Via Teleconference

11:20 A.M. EST

MR. ZIENTS:  Good morning, and thanks for joining us.

Today, we’ll start with an update from Dr. Walensky on Omicron cases in the U.S. and around the world.

Over to you, Dr. Walensky.

DR. WALENSKY:  Good morning.  Thank you, Jeff.  I’d like to start by walking you through today’s data.

The current seven-day daily average of cases is about 117,900 cases per day.

The seven-day average of hospital admissions is about 7,800 per day, an increase of about 7.7 percent over the prior week.

And the seven-day average of daily deaths are about 1,100 per day, which is at an increase of about 5 percent over the previous week.  And, of course, tragically, this week as a nation, we mark 800,000 deaths from this virus.

Science is emerging about the Omicron variant with each passing day.  Today, I will walk you through the most recent updates. 

At least 36 states and over 75 countries have reported confirmed cases caused by the Omicron variant.  And yesterday, CDC released data that estimate the prevalence of the Omicron variant based on our national genomic sequencing analysis.

Although the vast majority of cases continue to be Delta, representing about 96 percent of cases across the country, the Omicron variant is now estimated to represent about 3 percent of the cases in the United States.

In some areas of the country, the estimates of Omicron are even higher, including in New York and New Jersey where CDC projects that Omicron could represent about 13 percent of all cases.

In looking at early data on transmissibility of Omicron from other countries, we expect to see the proportion of Omicron cases here in the United States continue to grow in the coming weeks.  Early data suggest that Omicron is more transmissible than Delta, with a doubling time of about two days.

What does this mean for individuals and families as we head into the winter months — a time when families may be gathering with one another over the holidays?  It means that it is vital for everyone to get vaccinated and boosted if they are eligible.

Given the increase in transmissibility, this also means continuing to be vigilant about masking in public indoor settings, in areas of substantial or high community transmission.  And as of now, this represents about 90 percent of all counties in the United States.

Vaccination, boosting, and masking are especially critical for those who are most vulnerable, including seniors, pregnant people, and those who are immunocompromised. 

Tomorrow, we will release data on CDC’s COVID Data Tracker that provide a snapshot of national- and state-level data on COVID-19 vaccine and booster effectiveness among residents of CMS-certified long-term care facilities.

The graph displayed here shows COVID-19 cases among nursing home residents by vaccination status, including individuals who are unvaccinated — represented by the top red line; those who are fully vaccinated — represented by the middle blue line; and those who have received an additional booster dose — represented by the bottom green line. 

As expected, nursing home residents who are unvaccinated have the highest weekly COVID-19 case rates, which increased from 3.4 to 8.8 per thousand nursing home residents between October 31st to December 5th.

For those who are fully vaccinated, we are starting to see cases increase, which is likely due to the waning of vaccine protection over time. 

But the good news is that these data show that nursing home residents who are fully vaccinated and have received a booster dose have a 10 times lower rate of getting SARS-CoV-2 in comparison to those residents who have only received a primary vaccination series or are unvaccinated.

These data also show that COVID-19 case counts are increasing among residents who are unvaccinated and those who received a primary series with a booster — without a booster, while case rates are stable and low among those who have received an additional or booster dose.

Taken together, these data emphasize the critical importance of boosters to optimize the protection of vaccines over time, and that when boosters are used, that protection works.

Throughout the pandemic, we have understood the urgent need to provide protection to our aging populations.  And CDC has been actively working to equip nursing homes to best protect their residents and to encourage older Americans to get boosted.  These efforts have resulted in approximately 60 percent of eligible seniors receiving a booster already.

And while we’ve made good progress, we know we have more work to do.  CDC is working in close partnership with states, localities, and providers across the country to expand access to boosters and to ensure that every state has access to the resources and support they need to protect those at highest risk, including residents of long-term care facilities.

This includes CDC’s proactive assistance to long-term care facilities that need help by matching them with a retail pharmacy through the Federal Retail Pharmacy Program to provide an on-site clinic.  Thousands of facilities have already been matched through CDC or by requesting support through their state health department. 

