trials and in the real world, no vaccine is 100% efficacious or effective, which means that you will always see breakthrough infections regardless of the efficacy of your vaccine. There's primary vaccine failure, when the body actually doesn't amount an adequate immune response for a number of reasons. Could be immune status, health status, age, medications you're on, was something wrong with the vaccines? Storage, delivery, composition. Dr. Fauci: (13:13) Secondary vaccine failure may occur when immunity fades over time. Now a vaccine may fail also if a person is exposed to a newer, different strain or a variant. For example, influenza is the most common abyss, which mutates rapidly and drifts genetically generally from season to season. However, even if a vaccine fails to protect against infection, it often protects against serious disease. Dr. Fauci: (13:47) Next slide. Dr. Fauci: (13:47) If you look at these group of selected vaccines, take a look at the chickenpox through shingles, highly, highly effective vaccines. If you look at influenza, even on a very good year, it's 40 to 60% effective, but let's drill down on that for a second, next slide, because it really is important to COVID, which I'll get into in a moment. Dr. Fauci: (14:13) The benefits of the flu vaccine and the importance of partial protection. If you get vaccinated, no doubt you're less likely to get the flu. But even if you do get flu and get sick, vaccination can reduce the severity and duration of illness and could help get you out of trouble. If you get a little bit more granular on flu, the benefits of flu vaccination in a 2019-2020 season, despite a vaccine that was only 39% effective and only 52% of people actually got vaccinated, look at the health benefit that year. 7.5 million illnesses were prevented, 3.7 million medical visits, over 100,000 hospitalizations, and 6,300 flu deaths on a year where almost half people were not vaccinated with a not very effective vaccine. Dr. Fauci: (15:16) Next slide. Dr. Fauci: (15:17) Let's focus really in quickly on the clinical trials, mainly the data we got from the phase three clinical trials of vaccines that ultimately developed in EUA. If you look at the vaccine group, but the number of breakthroughs over the number of vaccinations, and you see... Or the number of breakthroughs, number of infections, and the number of people, there are always breakthroughs regardless of what the efficacy of the vaccine is. Dr. Fauci: (15:46) Next slide. Dr. Fauci: (15:47) If you then go into the real world, if we can have the next slide here, of real world effectiveness. Again, if you look at fully vaccinated people versus unvaccinated people, obviously given the relatively small numbers, thousands, hundreds, compared to the tens and tens and tens of millions of people who've been vaccinated, you will always see breakthrough. The critical issue is always look at the denominator, look at what you are comparing it with. Dr. Fauci: (16:20) Next slide. Dr. Fauci: (16:22) I do want to mention one thing about a special group that we're obviously paying a lot of attention to, and those are people with organ transplants. Because in a recent study from JAMA just a couple weeks ago, only 17% of the participants mounted an appreciable anti-spike antibody response. So full vaccination is very important for this population. Dr. Fauci: (16:46) And finally, next slide and last slide, as I alluded to just a moment ago, one of the wild cards in vaccine failures are variants. And depending upon the particular variant, vaccines handle them relatively well or not necessarily as well. But as I mentioned before, even with the 351 in which J&J, for example, efficacy was down to 64%. There were essentially no deaths or hospitalizations in the individuals who were vaccinated. One final comment about B.1.1.7. It is covered really quite well by the mRNA vaccines and highly likely by J&J, but we just need more data on that. So I'll stop there and go back to you, Andy. Andy: (17:37) Thank you. All right, let's go take some questions. Speaker 1: (17:43) First question, Nancy Cordes at CBS. Nancy Cordes: (17:49) Hi there. Thank you so much for taking my question today. My question has to do with kids and vaccines. Right now, what timeline are you operating under for at least the Pfizer vaccine to be approved for kids 12 to 16? And where do you believe that most of them would get vaccinated? Would it take place like adults at mass vaccination sites and pharmacies, or do you anticipate that more the vaccine would be distributed to pediatricians' offices and the kids would get their vaccinations there like they get their other shots? And then beyond that, given the current rates of vaccine hesitancy, is it possible for the US to reach herd immunity without vaccinating preteens and maybe even younger kids? Andy: (18:34) Okay, three questions. I think the first one on the likely timing and the third one on thoughts around how vaccinating kids impacts herd immunity. Maybe Dr. Fauci you can answer those and I'm glad to help out on the where