Via Teleconference 

11:03 A.M. EDT

ACTING ADMINISTRATOR SLAVITT:  Good morning.  Thank you for joining us.  Today, we’re joined by Drs. Walensky and Fauci.

I want to begin by providing an update on the progress of our accelerating vaccination program.  We’ve now vaccinated 120 million Americans, including over 72 million who have been fully vaccinated.  Forty-six percent of adults have had at least their first shot, and twenty-eight percent of adults are now fully vaccinated across the U.S.

We’ve made significant progress also in vaccinating Americans over the age of 65.  Seventy-eight percent have now had at least their first shot.  And by this time next week, all adults across the country will be eligible for their vaccine. 

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 U.S. has reported administering nearly 22 million shots. That’s more than 8 percent of the adult population in a single week.

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 vaccine supply 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.  And to provide even more capacity to administer all of the vaccine supply we have, we are accelerating our efforts to put more vaccinators in the field and add more vaccination sites. So, 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.  And 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.

And 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 percent 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 they’re ordering the full amount available to them and efficiently distributing those vaccines to the places that need them.  We want states to be ordering and administering 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.  And 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.  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 to 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 program, to monitor school sports.

On therapeutics, we’re 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. 

So, with that, let me turn it over to Dr. Walensky.

DR. WALENSKY:  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 the seven-day average for new cases has increased about 3 percent over the prior seven-day period to over 66,000 cases daily.

Hospital admissions also continued to increase.  The most recent seven-day average — a little over 5,300 admissions per day — is a 6.6 percent increase from the prior seven-day period.

And deaths decreased 5.2 percent 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. 

I want to reflect for just a moment on this tremendous progress.  And while we 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 in racial and ethnic disparities and COVID-19 hospitalizations across this country.  Looking at data from March through September — through December 2020, we confirmed the preliminary findings that were published last year. 

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. 

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 Alaskan 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.  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 affected 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 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 wellbeing 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.

Looking at the data available, the total number of vaccines administered, Black and African American individuals make up about 12 percent of the U.S. population and are just 8.4 percent of those receiving at least one dose of the vaccine.  And 18 percent of the country identifies as Hispanic or Latino, yet they make up only 10.7 percent of those receiving vaccinations. 

We must do better and we will do better, and here’s how: 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 provide and control COVID- — to prevent and control COVID-19 among populations at 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 will build bridges with communities that allow for ongoing engagement to improve longstanding 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:  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?

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 percent 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.  It could be immune status, health status, age, medications you’re on, or something wrong with the vaccines — storage, delivery, composition.

“Secondary vaccine failure” may occur when immunity fades over time.  Now, a vaccine may fail also if a person is exposed to a new or a different strain or a variant.  For example, influenza is the most common of this, 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.

Next slide.

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 percent 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.

“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 percent effective and only 52 percent of people actually got vaccinated.  Look at the health benefit that year.  There were — 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.

Next slide.

So let’s focus in really quickly on the clinical trials, namely the data we got from the Phase III clinical trials of vaccines that ultimately developed an EUA.  If you look at the vaccine group — at the number of breakthroughs over the number of vaccinations — and you see — or the number of breakthroughs, number of infections in the number of people — there are always breakthroughs regardless of what the efficacy of the vaccine is. 

Next slide. 

If you then go into the real world — if we could 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. 

Next slide. 

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 of weeks ago, only 17 percent of the participants mounted an appreciable anti-spike antibody response.  So full vaccination is very important for this population. 

And finally — next slide, and last slide — as I alluded to just a moment ago, one of the wildcards 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 the J&J, for example, efficacy was down to 64 percent — there were essentially no deaths or hospitalizations in the individuals who were vaccinated. 

One final comment about we — B117: 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. 

ACTING ADMINISTRATOR SLAVITT:  Thank you.  All right, let’s go take some questions. 

MODERATOR:  First question, Nancy Cordes at CBS. 

Q    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 of 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 U.S. to reach herd immunity without vaccinating preteens and maybe even younger kids? 

ACTING ADMINISTRATOR SLAVITT:  Okay, so 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:  Okay.  So, with regard to herd immunity — you want me to start with that, Andy?  That —

ACTING ADMINISTRATOR SLAVITT:  I think — I think the two pieces are herd immunity and also whatever thoughts you have on the timing of approval for the FDA. 

DR. FAUCI:  Yeah.  So 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 percent 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’re 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 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 percent, 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.

ACTING ADMINISTRATOR SLAVITT:  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 and 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 percent of Americans will be living within — I should say 90 percent 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, or you’re welcome to comment on that.  And that’s important, both for teens and for younger kids, because it’s some — it’s an important point of trust for parents and teens.  And there’s also a process that’s — for getting childhood vaccinations to pediatricians that’s been well established.