Given the data presented today, we urge participation of both residents and staff in our booster program.

And we are collectively working closely with states at all levels, including weekly calls with governors, state health official — officers, and immunization programs. 

Just yesterday, we celebrated the one-year anniversary of the first COVID-19 vaccine in the United States.  And now we have over 200 million Americans fully vaccinated and more than 55 million boosted.

In this moment, as we continue to learn more and are guided by the evolving science, it’s important to remember that we have far more tools to fight this virus than we ever did just one year ago.

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

DR. FAUCI:  Thank you very much, Dr. Walensky.  I’d like to now spend a few minutes talking about the Omicron variant in the light of the effect of boosters — if I could have the first slide.

Clearly, because — first slide please — clearly because we have an intense interest on the evolving scenario with Omicron, a number of studies have been done throughout the country and the world to take a look at how we might prepare in the context of vaccinations.  And I’ll divide it up into two components.

Next slide.

The first is to look at selected in vitro neutralization studies, namely the capability of vaccine-induced antibodies to neutralize the new Omicron variant. 

Next slide. 

This is data from Pfizer BioNTech.  If you look on the left-hand part of the slide, this is 21 days after the second dose of the Pfizer product. 

Note the purple bar in the middle on the left, which is Omicron — clearly a substantial diminution in the pseudo virus neutralization titer, which is measured on the vertical axis.

On the right-hand part of the slide, one month after the third dose, take a look now again at the purple bar, which has gone up substantially from the 6, which is circled on the left, to 154.  Again, this is one of a number of representative studies. 

Next slide. 

Another study from the Rockefeller University in New York, funded by the National Institute of Allergy and Infectious Diseases, again, showing that Omicron exhibits a rather profound degree of neutralization escape looking at the low levels of the blue triangles on the left part of the panel. 

However, the two-dose mRNA vaccinated people who received a booster dose — look — had a substantial increase in neutralizing activity to the tune of a 38-fold increase. 

Next slide. 

And most recent data from our own Vaccine Research Center, which is the first in a series of data that will be coming out over the next few days and be published in a preprint server next week, this is a sampling of the data.

Again, two weeks post-dose, look at the Omicron ID50 neutralizing activity: substantially low.  Look at the three dots that are even below the level of detection. 

However, if you look at two weeks post the third dose, note the substantial degree of elevation of the neutralizing titer well within the range of neutralizing Omicron. 

Next slide. 

Now we look at selected clinical studies. 

Next slide. 

As is shown here, this is not looking at booster, it’s looking at the effectiveness of a two-dose Pfizer vaccine against the Omicron variant.

On the left-hand part, as has been reported in multiple other studies, the effectiveness against SARS-CoV-2 infection is about 33 percent, down from 80 percent to the pre-Omicron era. 

But note, on the right-hand part of the slide, that the effectiveness against hospitalization, which is critical, still maintains a 70 percent effectiveness. 

Obviously, this is significantly down, but there is the maintaining of a degree of protection against hospitalization. 

Next slide. 

Now, if you look at the UK Data, if you look at the Delta in the blue boxes, you see that effectiveness is significantly lower when you look at the time since the vaccine was given, measured in weeks. 

However, when you get the booster, which is in the red circles, for Omicron, it increases to 75 percent effectiveness against symptomatic disease with a booster dose. 

So what is all of this telling us very clearly and very emphatically? 

Last slide. 

The Omicron variant undoubtedly compromises the effects of a two-dose mRNA vaccine-induced antibodies and reduces the overall protection.  However, as I showed on a prior slide, considerable protection still maintains against severe disease.

The early in vitro and clinical studies that I mentioned indicate that boosters reconstitute the antibody titers and enhance the vaccine protection against Omicron. 

And so, finally, our booster vaccine regimens work against Omicron.  At this point, there is no need for a variant-specific booster. 