part, although you can cover that as well. Dr. Fauci: (18:54) Okay. With regard to herd immunity, you want me to start with that, Andy? Andy: (19:00) I think the two pieces are herd immunity and also whatever thoughts you have on the timing of approval for the FDA. Dr. Fauci: (19:07) Pfizer has already mentioned that on the basis of their clinical trial, that they are going to try to look for an amended EUA for kids 12 to 15 years old. Because as you might recall from a prior presentation that we made here on a press conference, they really had literally 100% efficacy with 18 events in the unvaccinated or placebo group and zero events in the vaccine group. So I think that is imminent. I know they are going to be putting in for that. We had mentioned on a couple of discussions Andy, that we would hope that children in high school will be able to be vaccinated by the time we get to the early fall season. With regard to children and herd immunity, again, I would like to get people away from this concept of referring to something that it is very elusive in its definition, because we don't- Dr. Fauci: (20:03) ... Think that it is very elusive in its definition because we don't know what herd immunity percentage of vaccinators, vaccinated people, plus people who've recovered. We've made estimates that is somewhere between 70% and 85%, but we don't know that as a fact. So that rather than concentrating on an elusive number, let's get as many people vaccinated as quickly as we possibly can, which we are doing apropos of the numbers that were just mentioned by Andy and by Dr. Walensky. Andy: (20:36) So let me just add in terms of locations. But before I do that, I would say we were all extremely encouraged, as I think parents around the country were, by the reporting of that information. And indeed to Dr. Fauci's point of having this being able to be done by the fall, that's a very good sign. Obviously we're going to await the FDA in their work and then the CDC's follow up recommendations. We have over the last few months, created many, many, many places for adults to get vaccinated. Including, as we talked about earlier, what will end up being over 40,000 pharmacies. And as a result, 95% of Americans will be living within... Andy: (21:21) I should say 90% of Americans will be living within five miles of a place to get vaccinated. But as it relates to kids, there is a well- established route of vaccinations through the pediatrician's office. And Dr. Walensky, you may want to comment on that. You're welcome to comment on that. And that's important both for teens and for younger kids because it's an important point of trust for parents and teens. And there's also a process for getting childhood vaccinations to pediatricians that's been well-established. Anything you'd care to add, Dr. Walensky? Dr. Walensky: (22:01) No, I will just say that once FDA has put forward the authorization, CIP will immediately follow and we're working to make sure that there's actually no delay there. We also simultaneously have been working through figuring out what the best channels are for these adolescents. As you know Andy, many of them and their parents would like to see these vaccines in pediatrician's offices and we've actively been doing outreach with them to make sure that it's available in those settings. Andy: (22:29) Great. Next question. Speaker 2: (22:33) [inaudible 00:22:33] with PBS. Speaker 3: (22:37) Hi, thanks so much for taking my question. Two questions. The first is there was a study that's being cited in an Israeli study that showed the vaccine variant out of South Africa, the B.1.3.5.1, was able to evade protection of some Pfizer vaccines. And I know Dr. Fauci, you just said that there will be breakthroughs 100% of the time. I just wonder if there's worry that this particular strain is breaking through more than others? And then a follow up question to that is for multi-generational homes in this community, from Dr. Walensky, for multi-generational homes where everyone has been vaccinated, should people be worried about having to go to work and coming back and infecting their elderly family members that might be living in the home with them? Andy: (23:23) Okay. Dr. Fauci, want to take the first question? Dr. Fauci: (23:26) Yeah. I'm glad you asked that question because with all due respect to my so many Israeli friends, I think that that preprint as it were, was about as confusing as you possibly could be. The only thing that wasn't confusing about that was that you probably need two doses the way we've been saying absolutely if you want to get protected and get greater protection, because you saw things shifted when you were one or two weeks beyond the second dose. So that's the first point. The second point is that I believe the misleading part about it is it made it seem like you were more likely to get the 3.5.1 if in fact you were vaccinated against the mRNA. Dr. Fauci: (24:10) That wasn't the case. If you were going to get infected with anything, you would get infected with the more difficult variant, which was 