Via Teleconference
11:13 A.M. EDT
MR. ZIENTS: Good morning, and thanks for joining us. I’ll turn to Drs. Walensky, Fauci, and Murthy in a moment.
First, I want to provide an update on our efforts to protect more Americans by getting more shots in arms, starting with vaccinating the unvaccinated.
We’ve made tremendous progress across the past nine months. As of today, 77 percent of eligible Americans — those 12 and older — have gotten at least their first shot.
And thanks to the President’s leadership on vaccination requirements, we continue to make important progress.
More than 3,500 organizations — from healthcare systems, to educational institutions, to state and local governments, to private businesses — have already stepped up to adopt vaccination requirements.
These vaccination requirements have increased vaccination rates by 20-plus percentage points, with organizations routinely seeing their share of fully vaccinated workers rise above 90 percent.
On Monday, Washington state announced that more than 90 percent of state employees are now fully vaccinated. That’s up from around 49 percent just five weeks ago, with more people getting vaccinated each day ahead of the state’s October 18th deadline.
And importantly, since late July, when the President first announced vaccination requirements and called on organizations to follow his lead, the number of eligible Americans who are unvaccinated has decreased by about one third — from 97 million down to 66 million individuals.
Every day, there is stronger evidence that vaccination requirements are working. They’re driving up vaccination rates.
Higher vaccination rates make workplaces, schools, and communities safer; accelerate our path out of the pandemic; and strengthen our economy.
According to economists at Goldman Sachs, vaccination requirements could help return up to 5 million workers into the labor force as people feel safer going back to the workplace and face fewer disruptions, including to childcare.
Higher vaccination rates will also increase consumer demand and spending as people feel more comfortable traveling, dining out at restaurants, and shopping at local small businesses.
It’s straightforward: People want to work, shop, and visit where they feel safe. And that’s why vaccination requirements are supported by a majority of the American people and are becoming the standard across all sectors.
In fact, just yesterday, Boeing — one of the nation’s largest employers — announced that it will require its 130,000-person U.S. workforce to be fully vaccinated by December 8th.
And we will see more and more organizations adopt vaccination requirements in the coming weeks.
Next, a brief update on our boosters program.
By the end of today, we estimate that over 7 million Americans will have gotten their booster shot, including about 3 million just in the last week. And importantly, in less than three weeks, more than one in three eligible seniors have already gotten their third shot.
So, our program is off to a very strong start and continues to accelerate.
As we await the FDA and the CDC’s decisions on potential Moderna and J&J boosters in the coming days, we’re working with our partners to prepare. We have the vaccine supply, and we will be ready to hit the ground running as soon as any additional boosters are authorized.
I’ll close with this: We are on the right track in our fight against the virus. Two out of three eligible individuals — 188 million Americans — are now fully vaccinated, with more Americans getting vaccinated each day. The most vulnerable among us are getting extra protection from a booster.
We have the tools, the resources, and the know-how to accelerate our path out of this pandemic, and we are not letting up. We’re laser-focused on getting more shots in arms. And we’ll keep using every available tool to protect people and keep following the science to stay ahead of the virus.
But as the President has said from day one, we need everyone to do their part. So, if you’re unvaccinated or eligible for a booster, please go get a shot. It’s free. It’s safe. It’s convenient. And it will protect you, your loved ones, and your community.
With that, over to you, Dr. Walensky.
DR. WALENSKY: Thank you, Jeff. Good morning everyone. Let’s begin with an overview of the data.
We ended last week with a seven-day daily average of cases of about 92,600 cases per day, which represents a decrease of about 12 percent over the previous week.
Last week, our seven-day average of hospital admissions was about 7,080 per day — also a decrease of about 11 percent from the previous week.
And seven-day average daily deaths last week was about 1,400 per day — a decrease of about 5 percent from the previous week.
We’re halfway through October and two months into the schoolyear. At the start of the year, we made it clear that our goal was to have children in school for in-person learning. We know this is best for their education, as well as their social and emotional wellbeing.
