Via Teleconference

11:06 A.M. EST

MR. ZIENTS:  Good morning.  And thanks for joining us.

Today, Dr. Walensky will give an overview of the state of the pandemic and on new practices that will help keep schools open, and Dr. Fauci will provide an update on the latest science and the importance of boosters.

But before we start, I want to talk about how we should think about this moment.

As we’ve explained in prior briefings, the Omicron variant is more transmissible and our medical experts anticipate it will lead to a rise in cases.

But unlike last winter, we now have the power to protect ourselves.

Our vaccines work against Omicron, especially for people who get booster shots when they are eligible.  If you are vaccinated, you could test positive.  But if you do get COVID, your case will likely be asymptomatic or mild.

We are intent on not letting Omicron disrupt work and school for the vaccinated.  You’ve done the right thing, and we will get through this.

For the unvaccinated, you’re looking at a winter of severe illness and death for yourselves, your families, and the hospitals you may soon overwhelm.

So, our message to every American is clear: There is action you can take to protect yourself and your family.  Wear a mask in public indoor settings.  Get vaccinated, get your kids vaccinated, and get a booster shot when you’re eligible.

We are prepared to confront this new challenge.   We have plenty of vaccines and booster shots available at convenient locations and for no cost.  There is clear guidance on masking to help slow the spread.  And we have emergency medical teams to respond to surges as necessary.

So, this is not a moment to panic because we know how to protect people and we have the tools to do it.  But we need the American people to do their part to protect themselves, their children, and their communities.

The more people get vaccinated, the less severe this Omicron outbreak will be.  One hundred sixty thousand unvaccinated people have already needlessly lost their lives just since June, and this number will continue to go up until the unvaccinated take action.

So, I’ll say it once more: Get vaccinated.

With that, I’ll turn it over to Dr. Walensky.

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

The current seven-day daily average of cases is at about 119,500 per day.

The seven-day average of hospital admissions is at about 7,800 per day, an increase of about 4 percent over the previous week.

     And the seven-day average of daily deaths is at about 1,200 per day, which is an increase of over 8 percent from the prior week.

Now let me bring you up to date on what we know about Omicron.  At least 39 states and over 75 countries have reported confirmed cases of the Omicron variant.

And although Delta continues to circulate widely in the United States, Omicron is increasing rapidly and we expect it to become the dominant strain in the United States, as it has in other countries, in the coming weeks.

We’ve seen cases of Omicron among those who are both vaccinated and boosted, and we believe these cases are milder or asymptomatic because of vaccine protection.

What we do know is we have the tools to protect ourselves against COVID-19.

We have vaccines, we have boosters, and we know multi-layer prevention strategies — masks in public indoor settings, practicing physical distancing, frequent handwashing, improving ventilation, and testing to slow transmission — are vitally important, especially as we prepare for more Omicron and even if you are vaccinated and boosted.

This morning, I want to talk with you now about how we can use these tools to help keep our children in school.

Over the past few months, CDC has collaborated with school districts across the country to evaluate a new strategy known as “test to stay.”

     Today, we’re releasing CDC science on “test to stay” that allows unvaccinated children to stay in school even if they have been exposed to the virus so that they don’t have to miss school while they’re quarantining at home.

In the test-to-stay protocol, there is increased testing of close contacts after a COVID-19 exposure, and that testing needs to be at least twice during the seven-day period after exposure. If exposed children meet a certain criteria and continue to test negative, they can stay in school instead of quarantining at home.

CDC is also releasing two MMWR reports with evidence supporting the use of “test to stay” and how well it worked in two communities: Lake County, Illinois, and Los Angeles County.

These studies demonstrate that “test to stay” works to keep unvaccinated children in school safely.

In order for “test to stay” to be implemented safely and correctly, some key prevention measures need to be included. 

In both of these studies, masks were worn consistently and correctly, close contacts of a positive case were monitored for symptoms and stayed home if they became ill, and those who did not develop symptoms had regular testing.  

“Test to stay” is an encouraging public health practice to help keep our children in school.  And CDC is updating our materials to help schools and parents know how to best implement this promising and now proven practice, along with our multi-layer prevention strategies that will help keep our children in the classroom safely.

Importantly, vaccination is another critical piece in our multi-layer prevention strategies to protect our children from COVID-19.

I’d like to take another moment to encourage parents to get their children vaccinated.

Just yesterday, CDC’s Advisory Committee on Immunization Practices met to discuss new safety data following six weeks of COVID-19 vaccinations in children between the ages of 5 to 11.

