While struggling to get Americans vaccinated, health experts reveal need for a third COVID shot

Jeff Zients, coordinator of the White House COVID-19 Response Team; Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases; Dr. Vivek Murthy, U.S. surgeon general; and Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention take part in a COVID-19 teleconference. – The Dallas Examiner screenshot/White House video

 

By DIANE XAVIER

The Dallas Examiner

 

With the rise of COVID-19 cases in the United States due to the Delta variant, the White House COVID-19 Response Team and Public Health Officials held a teleconference on Aug. 18, which recommended the public get booster shots for those already fully vaccinated.

The conference featured Jeff Zients, coordinator of the White House COVID-19 Response Team; Dr. Vivek Murthy, United States surgeon general; Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention; and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical advisor to President Joe Biden.

Zients began by pointing out that recent data has shown a rise in cases caused by the Delta variant, with cases located in areas that have lower vaccination rates.

“So this remains a pandemic of the unvaccinated,” Zients said. “We know getting more people vaccinated is the best way to end this pandemic. Thanks to our relentless efforts to get more shots in arms, we are making progress. In the last two weeks alone, nearly 7 million Americans have rolled up their sleeves and gotten their first shot. Seven million. That’s the highest two week total since the beginning of June. Over the past month, we’ve also seen a 75% increase in the average daily number of 12- to 15-year-olds getting vaccinated, particularly important as adolescents begin going back to school.”

Currently, 200 million Americans have received their first dose of the vaccine.

“Two hundred million Americans with at least one shot,” Zients concluded. “That’s a major milestone. Americans across the country are continuing to step up, do their part, and get vaccinated. We are using every lever at our disposal to fight the virus, including by ensuring state and local leaders have the tools and the resources they need to get more shots in arms and to respond to any outbreaks caused by Delta.”

The COVID-19 Surge Response Teams consist of experts and personnel and resources from Health and Human Services, the Center for Disease Control and Prevention, FEMA, the Department of Defense and the Department of Veteran Affairs.

“These Surge Response Teams are now working with 16 states to address their particular needs from deploying hundreds of personnel to provide medical care, to standing up free testing sites, to surging critical assets like ventilators and ambulances to strained health systems, to getting shots in arms, including through the use of mobile clinics, to sending and supporting the use of lifesaving treatments,” Zients stated. “We will continue working closely with states to do all that we can and to match resources to their needs.”

Zients said that Biden is committed to helping the American people and that he would do everything in his power to end this pandemic.

“From his first day in office, the president has marshalled a wartime effort to do exactly that,” he said. “We’ve been preparing for every scenario, including the potential need for vaccine booster shots. Our approach on booster shots is simple, and it’s consistent with our approach on every other front of this war, and that is to be guided by the science, and always, always stay one step ahead of the virus.”

 

Planning for booster shots

Afterwards, Murthy offered an update on booster shots in the U.S.

“Our top priority has always been protecting people and their families from COVID-19,” Murthy said. “We have been fortunate to have safe and effective vaccines that offer outstanding protection against the worst outcomes of this virus such as severe disease, hospitalization and death. The COVID-19 vaccines that are authorized in the United States have been remarkably effective, even against the widespread Delta variant. But we know that even highly effective vaccines become less effective over time. Our goal has been to determine when that time might come for the COVID-19 vaccines so we can make a plan to take proactive steps to extend and enhance the protection the vaccines are giving us.”

Murthy continued saying that after having reviewed the latest data on the virus situation in the country, it is time to plan for COVID-19 boosters.

“Recent data makes clear that protection against mild and moderate disease has decreased over time,” he said. “This is likely due to both waning immunity and the strength of the widespread Delta variant. Even though this new data affirms that vaccine protection remains high against the worst outcomes of COVID, we are concerned that this pattern of decline we are seeing will continue in the months ahead, which could lead to reduced protection against severe disease, hospitalization, and death. That is why we are announcing our plan to stay ahead of this virus by being prepared to offer COVID-19 booster shots to fully vaccinated adults 18 years and older. They would be eligible for their booster shot eight months after receiving their second dose of the Pfizer or Moderna mRNA vaccines. We plan to start this program the week of Sept. 20.”