To keep kids in school, it’s important that we have the measures in place to protect children from COVID-19. For those who are eligible, this means vaccination. For those who are not yet eligible for vaccines, it means putting in place layered prevention strategies, including masks for all students, teachers, and staff; improved ventilation; increased access to testing; and community-wide vaccination efforts to protect our children.
CDC is working closely with school districts across the country to continue to demonstrate the importance of implementing layered prevention strategies in schools. Our ongoing work with state, local, and territorial health departments assist with their K-through-12 school testing plans, providing resources, guidance, and technical assistance to effectively carry out these strategies.
Additionally, CDC offers schools the options to be matched with a peer school to facilitate discussions about challenges and implementation of prevention strategies, such as screening protocols, that these schools might be facing and creative solutions that will better equip teachers and administrators to meet those challenges.
Recently, we published two important studies in the MMWR. The first study looked at COVID-19-related school closures across the country and found that through the end of September, 96 percent of schools remained open for full in-person learning; 1,800 schools had closures attributable to COVID-19 outbreaks, and these closures affected nearly 1 million students.
At the start of the year, we made it clear that we wanted children in school for in-person learning. And today, more than 95 percent are open full time.
The second study was done in collaboration with Maricopa and Pima Counties in Arizona. Schools in these counties resumed in-person learning in late July. Nearly 1,000 schools were included in the final analysis. And in the first month and a half of learning, there were 113 COVID-19 outbreaks in schools that had no mask requirement and only 16 COVID-19 outbreaks in schools with early mask requirements.
In this Arizona study, schools without a mask requirement were three and a half times likelier to have a COVID-19 outbreak than schools that require masks. Masks in schools work to protect our children, to keep them and their school community safe, and to keep them in school for in-person learning.
It’s important that we not only protect children when they’re in school but also that we protect them at home and in the community so they can prevent COVID-19 from entering schools in the first place.
Last week, CDC led a study that was published in JAMA Pediatrics that looked at the risk of COVID-19 in children during periods of high transmission in the community. Households with at least one child in New York City and multiple counties in Utah were included in the analysis. In the study, children had similar infection rates compared with adults, confirming that risk in community translates to risk inside the household and risk to people of all ages. Children were more likely to be asymptomatic than adults.
A second study published in JAMA Internal Medicine showed what happens when children are surrounded by people in their household who are vaccinated. In this study, nearly 2 million people from over 800,000 families were included. Each family had between two and five family members. And the study demonstrated that as the number of family members vaccinated against COVID-19 increased, the risk to the unvaccinated family members decreased. Families with three or more family members vaccinated provided greater than 90 percent protection for those who were unvaccinated.
For those children who are not yet eligible for vaccination, the best protection we can provide them is to make sure that everyone around them in the household is vaccinated and that they are wearing a mask when they’re at school and during their indoor extracurricular activities.
I strongly encourage those who have not yet been vaccinated against COVID-19 to consider the benefits of receiving a COVID-19 vaccine and to get vaccinated and to get their eligible teenagers vaccinated — not just for themselves, but also for their children and families.
Thank you. I’ll now turn things over to Dr. Fauci.
DR. FAUCI: Thank you very much, Dr. Walensky.
Very often, my colleagues on the medical team and I get asked, “Where are we in this outbreak? Where are we going? And where might we be as we go into the coming winter?” I thought it would be useful to very briefly put this into perspective of outbreaks in general.
If I can have the first slide.
When one thinks in terms of pandemics, there are multiple areas that one can go through. The first is the pandemic phase of the outbreak. Much of the world — and in some respects, including ourselves — are still in the pandemic phase.
As I’ll mention in a moment, there is a point where you get a decline in the acceleration and a turnaround of cases where, as I’ll mention very shortly, that’s where we are.
But then there’s the issue of control. What do we mean by “control”? Mainly, there’s a low level of infection that doesn’t disrupt society in any meaningful way. For example, there are countries in Africa that used to be beset with an extraordinary amount of malaria, and now malaria is not absent, but it is very well controlled.
