Via Teleconference 

12:40 P.M. EDT

MR. ZIENTS:  Good morning, and thank you for joining us.  Dr. Walensky, Dr. Fauci, Dr. Nunez-Smith and I will keep our comments brief this morning so we can get to your questions.

I’ll start with an update on our fight against the Delta variant.  The Delta variant continues to drive a rise in cases, with cases concentrated in communities with lower vaccination rates.

In the past week, Florida has had more COVID cases than all 30 states with the lowest case rates combined.  And Florida and Texas alone have accounted for nearly 40 percent of new hospitalizations across the country.

We all know that vaccinations are the very best line of defense against COVID and how we end this pandemic.  That is why we’ve been tireless in our efforts to get more and more Americans vaccinated.

For the first time since mid-June, we’re averaging about a half million people getting newly vaccinated each and every day. And overall in the last week, 3.3 million Americans rolled up their sleeve to get their first shot.

In the past month, we have doubled the average number of 12- to 17-year-olds getting newly vaccinated each day — critical progress as millions of adolescents start heading back to school.

Importantly, we’re seeing the most significant vaccinations progress in states with the highest case rates.

In fact, in the past month, we have nearly tripled the average number of shots each day in Arkansas and quadrupled in Louisiana, Alabama, and Mississippi.

So, we’re getting more shots in arms in the places that need them the most.  That’s what it’s going to take to end this pandemic: more vaccinations, more Americans doing their part and rolling up their sleeve.

Over the past few weeks, we’ve seen strong actions from across the public and private sectors to help end the pandemic.

The President recently announced vaccination requirements for all 4 million federal workers, and we are working to apply similar standards to all federal contractors.

On Monday, the Department of Defense announced its plans to add COVID-19 vaccines to the list of vaccines required for more than 1.7 million active duty, reserve, and National Guard personnel.

And just this morning, the Department of Veteran Affairs and the Department of Health and Human Services announced new requirements: All 350,000 VA healthcare personnel and all 25,000 HHS healthcare personnel must now be fully vaccinated.

State and local governments; healthcare systems; businesses, small and large; universities; and other institutions are also stepping up.

Since last week, Washington State; Washington, D.C.; and Seattle have all adopted vaccination requirements, and more than 50 health systems across the country have announced that all staff need to be vaccinated, bringing the total to more than 200 health systems.

Just in the past 24 hours, Amtrak, McDonald’s, NBCUniversal, Discovery, and Capital One all announced new rules that workers must be vaccinated to return to the office.

California announced all schoolteachers and staff in the state, serving more than 6 million students, will be required to be vaccinated or tested weekly.

And the NEA and the AFT, two of the largest unions in the country — representing 5 million educators, childcare workers, and school staff — both came out in favor of school districts pursuing COVID-19 vaccination policies, including requirements for teachers and staff.

And across the country, nearly 700 colleges and universities have announced vaccination requirements, which will cover roughly 5 million students getting ready to head back to school.

So, clearly, vaccination requirements are gaining momentum across the country and are already covering tens of millions of workers, educators, college and university students, and healthcare providers.

They will help keep people and communities safe and help stop the spread of the virus.

Here’s the bottom line: Through vaccination requirements, employers have the power to help end the pandemic.

As we drive progress on vaccinations, we are accelerating our efforts to help states respond to outbreaks caused by Delta.

Our COVID-19 Surge Response Teams have deployed more than 500 federal personnel, including hundreds of healthcare personnel in Louisiana, Mississippi, and Arizona to provide emergency medical care.

CDC is on the ground in Tennessee, Illinois, and Missouri to help local outbreak investigations and vaccination efforts.

We’ve sent ambulances and paramedics to Missouri and Louisiana.  And in Florida, we’ve stood up dozens of free testing sites and sent 200 ventilators to hospitals in the state.

And importantly, as Dr. Nunez-Smith will discuss, we sent five times as many lifesaving therapeutics to states in July compared to June.

I’ll close with this: We are doing everything we can to get people vaccinated and support state and local leaders on the ground.  But as we have said from the start, ending this pandemic requires every American doing their part.

