Anthony Stephen Fauci, Andrew M. Slavitt, and Rochelle Paula Walensky

“ While we are starting to see emerging evidence that the vaccines remain effective against circulating variants and that the risk of breakthrough infections in vaccinated persons and spreading the virus to others is low, we must be resolute in our efforts to fully answer these critical questions. When answered, they will inform the future guidance that will enable us to safely resume activities, while also protecting others who remain vulnerable to this disease. ”

“ Take, for example, individuals who have immunodepression either by a disease or iatrogenically by a drug.
We may show that the level of immune response is good, but that the durability of that might be different because of the compromise of the immune system in these individuals.
And then, we want to know: What is the efficacy of vaccination on reducing disease and transmission in certain special populations? There may be a difference between them and individuals in what we refer to as the “normal adult population.” ”

“ Is that going to speed how quickly we can get every American vaccinated?And secondly, I know you guys have talked before about when we’re going to get to the point where we have more supply than demand for the vaccine, and I wondered if you are seeing any areas yet where we are approaching that. I know there’s been reports from places like Louisiana, and Alabama, some of the Carolinas, where there seems to be more supply than demand in the states than have been expanding their population of who’s eligible. ”

“ The age range that is currently authorized for the SARS-CoV vaccination, as you well know, is 18 and older from Moderna, 16 for Pfizer, and 18 for J&J. There are vaccine safety and immunogenicity studies in adolescents and children that are either ongoing and/or planned.
For example, Pfizer-BioNTech’s study in persons aged 12 to 15 is fully enrolled, as is the teen COVE study from Moderna in individuals 12 to 17. ”

“ We also reiterate that in other scenarios, including public settings and travel, people who have been fully vaccinated should continue to wear masks and practice safe public health prev- — precautions, just like people who have not yet been vaccinated.
In addition, the commentary includes information about the scientific basis for CDC’s new recommendations that balance the risk of fully vaccinated individuals with the risk of infection and spread among the still 90 percent of the American public not yet protected by a COVID-19 vaccine. ”

“ I want to also mention that we don’t want to get too hung up on reaching this endgame of herd immunity because every day that you put 2 million to 3 million vaccinations into people makes society be more and more protected. ”

“ And then, importantly, there are immunocompromised individuals — those who have immunosuppressive medical conditions, either primary immunodeficiencies or acquired immune deficiencies, such as HIV — or individuals who are receiving immunosuppressive treatment or chemotherapy. That could be either due to an underlying neoplasm or, maybe even more frequently, to individuals with one form or another of an autoimmune disease requiring suppression of a hyperactive immune system. It’s estimated that about 3 percent of U.S. adults fall within that category. ”

“ We’re doing vaccine confidence consult: if people have challenges, in terms of vaccine hesitancy, how can we address those challenges.There’s a lot of work going on so that we can actually delay the period of time where people don’t want the — you know, where we have that inflection point. We want to have a lot of vaccine out there and we want to have a lot of people who want it. ”

“ America leads the world in total vaccinations. On June — January 20th, there was a seven-day average of 890,000 shots per day. And today, we’re averaging above 2 million shots per day. On Saturday, we set an all-time, single-day record: nearly 3 million Americans vaccinated — a pace seen nowhere else in the world. ”

“ First of all are pregnant individuals. There are about 3.7 million births in the United States in 2019. Then there are adolescents and children — a very important topic when we think in terms of schools and the protection of children. There are about 73 million individuals between the ages of birth and 18 years. ”

“ Now, there are also trials in younger children which will follow — referred to, for example, as the Moderna “Kid-COVE” study. And as I mentioned previously, J&J is also planning studies in pediatrics. Next slide.
And then on this last slide, just a couple of other considerations. People with HIV — questions we get asked all the time. People with stable HIV infection are included in the trials, although the data are limited. The HHS guidelines for HIV recommend that people with HIV should receive the SARS-CoV-2 vaccine because the potential benefits certainly outweigh the potential risks. ”

“ We don’t know what that number is, but you can calculate based on, for example, extrapolations from diseases like measles and the vaccine protection of measles and the transmissibility of measles — which is very, very high. The herd immunity level for measles is around 90 percent. Once you get into the 80s, then you could start getting into trouble. ”

“ Maybe I’ll just add that the point of — incredibly important that these are local rates as well, so if you have a population rate that is 85 percent protected across the country but a community that’s only 50 percent protected, you can have outbreaks in that community. And so really we need this level of protection pervasive across all communities across the country. ”