And then there’s elimination. We’ve eliminated, for example, polio from the United States. And except for an occasional breakthrough in unvaccinated groups, we’ve done the same with measles. Some countries in Africa that used to have malaria have eliminated it.
And there’s been only one disease that’s a human disease that’s been eradicated, and that is smallpox.
So, let’s look at where we are right now with COVID-19.
Next slide.
As I mentioned, much of the world and until very recently — and still we are in some aspects in the pandemic phase of the outbreak. However, most recently, as shown on the chart by Dr. Walensky — next slide — we are seeing now a decline in acceleration and the turnaround of cases.
Where do we ultimately want to be? As I mentioned, it is going to be very difficult — at least in the foreseeable future and maybe ever — to truly eliminate this highly transmissible virus. And again, as I mentioned, we’ve only eradicated one.
So, what are we looking for?
Next slide.
We’re looking for a level of control of the virus that would allow us to be able to essentially approach the kind of normal that we are all craving for and that we all talk about.
Next slide.
So, let’s go to the — to the schematic that Dr. Walensky showed us. And take a look at where we’ve been and where we hope to be. If you look at the far left of the slide, we had that surge in the early spring of 2020. And then when we got into the early summer, we had another surge. But, note, we never got to the point — we always went to a peak, the acceleration diminished, and we turned the corner and we came back down, but we never got to control.
Look at the late fall in red. We had a major peak. It came down, but, again, we never got it under what we would call “adequate control.”
And then we have the most recent on the far-hand right, and that’s where we are right now. We had an acceleration. We had a peak. And as Dr. Walensky just mentioned, all three of the parameters — cases, hospitalizations, and deaths — are going down. But we have got to do better than that.
Where do we need to be to get control?
Next slide.
We need to get that curve to go much further down than it is because we’re dealing with a situation where you have a highly transmissible virus and where the dynamics of the virus are at 80- to 90,000 cases a day. That’s not where you want to be.
So, how can we get to that level of control?
Next slide.
Obviously, you know what the answer is: It’s vaccination. But as shown here, we still have — as we emphasize over and over again — about 66 million people who are eligible to be vaccinated who remain unvaccinated. And the age groups are shown on the bar graph: Horizontally are the ages; vertically is the percent vaccinated.
Note that, particularly among the younger groups, we have a long way to go. We can get to control. Without a doubt, it is within our power and within our capability.
Next slide.
And my final message is going to be: We know that these vaccines work because, when you look at the real-world efficacy, including that in the United States — that if you compare fully vaccinated people with unvaccinated, they have a five times lesser likelihood of getting infected, a ten to eleven to twelve times less likelihood of being hospitalized, and a more than ten times less likelihood of dying.
And the final message of all of us is always the same on the last slide: Protect yourself and those around you. Vaccination is the answer to getting us to control.
Back to you, Dr. Murthy.
SURGEON GENERAL MURTHY: Well, thank you, Dr. Fauci. And it’s good to be with everyone again this morning.
Today I want to share an update about two of the upcoming vaccine decisions we’re looking ahead to in the next month. Number one, decisions about boosters. And number two, decisions about the Pfizer vaccine for kids age 5 to 11.
Let’s start by stepping back and talking about the role that advisory committees often play for two of our most important public health agencies: the FDA and the CDC.
Now the first committee to meet is the FDA’s Vaccines and Related Biological Products Advisory Committee, or VRBPAC.
VRBPAC holds a public meeting where scientific experts weigh in on the data and discuss key scientific questions. Following the VRBPAC meeting, the FDA synthesizes the committee’s proceedings and then makes an official decision that can be implemented by our healthcare system.
A similar process is then conducted by the CDC. The CDC’s Advisory Committee on Immunization Practices — or A-C-I-P, or ACIP — holds a public meeting where scientific experts weigh in on the data and on key questions.
Then, following the ACIP meeting, the CDC takes their input into account and makes a clinical recommendation for healthcare providers.