We now have experience vaccinating over 20 million children under the age of 17, and over 5 million of whom are under the age of 11.

Looking specifically at vaccine safety data from over 50,000 children 5- to 11-year-olds, we found no evidence of serious safety concerns.

The most common reported side effect including pa- — included pain at the injection site, fever, tiredness, and headaches/muscle aches, which we know are normal and are all signs of the body — that the body is building immunity to the virus.

This further adds to the strong evidence of the safety of these vaccines for children and should be an encouraging reason for those who are waiting for more data to now feel confident in making the decision to get your child vaccinated. 

In addition to reviewing safety data yesterday, CDC’s advisory committee on vaccine experts met to evaluate recommendations surrounding the Johnson & Johnson COVID-19 vaccine, evaluating the benefits of vaccination, the safety data and rare adverse events, and the COVID-19 vaccine supply.

Following their discussion, ACIP made a recommendation to preferentially use mRNA vaccines over the Johnson & Johnson vaccine.

And I endorsed their recommendation and agreed with the Advisory Committee’s emphasis, importantly, that given the current state of the pandemic both here and around the world, any vaccination is better than no vaccination.  Individuals who are unable or unwilling to receive an mRNA vaccine will continue to have access to Johnson & Johnson COVID-19 vaccines.

And, finally, as we head into the holiday season, when many will be gathering with their loved ones, I want to again encourage everyone to utilize the proven prevention strategies that keep everyone safe: get vaccinated and get boosted, mask in public indoor settings, physical distancing, handwashing, improve ventilation, and testing to slow transmission.

We know that these strategies work and will help to keep you and your loved ones safe and healthy this holiday season. 

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

DR. FAUCI:  Thank you very much, Dr. Walensky.  I’d like to spend the next couple of minutes talking about the importance of COVID-19 booster shots, both in the current Delta surge and in the evitable upcoming Omicron surge.

So, if I could have the next slide.

Let’s take a look at some of the data that fortifies what I just said.  This is a recently published study in the New England Journal looking at individuals 50 years of age or older who received the booster about five months after a second dose of the Pfizer-BioNTech.  There was a 90 percent lower mortality due to COVID-19 than participants who did not receive a boost. 

Now, albeit, the mortality is low in people who are vaccinated anyway.  However, it goes down to practically negligible values — if you look at the blue line, compared to the pink line.

Next slide.

Now let’s take a look at Omicron-specific situations.  In this study, one looked at three separate vaccines: the mRNA of Moderna, the Pfizer, and then the Ad26 J&J followed by an mRNA boost.  Again, if you look at the “times two,” which means a standard vaccination, and then take a look at the pseudovirus neutralization following the boost, the increment of that is really rather profound: 19 times for the one on the left, 27 times for the one in the middle, and 4 times for the one on the right.

Next slide.

Now, also, if you look at the neutralization of multiple different variants by pseudovirus analysis and take a look again at two separate studies — one from the Vaccine Research Center at NIH and one from Duke University.  Note, on the left panels, four weeks following the second dose.  Look specifically at the pink bar.  There you see a rather low level of neutralization with Omicron. 

However, if you look at two weeks post the third, or booster dose, note how much it goes up.  For example, if you look at the Omicron comparing in the Duke line: You see it is about 2002, whereas after a second dose it’s only 62 — a dramatic increase. 

Next slide.

Another example: if you look at the sensitivity of variants to neutralization by people who are vaccinated with the Pfizer vaccine.  If you look again, five months after the second dose, and look under the Omicron — the red circles — nominal.  In other words, virtually no degree of neutralization protection.  Again, one month after the third dose, it goes well within the protective range.

Next slide.

If you look at now convalescent serum, and take a look at each of the panels.  On the left, you have a convalescent serum six months after infection.  Again, the level of protection that would be projected from the antibody levels is very low — as you see with Omicron, pretty low level with these circles that are red.  Twelve months later, it even gets worse. 

But take a look at what happens if you take a person who’s convalescent but you boost that person now with a dose of Pfizer and wait one month.  The red circles go way up into the protective range.

Next slide.

And then if you look at actual clinical issues — take a look in a UK study about individuals who had a — who had symptomatic infection.  Look at Delta in the blue boxes.  As you go — the time since the vaccine and look at the weeks, which are showed on the bottom line, you get a diminution against Delta but a very profound diminution — below 40 percent effectiveness with Delta.  When you boost, not only do you bring it up to Delta — in the blue — but also to Omicron.