And so the message remains clear: If you are unvaccinated, get vaccinated.  And particularly in the arena of Omicron, if you are fully vaccinated, get your booster shot. 

Back to you, Jeff. 

MR. ZIENTS:  Thanks, Dr. Fauci.

So, as we just discussed, as Dr. Fauci presented, each day we are getting additional data that gives us a clearer understanding of the Omicron variant. 

And as Dr. Fauci just importantly explained, our vaccines work.  They continue to provide people protection against this new variant.  And booster shots provide the highest level of protection.

From day one, President Biden has been laser-focused on getting shots in arms.  He marshaled a whole-of-government effort to make vaccines readily available and easy to get at more than 80,000 locations nationwide.  And he empowered local leaders with the tools and resources they needed to answer people’s questions and get their communities vaccinated.

Vaccines are the best line of defense against COVID.  Plain and simple.  They keep people out of the hospital and save lives.

The latest data from CDC shows that an unvaccinated individual is 8 times more likely to be hospitalized due to COVID and 14 times more likely to die from COVID compared to a fully vaccinated individual.

Just yesterday, a new study from researchers at the Yale University School of Public Health and the Commonwealth Fund quantified the impact of our relentless effort to get Americans vaccinated.

Looking at the impact on hospitalizations and death, what you see on this slide is that the U.S. vaccination program has already prevented 10.3 million hospitalizations.  And it has saved 1.1 million American lives.  1.1 million American lives saved — that’s the power of vaccines. 

That’s why we have worked so hard to get shots in arms.  And that’s why getting more Americans vaccinated and boosted is central to the President’s plan to fight COVID and confront Omicron this winter.

Since the President announced his Winter Plan on December 2nd, we have been hard at work executing, using every tool at our disposal.

The President’s plan is delivering significant results.  Sixty percent of all eligible seniors, including about 60 percent of eligible long-term care residents — those most vulnerable — are now boosted.  And these numbers increase each day.

Overall, we’re now getting booster shots to millions of Americans each week.  As I said earlier, it’s really important to emphasize the importance of everybody getting the booster but particularly eligible seniors.  And we’re at 60 percent.  And, as Dr. Walensky said, we want that number to go up each and every day. 

Overall, we’re now getting booster shots to millions of Americans each week.  In fact, across the first two weeks of December, we have gotten 14 million booster shots.  That’s our highest-ever two-week total.

So our booster program is accelerating, and our overall vaccination program is also on the increase.

In the first two weeks of December, we have gotten 26 million total shots in arms.  That’s up 40 percent from the last two weeks of November.

This is significant progress, putting us in a stronger position as we confront Omicron and head into winter.

Let me close with the message that we want every American to hear: If you’re eligible for a booster shot, it’s critical that you go get boosted today.  Don’t wait.  And please get your kids and yourself fully vaccinated, if you haven’t already.

It’s safe and effective, free and easy.  And it’s the best way to protect yourself, your loved ones, and your communities this holiday season and winter.

With that, let’s take some questions.  Over to you, Kevin.

MODERATOR:  Thanks, Jeff.  We have time for a few questions today, so let’s please keep the questions to one question. 

Sabrina Siddiqui at The Wall Street Journal.

Q    Hi, thank you as always for doing the briefing.  So, given that the Omicron variant compromises the effects of a two-dose mRNA vaccine and reduces overall protection, I wanted to ask about those who are not eligible for boosters, namely adolescents aged 12 to 15 who first started getting the vaccine in May.  How confident are we, since they’re not eligible for a booster, that that category of adolescents has protection against Omicron?  And also, is there any cause for concern that children ages 5 to 11 who are being administered the first round of vaccines would not have sufficient protection against this new variant?

MR. ZIENTS:  Dr. Fauci?

DR. FAUCI:  Well, it’s very clear that when you look in general at a population level, that younger individuals have a much more robust immune response than adults, particularly among elderly.  So, the comparison there is that you would expect a rather substantial power of the immune response. 