To summarize: VRBPAC offers their advice, then the FDA makes a decision; ACIP offers their advice, and the CDC makes a decision. The advisory committees are a valuable part of the process, and they provide helpful guidance to the FDA and CDC as the agencies themselves make their ultimate decisions.
Now, this process is not new; it’s been around long before COVID-19. During the pandemic, this same process has been implemented for major decisions — from the initial vaccine authorization for Pfizer, Moderna, and J&J; to the authorization of our vaccine for children 12 to 16; and most recently, the Pfizer booster shot recommendations.
But it’s worth reviewing this process because in the next month, it will unfold again for two very important decisions: first, the decision about whether to authorize booster shots for Moderna and J&J recipients, and then the decision about whether to authorize vaccines for children under 12.
Regarding boosters for Moderna and J&J recipients, VRBPAC will begin meeting tomorrow, followed by ACIP next Wednesday. So, we anticipate hearing decisions from both the FDA and CDC very soon afterward.
Then, regarding pediatric vaccines, VRBPAC will meet beginning on October 26th, followed by ACIP on November 2nd. So we could hear decisions from both agencies — the FDA and CDC — by early November, and we will be ready to implement their recommendations as soon as we hear them.
Finally, I just want to highlight that all of these layers of review — the thousands of pages of data, the expert committees, and the fact that this is open to the public — they should all bolster our confidence that we have a rigorous, independent, and transparent review process for vaccines in our country.
That confidence is why I will be ready to recommend to my eligible family members and friends that they get their Moderna and J&J booster shot if it’s authorized. It’s why I will be ready to take my five-year-old son to get his first vaccine dose as soon as we hear the final word from the FDA and CDC.
And as always, we will keep everyone updated about the final recommendations so that we can all use them to make informed decisions about our health and the health of our loved ones.
Thanks for your time today. I’ll turn it back to Jeff for questions.
MR. ZIENTS: Well, thank you, Doctors. Let’s open it up for a few questions.
Kevin.
OPERATOR: Thanks, Jeff. A reminder to keep your question to one question. First, we will go to Dave Schaper at NPR.
Q Hi. Thank you for taking the question. I have a question about airline pilots.
Commercial airline pilots are held to pretty high physical fitness standards. They undergo medical evaluation every six months to maintain their medical certificate to fly. And pilots at American and Southwest Airlines, in particular, are arguing that some pilots may be reluctant to get vaccinated because of concerns about potential for career-ending side effects.
They note that, you know, the FAA’s Federal Air Surgeon has ordered pilots not to fly for 48 hours after each shot because of the immediate side effects. They’re concerned there could be long-term side effects that could cause them to then lose their medical certification and thus lose their jobs and their livelihood.
So, is this a valid concern? What are the potential long-term side effects, if any, if a pilot is vaccinated?
MR. ZIENTS: Let me turn to Dr. Fauci about the safety and effectiveness of the vaccines.
Dr. Fauci.
DR. FAUCI: Thank you, Jeff. Well, right now, on the basis of literally hundreds and hundreds and hundreds of millions of vaccinations that we’ve had, the safety of these vaccines have been clearly established.
When you look at immediate reactogenicity, that’s what the airlines are talking about — about not having a person fly for, I believe, 24 to 48 hours after because we do know that it is not uncommon to get a sore arm or to maybe get a low-grade fever or some aches that almost invariably diminish and dissipate over a period of a couple of days.
The long-term effects that the people are apparently concerned about really have with — I’m sure there is a very very, very, very, very rare exception, but the long-term effects are really essentially nonexistent in the sense of anything that has been a red flag on the part of the follow-up of these individuals.
So, although one, I guess, can theoretically say, “I’m concerned about a long-term effect,” the fact of the safety and the follow-up over now — over a considerable period of time — almost a year in so many individuals — we have just not seen that.
So, we don’t really see any true basis in that concern.