Murthy discussed the FDA’s role regarding booster shots.

“This plan is pending the FDA conducting an independent evaluation of the safety and effectiveness of a third dose of the Pfizer and Moderna mRNA vaccines and the CDC’s Advisory Committee on Immunization Practices issuing booster dose recommendations based on a thorough review of the evidence,” Murthy said. “The plan ensures that people who were fully vaccinated earliest in the vaccination rollout will be eligible for a booster first. This includes our most vulnerable populations, like our health care providers, nursing home residents and other seniors. We will also begin delivering booster shots directly to residents of long-term care facilities.

“For people who received the Johnson & Johnson vaccine, we anticipate vaccine boosters will likely be needed. The J&J vaccine was not administered in the U.S. until March of 2021, and we expect more data on J&J in the coming weeks. With those data in hand, we will keep the public informed with a timely plan for J&J booster shots.”

He said the decision to offer booster shots was rigorously researched after consulting with top public health experts and with the Department of Health and Human Services.

“It was informed by data, thoughtful analysis, and by our collective years of experience addressing illness and epidemics,” Murthy said. “As always, we will continue to follow the science on a daily basis, and we’ll take whatever steps are necessary to protect our nation from COVID-19. This plan to administer booster doses does not change our commitment to vaccinating those who are not yet vaccinated here in the U.S. and around the world. The overwhelming majority of hospitalizations and death continue to occur among the unvaccinated.  We will continue to ramp up efforts to increase vaccinations here at home and to ensure people have accurate information about vaccines and access to vaccinations. We will also continue to expand our efforts to increase the supply of vaccines for other countries, building on the over 600 million doses we have already committed to donate globally.”

Murthy said that it is important to work with other nations in ending this pandemic.

“We understand well that global pandemics require a global response and strong leadership,” he said. “We will not stop until America and the world are vaccinated against COVID-19. I’m speaking to you today as your Surgeon General, but most importantly as a fellow American who has felt the pain of losing family members to this disease and who hears, each day, the stories of people whose lives have been upended and forever altered by COVID-19 such as the brave doctors and nurses in our hospitals, the teachers working to get our kids back to school, and the frontline workers who have put themselves on the line to make sure we can get groceries and supplies. We all want this pandemic to be over. Right now, our quickest path to getting COVID-19 under control, once and for all, is getting vaccines to those who need them as quickly as possible.”

Murthy summarized for those that are fully vaccinated that they still have a high level of protection from the worst-case scenarios of the virus which include severe disease, hospitalization and death.

“We are not recommending that you go out and get a booster today,” he said. “Instead, starting the week of September 20, fully vaccinated adults could begin getting their booster shots eight months after their second shot of an mRNA vaccine. All of us must do everything we can to protect our communities from COVID-19. That means encouraging our family and friends, our patients and students, our coworkers and neighbors to get vaccinated. That is our path to ending this pandemic.”

 

Taking swift action

Walensky then presented some data that helped inform the response team to take action fast.

“Recognizing that for most vaccines, there is a reduction in protection over time, we have been analyzing the data closely from a number of cohorts in the United States and around the world to understand how long protection from the initial COVID-19 vaccine series will last,” she said. “Examining numerous cohorts through the end of July and early August, three points are now very clear. First, vaccine induced protection against SARS-CoV-2 infection begins to decrease over time. Second, vaccine effectiveness against severe disease, hospitalization and death remains relatively high. And third, vaccine effectiveness is generally decreased against the Delta variant.”

Walensky said that the CDC has published data from the National Healthcare Safety Network, which is a nursing home cohort where they analyzed over 85,000 weekly reports in over 14,900 facilities nationwide.