So, please, if you’re unvaccinated, get your shot.  It’s free, it’s convenient, it works, and it’s never been more important.

With that, let me hand it over to Dr. Walensky.

DR. WALENSKY:  Thank you, Jeff.  Good afternoon.

Let’s begin with an overview of the data.  Yesterday, CDC reported 132,384 new cases of COVID-19.  Our seven-day average is about 113,000 cases per day, and this represents an increase of nearly 24 percent from the prior seven-day average. 

The seven-day average of hospital admissions is at about 9,700 per day, an increase of about 31 percent from the prior seven-day period.  And the seven-day average of daily deaths has also increased to 452 per day, an increase of 22 percent from the prior seven-day period. 

We continue to see cases, hospitalizations, and deaths increase across the country.  And now, over 90 percent of counties in the United States are experiencing substantial or high transmission. 

As we have been saying: By far, those at highest risk remain people who have not yet been vaccinated.  This week, we are taking two important steps in encouraging and improving vaccine protection for Americans. 

First, for pregnant people who are at higher risk of severe illness from COVID-19, we are strengthening our guidance and recommending that all pregnant people or people thinking about becoming pregnant get vaccinated. 

We now have new data that reaffirm the safety of our vaccines for people who are pregnant, including those early in pregnancy and around the time of conception.  These data build on previous evidence from three safety monitoring systems that did not find any safety concerns for pregnant people who are vaccinated late in pregnancy or for their babies. 

Now these new data found no increase in the risk for miscarriage among people who received an mRNA COVID-19 vaccine before 20 weeks of pregnancy.

Clinicians have seen the number of pregnant people infected with COVID-19 rise in the past several weeks.  The increased circulation of the highly contagious Delta variant, the general low vaccine uptake among pregnant people, and the increased risk of severe illness and pregnancy complications related to COVID-19 infection among pregnant people make vaccination for this population more urgent than ever. 

Second, I want to take a moment to discuss what we are doing to help increase protection against COVID-19 for certain individuals who are moderately and severely immunocompromised. 

As we’ve been saying for weeks, emerging data show that certain people who are immunocompromised, such as people who have had organ transplant and some cancer patients, may not have had an adequate immune response to just two doses of the COVID vaccine. 

To be clear, this is a very small population.  We estimate it to be less than 3 percent of adults. 

We’ve been working to identify how best to provide increased protection to these vulnerable people who are disproportionately impacted by severe outcomes due to COVID-19.  FDA is working with Pfizer and Moderna to allow boosters for these vulnerable people. 

An additional dose could help increase protections for these individuals, which is especially important as the Delta variant spreads. 

Following the FDA’s decision, CDC will hold a meeting of its Advisory Committee on Immunization Practices tomorrow to discuss this issue and offer their expert insights and recommendations.  We look forward to that discussion and to helping support this vulnerable population. 

At this time, only certain immune compromised individuals may need an additional dose.  Emerging data, including from a significant study published in the New England Journal of Medicine yesterday, show that there’s an enhanced antibody response after an additional dose of an mRNA COVID-19 vaccine in some immunocompromised people. 

This action is about ensuring our most vulnerable, who may need an additional dose to enhance their biological responses to the vaccines, are better protected against COVID-19. 

The science and resulting data in this pandemic are moving extremely rapidly.  The U.S. government, in turn, is moving swiftly to analyze the science and make the recommendations most appropriate to protect Americans.  We know our vaccines are safe and effective.  And if you have not gotten a vaccine yet, please do so today. 

Thank you.  I’ll turn things over to Dr. Fauci.

DR. FAUCI:  Thank you very much, Dr. Walensky.

So, it’s becoming very clear now — if you go to the first slide — that we are dealing with a global outbreak of the Delta variant.  I keep updating this slide; it now shows that at least 117 countries now have the Delta variant since it was first detected in June of 2020. 

So, let’s just review some of the aspects of Delta to help put it into the context of what we’re talking about.  We know the transmissibility — that it’s greater than the Alpha variant, at least two times as great.  This makes a major difference in transmissibility.  The viral load is up to 1,000 times greater in the nasalpharynx of people with Delta than Alpha, which is a mechanistic reason why you have such a tremendous increase in transmissibility.