SURGEON GENERAL MURTHY: And, Jeff, if I could just add also, exactly — totally agree with what Dr. Fauci said. I would also note that serious side effects with the vaccines are very rare. We have a lot of data to show that.
But consider the alternative: If pilots get COVID-19, the consequences to their health can be significant. The more we’ve learned about COVID, we’ve learned that it not only impacts the lungs, but it can impact the nervous system, the cardiovascular system. It can impact the kidneys. It can impact many systems in our body. This is a serious infection. So, the best way to protect yourself against long-term health consequences is actually to get vaccinated.
DR. FAUCI: Yeah. And, Jeff, one other thing also to emphasize, when pilots worry about impact on their career: We know that anywhere from 10 to 30 percent of people who get COVID, even when they recover from the organ system issues of COVID, they can get what’s called “long COVID.”
And we have examples of people — they may not necessarily be pilots, maybe there are some — who actually have gotten COVID and have had an unexplained but real impacting on their ability to function normally.
So, just to underscore what Dr. Murthy said, getting COVID is far, far worse than getting vaccinated for absolutely certain.
MR. ZIENTS: Wonderful. Next question, please.
MODERATOR: Cheyenne Haslett at ABC News.
Q Thank you. I was wondering if, Dr. Walensky, you could walk us through your considerations around test-to-stay policies in schools, and if and when the CDC will be issuing guidance on this.
DR. WALENSKY: Yeah, thank you for that question, Cheyenne. So, we are working with states to evaluate a test-to-stay policy as a promising potential new strategy for schools. And we anticipate that there will be guidance forthcoming.
MR. ZIENTS: Dr. Walensky, do you want to just expand for a few sentences for those who don’t know the actual policy?
DR. WALENSKY: Oh, sorry. Yes, absolutely. So, a test-to-stay policy would be a policy where rather than students quarantining after potential exposure that they could potentially instead come back to school but test so that we would know, as they’re returning to school on a frequent testing basis, that they were safe coming back to school.
MR. ZIENTS: Good. Next question, please.
MODERATOR: Go to Jeff Mason at Reuters.
Q Hi, thanks very much. Following up on what you were saying, Dr. Fauci, can you give us a sense of what risks you are expecting this country and the world to face over the winter, in terms of other variants?
And sort of along the same lines, for Dr. Walensky, the figures that you cited show kind of positive news with the cases and hospitalizations and deaths coming down. Is it too early to say we’re turning the corner? And what kind of implications will that have for masking and other policies?
MR. ZIENTS: Dr. Fauci?
DR. FAUCI: Yeah, let me answer the first part of that question. We know now, and we’ve had experience over several weeks to months, that the Delta variant is entirely dominant as the isolate in this country. It’s more than 99 percent of the isolates are Delta.
There are other variants that are around — certainly not in any manner or form more than a fraction of a percent in this country. So, we don’t expect there to be any emergence of a variant that’s going to outstrip the capability of Delta.
However, as we’ve always said — and I’ll repeat it again for clarity — a virus will not mutate or form a variant unless you give it the opportunity to replicate. So, as long as you get back to what I mentioned in my presentation — control of the dynamics of virus in the community, which is best done by getting the overwhelming proportion of the population vaccinated — then we can prevent the emergence of new, troublesome variants.
Over to you, Rochelle.
DR. WALENSKY: Great. Thanks. And certainly, it’s absolutely encouraging that our cases are coming down. I want to highlight what Dr. Fauci said in his presentation. And that is, despite the recent decrease in cases, most communities across the country are still experiencing substantial to high levels of community transmission and we’re certainly not at a place where our cases are in a control area, as Dr. Fauci noted.
So, we absolutely need to stay focused on continuing to get COVID under control around the country, especially as we head into the fall and winter season — respiratory virus season. And that includes sticking with our prevention measures that we know work. That includes masking. And, of course, that includes getting vaccinated, getting your family vaccinated, getting your booster if you’re eligible.