Anything you’d care to add, Dr. Walensky?

DR. WALENSKY:  No, I will just say that, you know, that once FDA has put forward the authorization that ACIP is — 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 note, 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.


MODERATOR:  Yamiche Alcindor with PBS.

Q    Hi.  Thanks so much for taking my question.  Two questions.  The first is: There was a study that’s being cited — an Israeli study — that showed the vaccine variant out of South Africa, the B1351, was able to evade protection of some Pfizer vaccines.  And I know, Dr. Fauci, you just said that there will be breakthroughs 100 percent of the time.  I just wonder if there’s worry that this particular strain is breaking through more than others. 

And a follow-up question to that is: For multi-generational homes — and this could be maybe for 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?

ACTING ADMINISTRATOR SLAVITT:  Okay.  Dr. Fauci, you want to take the first question?

DR. FAUCI:  Yeah.  You know, I’m glad you asked that question because, with all due respect to my so-many Israeli friends, I think that that reprint — or 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 351 if, in fact, you were vaccinated against the mRNA.  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 351.  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, that reprint, over and over again, and I can tell you it is really a little bit confusing.  The only thing that isn’t confusing is two doses are really good.

ACTING ADMINISTRATOR SLAVITT:  Dr. Fauci, let me — just to allow you to emphasize that, as you look at that preprint, 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 invasive variant?

DR. FAUCI:  Quite well, as a matter of fact.  Quite well. 

ACTING ADMINISTRATOR SLAVITT:  Right.  So it sounds — 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, Yamiche, 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?

Q    That was in the context of variants.  I was thinking if everyone gets vaccinated in a household, but then someone is 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 they’re — the whole household is vaccinated, but someone still has to go to work and they’re coming back to their elderly parents.

ACTING ADMINISTRATOR SLAVITT:  Well, yeah, I think either Dr. Walensky or Dr. Fauci, you’re 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:  You know, it —

DR. WALENSKY:  (Inaudible.)

DR. FAUCI:  Go ahead, Rochelle.

DR. WALENSKY:  I was just going to say, you know, 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 — should be active in a workplace. 

So, assuming you take those prevention measures at home — I mean, in an 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.

ACTING ADMINISTRATOR SLAVITT:  Anything to add, Dr. Fauci?

DR. FAUCI:   Yeah, I mean, I’m glad you asked that question because, you know, it leads to the answer that Dr. Walensky gave, which is the reason why we say, “When you are in the home — you are 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.


MODERATOR:  Carl O’Donnell at Reuters.

Q    Hi and thanks for taking my question.  I did — I wanted to ask a little bit more about the situation with the Emergent facility for the J&J shots.  Our understanding is that, you know, J&J had originally projected 24 million doses in April and that that was not contingent on Emergent 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 EUA is received, so I just wonder if you have any clarification on that and any guidance as to, you know, 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.

ACTING ADMINISTRATOR SLAVITT:  Yeah, let me begin with the big picture: 90 million doses over the last three weeks.  And, you know, you can expect, even without additional doses from Johnson & Johnson, for us to be somewhere in that neighborhood.  You know, if you do the math — 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.

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 over, you know — 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.

MODERATOR:  We’ll got to Niels Lesniewski at CQ Roll Call.

Q    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 D.C., 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.

ACTING ADMINISTRATOR SLAVITT:  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, most — 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 any — in some specific circumstances, we’ll find out about that and see what we can do to correct that. 

Next question.

MODERATOR:  Last question.  Let’s go to Heidi Przybyla at NBC News.

Q    Oh, thank you.  You know, 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. 

ACTING ADMINISTRATOR SLAVITT:  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:  Thanks, Andy.  And thank you for this question, Heidi. 

You know, when — there are different tools that we can use for different periods of when things are out breaking out — when there’s an outbreak.  For example, we know that if vaccines go in arms today, we will not see an effect of those vaccines, depending on the vaccine, for somewhere between two to six weeks. 

So when you have an acute situation, an 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 you 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. 

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, you know, impact in six weeks, and we don’t know where the next place is going to be that is going to surge.

ACTING ADMINISTRATOR SLAVITT:  Yeah.  So, look, our job here is to follow the science.  And I think, you know, 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 all — 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.  We just sent — 140 FEMA vaccinators have just moved into the (inaudible).  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 I some part 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. 

So with that, I think we’ve taken our last question.  And we look forward to being here and talking with you again on Wednesday.  Thanks.

11:38 A.M. EDT

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