Next slide. 

In previous reviews before this group, I have shown this slide, in checking the boxes as to the proof of protection against SARS-CoV-2 Delta variant. There was one glaring, missing check in previous iterations of this, and that was in the J&J clinical effectiveness. 

Next slide. 

I had showed you before this slide looking at data of immune responses in vitro.  And this was the J&J vaccine study, which showed that it elicited durable antibody and cellular responses against Delta with minimal decreases for at least eight months after immunization. 

Next slide. 

We now have a slide that recently — a study that recently came out from South Africa and other southern African countries — it’s called the Sisonke study — involving about 478,000 healthcare workers.  And this is real-world effectiveness against Delta, with a 91 to 96 percent protection against Delta, and then 71 percent protection against hospitalization. 

And remember, I showed you before that the durability of the immune response is out to eight months.  And this is the first real-world data to show the effectiveness of J&J from this challenging epidemiological setting of Delta, particularly in the context of people who might have HIV. 

Next slide. 

Finally, if you look at breakthrough infections — which are inevitable with any vaccine, because no vaccine is 100 percent effective — as you can see, as we’ve seen in other studies, the breakthrough infections, namely infections that occur in the setting of full vaccination, were mild in 96 percent, moderate in 3 percent, severe in less than 0.05 percent, with death in less than 0.05 percent. 

So, I’ll stop there and hand it over to Marcella Nunez-Smith. 

DR. NUNEZ-SMITH:  Thank you so much, Dr. Fauci.  And good afternoon to everyone.  Today, I’ll just take a couple moments.  I want to update you on vaccination equity, as well as on the importance of COVID-19 therapies.

So, first, when it comes to vaccinations and equity, important to note that the majority of people who are getting vaccinated through the direct federal programs are self-identifying as people of color — so that’s through community health centers, through dialysis centers, and at our Federal Retail Pharmacy partners. 

In a sense, President Biden made all adults in the U.S. eligible for vaccine on April 19th, and the majority of individuals receiving vaccines have identified as people of color. 

So that is notable progress, but it does not change the fact, as we’ve been discussing, that there is, of course, still more work to do. 

And the work in this phase of the vaccination campaign remains hyperlocal.  And that’s why the Biden-Harris administration will continue to work just hand in hand with states and territories, Tribes, cities — always centering our partnerships with faith-based and community-based organizations, supporting that trusted outreach work that needs to be done. 

I just want to provide a couple examples of the administration’s resource commitment to engage partnership.  You know, in June and July, the federal administration awarded over $240 million to support community-based workers, community-based efforts — really expanding local, tailored opportunity to build both vaccine confidence and vaccine access. 

This past week, the CDC officially launched the Partnering for Vaccine Equity program.  That’s an investment of $120 million in grants that have been awarded. 

And later this week, $20 million will be distributed specifically to Native Hawaiian communities.

In meeting people where they are, partnership is so powerful.  And many of the incredible partners doing this work are health centers.  This is National Health Center Week.  And on behalf of the administration, I want to say thank you to health centers across the country: your commitment, your dedication reaching underserved groups — health centers on that frontline in vaccine administration, in testing, and in the administration of safe, effective therapies. 

As Jeff mentioned earlier, these therapies do include monoclonal antibodies.  And I want to talk a minute about those, but to people across the country, let me just reiterate: The best strategy to remain protected from the worst of COVID-19 is to get fully vaccinated. 

But if you get COVID-19 and you’re at high risk, I want to assure you about these therapies.  The monoclonal antibodies work.  They are safe.  They’re free.  They keep people out of the hospital and help keep them alive. 

And our surge teams have been working closely with states, increasing access, provider uptake, and patient confidence.  We’ve conducted virtual trainings for physicians and health system officials.  And this has been — you know, in Arizona, Nevada, Utah, Wyoming, with more to come in Alabama and elsewhere. 

And in fact, in Arizona, we have a federal clinical team on the ground now, helping to set up and run two sites to provide these treatments.  And those efforts are paying off.

Now, of the COVID-positive patients the Arizona team has treated so far, not one has required hospitalization after that treatment. 