Having said that, we continually look at the durability of response and the level of response in the people that have been followed in the various studies.  So, this is something that we will continue to examine as to the possibility or necessity of providing boosts for that cohort of young people. 

Thank you.

MR. ZIENTS:  Next question.

MODERATOR:  Let’s go to Katherine Eban at Vanity Fair.

Q    Thank you for the briefing and thank you for taking my question.  Two weeks ago, the African Union put out a statement calling on donor countries to no longer send donated COVID vaccine doses that were ad hoc, provided with little notice, and had short shelf lives.  They also called on donor countries to include ancillary supplies with those donations, including specialized syringes for the Pfizer doses.

My question is: Has the White House, in light of this, reconsidered its policy of not including specialized syringes with the Pfizer donations?  Or has it made any change to that policy?

Thank you.

MR. ZIENTS:  Well, thanks for the questions.  I want to start — for the question.  And I want to start by saying that the doses that we are sending are not short-lived doses, meaning they have an extended period of shelf life. So, that might be happening with other countries’ donations, but not with the U.S. donations.

And we’ve sent 320 million doses now to 110 countries, and that’s more than every other country in the world combined.  And as you know, that’s part of an overall commitment of a minimum of 1.2 billion doses donated with no strings attached.  And we plan on building on that total across time.

I think, importantly, the U.S. State Department and USAID are leading the administration’s efforts to work to turn vaccines into vaccinations.  And that does mean that we need to make sure that there are enough syringes and needles.  And our team has been helping with the global effort to ensure that there are the syringes and needles.

The AID team and the State team are working to help train health workers to vaccinate people on the ground, run local media campaigns, and also to launch what we’ve done here: mobile vaccination clinics.

Just last week, USAID added $400 million.  That brings the total of $1.7 billion for global vaccine readiness.  Administrator Power made that announcement last week.  And that includes, within that 400, efforts to bolster the cold chain storage in various countries, set up field hospitals, train health workers, build data systems, and support campaigns to increase vaccine confidence.

So, we’ll continue to do all we can to support getting vaccines to countries and then, importantly, as you point out, taking vaccines and make sure that they become needles in arms and actual vaccinations.  And that includes efforts to support with the needles and syringes needed to do just that.

Next question, please.

MODERATOR:  Let’s go to Jeremy Diamond at CNN.

Q    Hey, thanks very much for doing the briefing.  So, tomorrow, the Advisory Committee on Immunization Practices is meeting to discuss the Johnson & Johnson vaccine.  I’m wondering if Dr. Walensky could say why that meeting was called and whether you believe that the benefits of getting J&J no longer outweigh the risks.

And then, secondly, given the rapid spread of Omicron and the data on protection against Omicron from a booster shot versus a two-dose regimen that Dr. Fauci just presented, isn’t it time to change the definition of “fully vaccinated” to three doses?  And if not, what more data are you waiting on to make that decision?

Thank you.

MR. ZIENTS:  So, Dr. Walensky, on the ACIP and then on the definition of “fully vaccinated.”

DR. WALENSKY:  Yeah, thank you for that question, Jeremy. So, the ACIP team meets intermittently to review the safety data of all of their vaccines.  And I will look forward to their discussions tomorrow, to review of those data, and to any recommendations that come thereafter.

In terms of the definition of “fully vaccinated,” as you know, the definition right now is two doses of an mRNA vaccine or a single dose of the J&J vaccine.

Certainly, as Dr. Fauci has demonstrated and even our CDC data have also demonstrated, we are continuing to follow that science and it is literally evolving daily.  And as that science evolves, we will continue to review the data and update our recommendations as necessary.

MR. ZIENTS:  Next question.

MODERATOR:  All right.  We’ll go through a few more.  Josh Wingrove at Bloomberg.

Q    Hi, there.  Thank you so much.  Can you give us a sense of what employers and schools should be doing right now?  We’re seeing a lot of employers put on hold their “return to office” strategies.  We’re seeing schools and colleges move to virtual or warn about the need to move to virtual.  We’re seeing widespread outbreaks in major league sports leagues, for instance.