“Weekly COVID-19 case counts were used to evaluate vaccine effectiveness over time. These data demonstrate that vaccine effectiveness declined over time, from 75% in March, to 53% as recently as August 1,” she said. “This represents a substantial decline in vaccine effectiveness against infection among those who are most vulnerable, including during months where Delta was the predominant circulating variant. Taken together, you can see that while the exact percentage of vaccine effectiveness over time differs depending on the cohort and settings study, the data consistently demonstrate a reduction of vaccine effectiveness against infection over time. Importantly though, despite waning vaccine effectiveness against infection, data analyzed through July continued to demonstrate the stable and highly effective protection against severe illness and hospitalization for people who are vaccinated. Included in the same reports described before, data from New York State and Mayo Clinic also show that vaccine effectiveness against hospitalization remains relatively high, both over time and during periods when the Delta variant was surging.”

She stated that the CDC has published data from the IVY network, which looks at data of over 3,000 adults admitted to 21 hospitals across 18 states, between the periods of March and the middle of July.

“This report compares vaccine effectiveness against hospitalizations early after vaccination, within 2 to 12 weeks, and later after vaccination, between 13 and 24 weeks, and found that vaccine effectiveness against hospitalization remained high.  However, in this study, only about 7% of samples sequenced were the Delta variant. Taken together, these data confirm that while protection against infection may decrease over time, protection against severe disease and hospitalization is currently holding up pretty well. To be clear, our top priority is to save lives and prevent severe infections. Our plan is to protect the American people and to stay ahead of this virus. While we are still learning about how these vaccines perform over time and how long they will last against emerging variants, one thing is very clear, getting vaccinated can keep you out of the hospital and getting vaccinated can save your life. In areas with low vaccination coverage, we continue to hear far too many heartbreaking stories of people who did not get vaccinated only then to get severe COVID-19. In these areas, the data are showing us that the more people who are in the hospital, and tragically, more people are dying of COVID-19.”

She said that the U.S. is currently averaging over 500 COVID-19 deaths per day.

“If you are still unvaccinated, please get vaccinated,” she said. “The single best action you can take to protect yourself and others is to simply get vaccinated in the first place.”

 

Vaccines for everyone

Finally, Fauci explained why a third booster mRNa immunization is necessary.

“First, antibody levels decline over time and second, higher levels of antibody are associated with higher levels of efficacy of the vaccine,” Fauci said. “Third, higher levels of antibody may be required to protect against the problematic Delta variant and finally, a booster mRNA immunization increases antibody titers by at least tenfold and likely much more. All of this supports the use of a third booster mRNA immunization to increase the overall level of protection.”

Zients then stated that Biden’s goal is to get every American that needs a booster shot, available.

“Pending FDA and ACIP approvals, boosters will be available starting the week of September 20 and the plan is to get your booster shot eight months after you got your second shot,” Zients said. And thanks to the aggressive actions we have taken to establish our vaccination program, it will be just as easy and convenient to get a booster shot as it is to get a first shot today.”

Zients said that the U.S. has enough vaccine supply for every American.

“You’ll be able to get a booster at roughly 80,000 places across the country, including over 40,000 local pharmacies,” he said. “In fact, 90% of Americans have a vaccine site within five miles of where they live. Importantly, boosters will be free, regardless of immigration or health insurance status and no ID or insurance is required. So the bottom line is that we are prepared for boosters and we will hit the ground running.

As we continue to vaccinate Americans, we will maintain our focus abroad, as we know this virus knows no borders.”

Zients stated that the government has shipped more than 115 million vaccine doses to over 80 different countries and that the U.S. has more vaccine doses donated than all the other countries in the world combined.

“Just this week, we started shipping the half a billion Pfizer doses that the U.S. pledged to purchase and donate to 100 low and lower-middle-income countries in need,” Zients said. “In the coming weeks and months, we will do even more to lead the global vaccination efforts, accelerating our work to build vaccine manufacturing and production capacity both here in the U.S. and in other countries. Our wartime effort will continue doing everything we can to get even more people vaccinated both here at home and around the world. We can and must do both at the same time because that’s what it’s going to take to end this pandemic. We will not stop until we get the job done.”

 

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