3.5.1. That doesn't mean you have a greater chance of getting it because when you went out into the post vaccination period, you were really quite well protected. So I think I'd be careful. You're going to read that reprint over and over again, and I can tell you what it is really a little bit confusing. The only thing that isn't confusing is two doses are really good. Andy: (24:43) Dr. Fauci, just to allow you to emphasize that, as you look at that pre-print, if someone were to have the Pfizer vaccine, both doses two weeks later, how did that line up as their protection against even this most evasive variant? Dr. Fauci: (25:04) Quite well, as a matter of fact. Quite well. Andy: (25:07) Right. So that study was missing the headline. It had everything else, but it was missing the headline. There was a second question about multi-generational households, and I'm wondering if you might clarify that question. Is that in the context of variants or is that just in the context of multi-generational households overall? Speaker 3: (25:30) That was in the context of variants. I was thinking if everyone gets vaccinated in the household, but then someone's going to work, should they be worried about the variants breaking through more, or maybe should they just be worried about getting COVID and still being able to pass it along to fully vaccinated people? Maybe that's not a concern, but I've been hearing from people that now their whole household is vaccinated, but someone still has to go to work and they're coming back to their elderly parents. Andy: (25:58) Well yeah, I think either Dr Walensky or Dr. Fauci welcome to comment. Particularly the notion that, A, no vaccine is perfect. But B, with two doses and two weeks, there is very, very strong protection. But do you want to take a run at some of the elements of that? Dr. Fauci: (26:19) It depends... Go ahead, Rochelle. Dr. Walensky: (26:22) I was going to say I would encourage people to continue once they're vaccinated to use all of the prevention measures that we've been talking about when they're outside their home, including masking and distancing and whatnot, and all of that should be active in the workplace. So assuming you take those prevention measures in the office place and outside the home, I think you're very safe in the home. What we do know when these breakthrough infections do occur, is they tend to occur with fewer symptoms, less virus, less transmissible virus. We're still learning about the transmissibility of this virus in the context of these breakthrough infections. But I would say use your prevention measures when you're outside the home and I think you're okay when you're in the home. Andy: (27:05) Anything to add Dr. Fauci? Dr. Fauci: (27:06) Yeah, I'm glad you asked that question because it leads to the answer that Dr. Walensky gave, which is the reason why we say when you are in the home, you have vaccinated people or you have a child and a grandmother, grandfather, whoever it is, as long as they're in good shape, you don't have to wear a mask. But once you go out into that big, bad world out there where there are a lot of infections going on, 80,000 new infections in one day, that there is an issue there that you've got to be careful with. And I think that your question just triggered the real reason why we say that all the time. Andy: (27:43) Great. Next question. Speaker 2: (27:46) [inaudible 00:27:46] at Reuters. Speaker 4: (27:52) Hi, and thanks for taking my question. I wanted to ask a little bit more about the situation with the emergent facility for the J&J shots. Our understanding is that J&J had originally projected 24 million doses in April, and that that was not contingent on a merchant receiving authorization, but I know that there's been some guidance suggesting that dose deliveries from J&J are going to remain low until that E-way is received. So I just wonder if you have any clarification on that and any guidance as to if we can still expect emergent to get authorization in April and for J&J to hit the 24 million target that's been forecast? Andy: (28:36) Let me begin with the big picture. 90 million doses over the last three weeks, and you can expect even without additional doses from Johnson & Johnson, for us to be somewhere in that neighborhood. If you do the math, there is plenty of supply to continue to vaccinate Americans at 3 million per day, and then some. That's not to mention the fact that there are many doses that have already been distributed into states. I think we're in the fortunate position, we have to remind ourselves, where we have three vaccines approved that are very effective vaccines, but we are also importantly not dependent upon this. Andy: (29:24) So the most important thing is just to let the FDA do their work and complete this authorization. We are pleased by the fact that Johnson & Johnson in the meantime has taken control of the plant, has eliminated the confounding factor of another vaccine being produced there, and they remain confident that they're going to be able to deliver at or near 24 million