Do we think that this is mostly the Delta surge that we’re seeing across the Midwest and Northeast?  Or is this believed to be that plus Omicron?

And do you think, overall, that we need to be, in essence, locking down a little bit again?  Should employers, should schools be taking the precautions that we’re seeing, or are they overreacting?

Thank you.

MR. ZIENTS:  Dr. Walensky?

DR. WALENSKY:  Yeah, maybe I’ll start, Josh, and just say, you know, our guidance from the CDC has actually been very clear as to what we should be doing in preventing these cases from happening.

Of course, as we’ve been saying, getting vaccinated, getting boosted, especially with emerging data that the boosts will really be helpful, both with regard to Delta, but also with regard to Omicron. 

But also, our masking guidance has actually not changed in areas of substantial or high transmission.  We should be having public indoor masking for everyone, vaccinated or unvaccinated; that is 90 percent of the counties right now.  Adding ventilation, adding distancing and hand washing — all of those continue to hold and continue to serve us very well in preventing disease.

And we would just encourage local jurisdictions to employ the interventions that we know work.

MR. ZIENTS:  Yeah, I would just add, consistent with what Dr. Walensky just said: You know, we have the tools to fight this virus, including Omicron.  And we’re in a very different and stronger place than we were a year ago.  And there’s no need to lock down. 

We have effective vaccines Dr. Fauci just talked about, including against Omicron.  We have booster shots for all adults.  We have now a vaccine for kids age 5 and 11.  That means we now have vaccines for 95 percent of Americans.

We know how to keep our kids in school and our businesses open, and we’re not going to shut down our economy in any way.  We’re going to keep our schools and our businesses open.

Next question.

Q    Let’s go to Serena Marshall at NowThis News.

Q    Thank you so much for doing this.  I was wondering —

MR. ZIENTS:  Hey, Serena, you’re cutting out.

Q    Can you hear me now?

MR. ZIENTS:  We’re having trouble hearing you.

Q    (Inaudible.)

MODERATOR:  Hey, Serena, we’ll just get back to you.  Let’s go ahead and go to our last question.  Let’s go to Brenda Goodman at WebMD.

Q    Can you hear me now?


Q    Americans are really tired, and there’s kind of a feeling of exhaustion out there from people that I’m talking to.  You know, we’re heading into our third year, and Omicron is just right around the corner.  And I think people are trying to read a really confusing set of tea leaves — you know, it’s more transmissible; the illness it causes may be less severe, particularly if you have some kind of underlying immunity.

So given all this complex stew of factors — and I know you’ve been looking at all of them — how worried should Americans be about Omicron, which is — you know, could be causing a surge, we’ve heard, around, you know, January or so?

MR. ZIENTS:  Dr. Fauci?

DR. FAUCI:  Yeah.  Well, again, getting back to the theme that we have all been underscoring: If you are unvaccinated, you are very vulnerable, not only to the existing Delta surge that we are experiencing, but also to Omicron.

And when you hear about Omicron being less severe or not, and you hear about those other things, it doesn’t matter: If you are unvaccinated, you need to get vaccinated to diminish your vulnerability, and if you are vaccinated, to get boostered.

It is very difficult to predict — as you say, to read the “tea leaves.”  So if you can’t read the tea leaves accurately, then do the things that we’ve been recommending — all of the recommendations from the CDC about prudence and wearing masks in indoor crowded places that are public settings, but also continue to understand the importance for yourselves and your families and your community of getting vaccinated.

Those are the tools we have.  If we didn’t have these tools, I would be telling you to really, really be worried.  But we have tools.

So, get vaccinated, get boosted, and the alleviation of the concern, even though we take all of this very seriously.

Back to you, Jeff.

MR. ZIENTS:  Good.  Well, thank you, everybody.  We look forward to the next briefing.

11:49 A.M. EST

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