But we can also report that we’ve surged shipments to the states with the highest rates of community transmission.  For example, Florida shipments increased over eightfold over the past month. 

And in July, more than 108,000 treatments were shipped all over the country by the federal government.  And as Jeff mentioned, this represents more than a fivefold increase nationally from June. 

Over the course of the entire pandemic, more than 600,000 patients across the country have received monoclonal antibody treatments; that’s hospitalizations averted and lives saved.

So, the Biden-Harris administration continues to stand ready to assist states and territories and jurisdictions across the country to get more people connected to testing, to treatment, and, absolutely, to vaccination.

So, thank you so much.  And with that, I’ll turn it back over to you, Jeff.

MR. ZIENTS:  Okay, well, thank you, doctors.  Let’s open it up for questions.

First question.

MODERATOR:  Sabrina Siddiqui at The Wall Street Journal.

Q    Yes.  Hi, thank you so much as always for doing the briefing.  We’re seeing a rising number of children being infected with COVID-19.  So, I have a two-fold question: Is there data to suggest that the Delta variant is more virulent in children?  And given that increase, are you still confident that schools can fully reopen for in-person instruction, or are you considering further changes to the guidelines?

MR. ZIENTS:  Let’s start with Dr. Fauci on the first part of the question, and then Dr. Walensky on school openings. 

Dr. Fauci.

DR. FAUCI:  Thank you, Jeff.  Well, in answer to the first part of your question: There’s no doubt that there are more children getting infected.  As I mentioned in one of my slides, the Delta variant is much more highly transmissible than was Alpha.  So, given that, you will see more children likely get infected. 

And since you have a certain percentage of children, even though the percentage is small, a certain percentage of children will require hospitalization.  So, quantitatively, you will see more children in the hospital.

Regarding the severity of illness, there was a couple of studies, mostly international, which suggested that Delta was more severe in adults, namely causing more (inaudible) relative percentage of hospitalization and more severe disease. 

With regard to children, this could possibly be the case, but we are not seeing this in a definitive way.  The only thing we know for sure is that more infections mean more children will be in the hospital.

With regard to the school part — about that, I think we’ll go back to Dr. Walensky.

DR. WALENSKY:  Thank you, Dr. Fauci.  And thank you, Sabrina, for that question.

What we know is that where we have higher rates of infection among children is where we have lower rates of vaccination, in general — higher rates of community transmission. 

We do know how to keep our children safe.  We know how to do so in schools.  And we know that most of the infections that is coming in through — into schools is coming from high rates of disease in the community. 

So, the best way to keep our schools safe — and we know how to do it — is to vaccinate everyone who can be vaccinated, vaccinate family members of children who cannot yet be vaccinated, and then to follow the mitigation strategies in our school guidance, including masking in schools.

MR. ZIENTS:  The one thing I’d add there is, due to the passage of the American Rescue Plan several months ago, all schools have the resources to implement those mitigation strategies.

Next question.

MODERATOR:  Josh Wingrove at Bloomberg.

Q    Hi, thank you.  Can you give us an update on the plan to start shipping those 500 million Pfizer doses that was meant to commence this month?  Has that started?  And what kind of pace will we see in the coming weeks?  Thank you.

MR. ZIENTS:  Thanks, Josh.  The 500 million Pfizer doses that were announced in June to be donated to the world — those shipments do begin this month, and we will ship a total of 200 million by the end of this year — this calendar year, with the remaining 300 million shipped no later than the first half of 2022.  So, everything is on schedule there, Josh, and shipments are beginning in the next several days.

Next question. 

MODERATOR:  Next question.  Let’s go to Weijia at CBS.

Q    Thanks, Kevin.  And thanks for taking my question.  My — a quick follow-up on Sabrina’s.  What is the latest data about children and long-haul symptoms after they recover even from mild cases? 

And then, Jeff, for you: Now that more entities are requiring vaccines, is the administration reconsidering something like a QR code or a passport to help verify people’s vaccination status?  And if not, what are you doing to stop the proliferation of fake vaccine cards?  Thank you.