What does all of this tell us? 

Last slide.

We are in the — in a situation where we are now facing a very important Delta surge and we are looking over our shoulder at an oncoming Omicron surge.  Clearly, unvaccinated individuals, as Jeff said in the beginning, are really at a high risk of serious involvement, including hospitalization.  The fully vaccinated are doing much better off.  But as I’ve shown you in the previous five or six slides, the optimum protection is fully vaccinated plus a boost. 

So the bottom line of what we’ve been telling you all along: It is critical to get vaccinated.  If you are vaccinated, it is critical for optimal protection to get boosted.

Back to you, Jeff.

MR. ZIENTS:  Well, thank you, Doctors.

With that, let’s open it up for some questions.  Over to you, Kevin. 

MODERATOR:  Thanks, Jeff.  Let’s go back to Serena Marshall from NowThis.

Q    Thank you. I appreciate you doing this and coming back to me right away.  So, I just wanted to — for some clarity:  Are we seeing Delta at — would seem to be more infectious, but is there evidence with the breakthrough infections that they’re more severe in any way? 

Is there any evidence to — that you could talk about with long COVID?  We’ve seen some new data that roughly 30 to 40 percent of anyone who tests positive have resulted in long COVID as well.  And there’s a lot of unknowns when it comes to how that’s going to play out.

MR. ZIENTS:  Why don’t we start with you, Dr. Fauci.

DR. FAUCI:  Well, I think you meant to say “Omicron.”  Yes, Omicron is more transmissible.  Everything we know about it, from what we’re seeing not only in South Africa, but its distribution throughout the world and as well as in our own country — we see what’s going on in New York City, when we’re getting beyond double digits of Omicron being the primary variant there in that percentage.

With regard to the seriousness of infection: Really, it’s still up in the air right now because there are a lot of confounding issues as to whether or not it is less severe.  Certainly, looking at what we see, it does not look like it is more severe, but we have to hold with — withhold judgment about the severity being less.

With regard to long COVID: We don’t have enough information on Omicron with regard to long COVID.  I would not expect it’s going to be any different than we have with Delta, but we’ll have to wait to see until we get more experience.

MR. ZIENTS:  Next question, please.

Moderator:  Let’s go to Cheyenne Haslett at ABC News.

Q    Thanks, guys.  My first question, for Dr. Fauci, you showed data showing how little protection people have after two doses a few months after getting it.  So, should Americans who are not eligible for their booster yet — not six months past their last shot — be concerned that they’re not well protected against Omicron and get boosted sooner than six months?

And then, my second question on our booster rate still being very low — only 30 percent of the fully vaccinated — how concerning is that as we head into this larger surge?

DR. FAUCI:  Well, let me answer the second one first, and that is the concern.  I mean, obviously that’s the reason why I have spent essentially my entire brief presentation on urging people to get boosted: for the simple reason that we do get optimal protection from a boost.

You mentioned the lowering of protection.  And if you look at some of the slides I showed — a, quote, “fully vaccinated” person, after a period of time, clearly has a diminution.

You still get protection that’s reasonably good against hospitalization.  We want to make that better with the booster. Whether or not we’re going to change what the time interval between your last vaccination and your boost, we always have these on the table for discussion, but, right now, there has not been a decision on that.

MR. ZIENTS:  The right way to think about the percent boosted is those eligible, and we’ve now boosted about 60 million Americans.  That’s about 40 percent — 4-0 percent — of the eligible Americans.

Importantly, of those over 65, we’re now more than 60 percent, and that’s important because they are the most vulnerable.

We are boosting about a million people a day.  So, booster shots are running at a million per day.  And that is accelerated from where we were, as Dr. Fauci said, stressing the importance of getting the boost when people are eligible.

And the President’s Winter Plan really builds momentum here.  Pharmacies are expanding appointments and hours and walk-in availability.  We’re launching, as you know, family vaccination sites where parents can get boosted at the same time that their 5- to 11-year-old might get their first or second shot. 

Medicare is reaching out to tens of millions of seniors, encouraging them to get boosters. 

So, our message is very clear.  Clinically, the docs have said: As soon as you’re eligible for a booster, get a booster.  We have plenty of supply.  We now have 90,000 sites — up another 10,000 from a few weeks ago — 90,000 sites that are convenient.  And, as you know, getting a booster shot is free and everyone should get their booster shot as soon as possible.

Next question.

MODERATOR:  Let’s go to Elizabeth Weise at USA Today.