MR. ZIENTS: Yeah, Jeff, I would just emphasize what Dr. Fauci and Dr. Walensky both said, which is we should focus on what we do know. And what we do know is that getting people vaccinated is the best way to accelerate the path out of the pandemic. And we talked about the progress: Three out of four eligible Americans have gotten at least their first shot, but there’s clearly more work to be done. And we know that getting more people vaccinated is how it we’ll accelerate the path out of the pandemic to bring down cases, hospitalizations, and deaths.
Next question.
MODERATOR: A couple more questions. Let’s go to Brenda Goodman at WebMD.
MR. ZIENTS: Brenda?
Q Hi. Sorry. Can you hear me now?
MR. ZIENTS: Now we can. Yes, thank you.
MODERATOR: Yep.
Q Sorry about that.
Jeff, you have said before that pending appropriate regulatory approvals and recommendations for CDC, that when it comes to the vaccines for children that could be coming out, that you expect that the rollout at pediatricians’ offices and other community sites. I was hoping that you might be able — do you have any guidance for parents about what to expect? Where will those — how will kids get vaccinated? Where will they get vaccinated?
MR. ZIENTS: That’s a good question, and we actually just spent time with governors and their teams across the last couple of days, and we’ll continue to work very closely with the state teams, with our community health centers, and with pharmacies.
The — as you know, the FDA, as Dr. Murthy said, has scheduled — has scheduled meetings for late this month and early next month, so we’ve been in frequent conversations, as I mentioned, with all the providers to get them prepared — the same way we got folks prepared for a successful launch of the Pfizer booster campaign.
We’ve asked governors to take steps to enroll providers, such as pediatricians. We’ll rely heavily on pediatricians and family doctors in the vaccination programs so they can bring — they can begin providing vaccinations right away.
We’ve asked states to plan outreach and education campaigns focused on parents and families in the communities. And we’ve communicated and will continue to communicate that equity, as it has been with all of our efforts, needs to be front and center. That means ensuring that we have sites in areas of high social vulnerability and also in rural areas.
If it’s authorized by the FDA and CDC, we will be ready. And we have the supply. I want to emphasize it’s a different supply; the dose for kids is a different dose than adults, so we’ll be getting different supply to providers. We’ll bring that vaccine, as we’ve talked about, to pediatricians’ offices, also directly to schools, where appropriate, and to community sites. And we’ll work with trusted messengers, as we have throughout — particularly those trusted messengers who can answer questions for parents and kids.
So we’ll make it convenient and easy for parents and kids to get vaccinated. We have the supply, and we will be ready.
Kevin.
MODERATOR: Last question. Let’s go to Meg Tirrell at CNBC.
Q Well, thank you. I was just hoping to follow up on what Dr. Fauci was saying about “control.” Dr. Fauci, what is that threshold that would actually mean that COVID is under control? I think in the past you’ve — you’ve said maybe 10,000 cases per day, which might be 100 deaths per day, which would make it similar to the flu. But does that mean we’re just kind of perpetually living with COVID like a bad flu season? What does “control” actually look like? What’s that threshold?
DR. FAUCI: Well, I can’t give you, Meg, the precise number. I mean, I have said in the past — and I think it’s a reasonable assumption — I’ve said “less than 10,000.” I would hope it would be considerably less than 10,000.
Regarding it being like the flu, people have spoken in those terms. I don’t know if we could definitively say that. The one thing that we do know is that we have a vaccine for COVID-19 that’s far, far better than the vaccines that we have for influenza. So, that might be the wild card in there to make it not like the flu and get much, much lower than we get with a flu season. That’s what I would hope would happen.
But again, as I’ve said over and over again, the way we will get to that form of control, whatever that number is, is by getting vaccinated because we have a very good, highly effective, and safe vaccine.
MR. ZIENTS: Thank you, everybody. We look forward to the next briefing.
11:45 A.M. EDT
To view the COVID Press Briefing slides, visit: https://www.whitehouse.gov/wp-content/uploads/2021/10/COVID-Press-Briefing_13October2021.pdf