MR. ZIENTS:  Okay.  Dr. Walensky, on the children, long-COVID question.

DR. WALENSKY:  Right.  Thank you for that question.

We are examining long COVID in children, and we are seeing long-COVID symptoms — mostly fatigue and headache.  They appear to be happening at rates that are lower than they are in adults — in the 2 to 3 percent.  But, of course, data with Delta and long COVID will need to be followed differently and longitudinally as we have been with Alpha.  So more data to follow on that.

MR. ZIENTS:  You know, on to vaccination verification: There are a number of ways people can demonstrate their vaccination status.  Companies and organizations and the federal government are taking different approaches.  And, you know, we applaud this innovation. 

There will be no federal vaccination database.  As with all other vaccines, the information gets held at the state and local level.  But any system that is developed, in the private sector or elsewhere, must meet key standards, including affordability, being available both digitally and on paper, and, importantly, protecting people’s privacy and security.

The second part of your question — you know, we are aware of some cases of fraud or counterfeit COVID-19 cards being advertised on social media sites and eCommerce platforms.  While the practice is not widespread, you know, I will remind everyone that it’s a crime and the Office of the Inspector General, the Department of Health and Human Services is investigating these schemes.

Next question.

MODERATOR:  Cheyenne Haslett at ABC News.

Q    Hi, thanks for taking my question.  I want to follow up on a question from last week about the hospitalization rates for unvaccinated versus vaccinated people.  The CDC has been saying it’s 97 percent of people winding up in the hospital who are unvaccinated.  Has that number changed with Delta?  And do you have better numbers on the efficacy, yet, Dr. Walensky?

DR. WALENSKY:  Thank you.  That 97 percent was data from January through May — January, sorry, through June.  And, of course, with more and more people being vaccinated and with the Delta variant, those numbers are fluid, and we’re continuing to evaluate those.

Next question.

MODERATOR:  Let’s go to Kelly Lienhard at Inside Health Policy.

Q    Hi, thanks for taking my question.  There have been reports from CDC that over a million people have already gotten unauthorized third doses of mRNA vaccines.  Do you know if private insurances and Medicare are still covering the administration fee for these shots even though they’re not recommended currently?

MR. ZIENTS:  Dr. Walensky.

DR. WALENSKY:  Yeah, we are doing an evaluation on that just to make sure and understand — and we have the capacity to track this and to understand the practice.  Many of these are occurring in the context of people who may believe they are — merit another shot, may be severely immunocompromised and are doing so in advance of our recommendations.

The one thing I want to highlight in the context of this is that it does undermine our ability to monitor safety in these contexts.  So, we are asking people to follow our guidance, to follow what ACIP will say and the FDA will say in the coming day — several days, and to follow recommendations so we can we can follow safety signals here as well.

Next question.

MODERATOR:  Last question.  Let’s go to Michael Erman at Reuters.

Q    Hi.  Dr. Fauci said this morning on an interview that he believes boosters, in general, are an inevitability.  I’m just wondering how soon you expect that you might make a decision on that.  And what sort of data are you looking for to make that decision?

DR. FAUCI:  Well, when I made that statement — it’s a true statement that we believe, sooner or later, you will need a booster for durability of protection. 

Right now, you know, (inaudible), as we mentioned, we are evaluating this on a day-by-day, week-by-week, month-by-month basis, looking at any of a number of studies, both international and domestic studies.  And as we’ve stated many times, right at this moment — apart from the immunocompromised, which was just discussed — we do not believe that others — elderly or nonelderly — who are not immunocompromised, need a vaccine right at this moment.  But this is a dynamic process and the data will be evaluated. 

The one thing we are doing is we are preparing for the eventuality of doing that.  So, if the data shows us that in fact we do need to do that, we’ll be very ready to do it and do it expeditiously.

MR. ZIENTS:  Yeah, I’ll just emphasize what Dr. Fauci ended with, which is if and when there is a decision, we are prepared.  We have the supply, and people will be able to get a booster in a fast and efficient way — if and when the science dictates.

Thank you.  And I look forward to seeing everybody at the next briefing.

1:08 P.M. EDT      

To view the COVID Press Briefing slides, visit:

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