this month and close to 100 million by May. And so we remain confident, big picture that we have more than enough vaccine to continue to vaccinate the public. Next question. Speaker 2: (30:04) [inaudible 00:30:04] Andy: (30:04) ... question. Speaker 5: (30:04) Go to Niels Lesniewski at CQ Roll Call. Niels Lesniewski: (30:09) Thank you for taking the question. I wanted to ask about the federal pharmacy program, and specifically whether or not it's your intention that people should be able to book vaccine appointments directly through their local CVS or Walgreens or an independent pharmacy. Because we've had some reports particularly here in DC, that all those doses are supposed to be dumped into a federal system or a local system, and the pharmacies are being told themselves not to book appointments directly. Is that the intent of the federal pharmacy program? Because it seems more difficult for people to get to their local pharmacy in those cases. Andy: (31:00) Yeah. I'm not sure of the particular example you're talking about. It sounds like it may be anomalous. We would love to follow-up and get more details, but let me just emphasize a few things more broadly. We've gone from 6,000 to 10,000 to 20,000 to 30,000 and soon 40,000 pharmacies with available doses. So that takes a little bit of time perhaps for everything to catch up with itself, but that will mean that as we go into next week, 40,000 pharmacies will have available doses. Most of the pharmacies, certainly the major national ones, have availability to book appointments directly. That will continue to be the case. If that's not the case in some specific circumstances, we'll find out about that and see what we can do to correct that. Next question. Speaker 5: (31:49) Last question. Let's go to Heidi Przybyla at NBC News. Heidi Przybyla: (31:53) Oh, thank you. Vaccines, we understand are not a panacea given a crisis situation in Michigan right now, but some public health officials, including Dr. Gottlieb over the weekend, are saying that the administration probably should have surged vaccines to Michigan two weeks ago when the data started coming in. Can you address that? And what is the argument against doing this, as well as what specifically are you doing on monoclonal antibodies to the state? Thank you. Andy: (32:25) Great. So why don't we begin with Dr. Walensky, since I think appropriately, as we've said here repeatedly, our goal and our job is to follow what the science dictates the right approaches are. Dr. Walensky: (32:39) Thanks Eddie. And thank you for this question, Heidi. There are different tools that we can use for different periods of when there is an outbreak. For example, we know that if that vaccines go in arms today, we will not see an effect of those vaccines, depending on the vaccine, for between two to six weeks. So when you have an acute situation, extraordinary number of cases like we have in Michigan, the answer is not necessarily to give vaccine. In fact, we know that the vaccine will have a delayed response. The answer to that is to really close things down, to go back to our basics, to go back to where we were last spring, last summer, and to shut things down to flatten the curve, to decrease contact with one another, to test to the extent that we have available, to contact trace. Sometimes we can't even do it at the capacity that you need, but really what we need to do in those situations is shut things down. Dr. Walensky: (33:39) I think if we tried to vaccinate our way out of what is happening in Michigan, we would be disappointed that it took so long for the vaccine to work, to actually have the impact. Similarly, we need that vaccine in other places. If we vaccinate today, we will have impact in six weeks, and we don't know where the next place is going to be that is going to surge. Andy: (34:01) Yeah. So look, our job here is to follow the science. And I think in that regard, exactly what Dr Walensky said, is important to us. We have to remember the fact that in the next two to six weeks, the variants that we've seen in Michigan, those variants are also present in other states. So our ability to vaccinate people quickly in each of those states, rather than taking vaccines and shifting it to playing whack-a-mole, isn't the strategy that public health leaders and scientists have laid out. There are other things that we can do. We have offered to surge monoclonal antibodies, testing. There's a CDC team on the ground. 140 FEMA vaccinators have just moved into the town. Those are things you can affect quickly, and we believe can ramp things up more quickly. We know there are appointments available in various parts of the state. And so that means that we have excess vaccine in some parts of the state. So we're going to help work with the state, and any state, quite frankly, to help the rebalancing, which occurs in a situation like this as we pay attention around the country. Andy: (35:13) So with that, I think we've taken our last question and we look forward to being here, talking with you again on Wednesday. Thanks.