Q    Okay.  This would be a question for Dr. Walensky.  In light of Omicron’s higher transmissibility rate, potentially including people who are vaccinated, is the CDC reconsidering its recommendations that vaccinated people don’t need to self-isolate after an exposure to someone who has COVID?

DR. WALENSKY:  Thank you for that question.  We are actively following the science in that area with regard to how the viral burden is, both among vaccinated people and unvaccinated people, and the natural history of that viral burden with regard to isolation.  And as that science emerges, we will update our evidence if need be.

MR. ZIENTS:  Next question.

MODERATOR:  Let’s go to Weijia Jiang at CBS News.

Q    Thank you, Kevin.  First, I have a question for Dr. Fauci.  I wonder if Omicron is more transmissible just because the nature of the variant or because the booster and vaccine offer less protection against contracting Omicron compared to other variants — or a mix of both?

And for Dr. Walensky, given your new recommendation for students to test to stay, does that extend to adults who are exposed too — that a 14-day quarantine is no longer necessary as long as you test negative? 

And when you say “continue to test negative,” how often should kids be getting tested to stay in school after exposure? 


MR. ZIENTS:  Dr. Fauci?

DR. FAUCI:  Well, with regard to the first question, if you look at the configuration and the constellation of amino acid substitutions which result from mutations on the spike proteins, you would have predicted that this would be a more transmissible virus because of its ability to bind to the receptors on the cell.

So, you need only look at the virus itself to determine why it is more transmissible — what it actually is.

MR. ZIENTS:  Dr. Walensky?

DR. WALENSKY:  Yeah, with regard to test to stay, so this was a strategy that looked at unvaccinated children because vaccines were not available.  Of course, in our school setting, we would encourage that all of our teachers who would be eligible would both be vaccinated as well as boosted. 

With regard to the protocols, there are numerous jurisdictions that are looking at test-to-stay strategies.  Some of them are — were testing every day; some of them, every other day; and some of them, twice a week. 

So, we would say no less frequent than twice a week, in order to employ the test-to-stay protocols. 

And these were limited to schools, to be clear, so we don’t yet have evidence about test-to-stay protocols in other settings.

MR. ZIENTS:  Kevin, next question.

MODERATOR:  Let’s go to a last question.  Sabrina Siddiqui at The Wall Street Journal.

Q    Thank you so much.  Just two quick questions.  France has imposed travel restrictions on the UK, and several other EU countries are also strengthening their border controls.  Are you reconsidering travel from either the UK or the EU, given the COVID outbreaks there?

And then, secondly, I know we’re in a very different place with vaccines and boosters than we were last year, but how would you characterize your message to the American people going into the holidays?  Is it safe for families and friends to get together before Christmas?  And what is your message to people as we approach the holiday season?

MR. ZIENTS:  So, why I don’t take the first question, and then I’ll hand it over to Dr. Walensky about the holiday season. 

Let me start with the fact that the U.S. has strict protocols in place to help protect the American people and stop the spread of the disease, as it relates to international travel.

Foreign nationals — all foreign nationals coming into the U.S. from a part of the world where the travel is not restricted due to Omicron must be fully vaccinated and show proof of a negative test.  And we’ve tightened that deadline for the timeframe for the negative test to be within one day of boarding a flight.

The CDC also strongly recommends that everyone get tested three to five days after they arrive in the U.S. 

But as we’ve done throughout the pandemic, we will continue to follow the science and evaluate the best protocols for international travel, and we’ll keep people up to date and, most importantly, the American people safe.

Dr. Walensky?

DR. WALENSKY:  Yeah.  As you know, Sabrina, I think we’re in a very different place this year than we were last year, and we really do want people to be able to gather and gather safely.  We have the tools now to do it.  And what we’re really saying is: Please, rely on those tools. 

Get vaccinated.  If you’re eligible for a boost, get boosted. 

And importantly, a week before the holidays, indoor mask in these areas that have — 90 percent of our counties have substantial or high transmission.  Use the next week to make sure you’re practicing those safe prevention/mitigation strategies so that when you come together for the holidays that people have been not exposed to the virus because, in fact, they’ve been vaccinated, boosted, and masked.

And for that extra reassurance as we have more disease in this country right now, do a test and make sure that you’re negative before you mix and gather in different households.

MR. ZIENTS:  Okay.  Well, thank you.  We look forward to speaking next week.  But I hope everybody has a safe and relaxing weekend. 

Thank you.

11:38 A.M. EST

To view the COVID Press Briefing slides, visit:

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