Joe Biden

Press Briefing by White House COVID-19 Response Team and Public Health Officials

April 23, 2021

Via Teleconference

11:01 A.M. EDT

MR. ZIENTS: Good morning, and thank you for joining us. Today, Dr. Walensky will provide an update on the state of the pandemic, Dr. Fauci will highlight the latest science, and Dr. Murthy will share an update on our efforts to strengthen vaccine confidence.

But first, I want to step back to provide an overview of where we are in our vaccination program, and where we're headed as we enter our next phase.

Our vaccination efforts to date have focused on significantly increasing the pace of vaccination. That required creating the infrastructure -- the people and the places -- for a first-of-its-kind nationwide vaccination program. It also meant creating sufficient vaccine supply that did not previously exist.

We have seen these efforts pay off. We have 75,000 places for Americans to get vaccinated. Importantly, now 90 percent of all Americans live within five miles of a vaccination site. By the end of May, we'll have enough vaccine supply for every adult who wants one.

And thanks to President Biden's directive, everyone 16 and over is now eligible to get a vaccine. And as we announced on Wednesday, we delivered 200 million shots in less than 100 days -- an incredible American achievement.

This crucial milestone of 200 million shots in less than 100 days enabled more than 52 percent of adults across the country to have at least one shot. That's more than 135 million Americans who are on their way to being protected from this virus. And more than 80 percent of invidid- -- individuals -- sorry -- 65 years and older now have at least one shot.

Importantly, seniors accounted for 80 percent of COVID deaths. But now, we've seen an 80 percent reduction in deaths and a 70 percent reduction in hospitalization among seniors, proving just how effective vaccination is in preventing death and severe disease.

This significant progress in a short period of time is a direct result of our deliberate, whole-of-government, wartime effort.

So where do we go from here? The next phase of our vaccination program has four key areas of focus. First, we will continue to vaccinate millions of Americans each day. As you can see on our vaccination report, our current seven-day average is 2.9 million shots -- nearly 3 million shots per day.

Going forward, we expect daily vaccination rates will moderate and fluctuate. We've gotten vaccinations to the most at-risk and those most eager to get vaccinated as quickly as possible. And we will continue those efforts, but we know reaching other populations will take time and focus.

Second, we will continue to increase accessibility and make it easier and easier for Americans to get a shot. I noted a moment ago that 90 percent of Americans have a vaccine site within five miles of where they live. And we are working with states, businesses, doctors, local pharmacies, and other partners to make it even easier for people across the country to get vaccinated.

We took a very important step on this front earlier this week by calling on all employers to give paid time off for vaccination, and announcing a tax credit for small- and medium-sized businesses to do this more easily. No one should lose a single dollar from their paycheck in order to get vaccinated.

Further, just as employers are effective at helping Americans get vaccinated, so too are doctors. People look to their doctors for medical information and advice. Estimates show that about 90 percent of doctors have gotten at least one shot, which makes doctors a powerful and important messenger.

We are working with doctors to encourage their patients to get vaccinated. And we're working with states to get primary care providers vaccine doses so more Americans can get vaccinated at their doctor's office the same way they are accustomed to getting other vaccinations.

You will also see us focusing on other ways to make it as easy as possible for Americans to get a shot, including encouraging walk-up availability at pharmacies and other vaccination sites and providing transportation options for those who need them.

Third, now that everyone 16 and over is eligible for a free COVID shot across the nation, we are laser focused on educating the public about these lifesaving vaccines. As Americans have seen their friends, family, and neighbors get vaccinated, confidence has increased. And over the coming days and weeks, we will double down on getting the facts to the American people about COVID-19, about the protection vaccines offer, and the critical path vaccines play in us getting back to our normal way of life.

To be clear, we have always known strengthening vaccine confidence was key to getting Americans vaccinated. Dr. Murthy will discuss these efforts in more detail, but they include funding for state and community groups, resources for local messengers, and partnerships with key voices to elevate the importance of vaccinations.

Finally, as we have since the start of the administration, we continue to place equity at the center of everything we do. We are committed to reaching everyone in our response and ensuring everyone has equitable access to vaccines by expanding our Community Health Center program, deploying more mobile and pop-up clinics, providing transportation options, and meeting people where they are.

To that end, we're opening two new federally-run vaccination sites today in Kentucky, with a combined capacity of 7,000 shots per week.

To close, we are excited about the tremendous progress to date and the opportunity ahead of us. Because of the vaccination program we have built, we are further along than many predicted. That's a very good thing. It means we're closer to returning to normal.

While we know the next phase of the vaccination program will involve improving access, increasing confidence, ensuring equity -- it won't be easy, but neither was getting to 200 million shots in arms in less than 100 days. But we did it. And that's a cause for a moment of reflection. It's what America is capable of when we come together and all of us do our part.

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

DR. WALENSKY: Thank you, Jeff. And good morning, everyone. I'm glad to be back with you again today. Let's begin with an overview of the data.

Yesterday, CDC reported nearly 63,000 cases of COVID-19. Our average seven-day is going down -- 62,500 per day. This is a 10 percent drop in average cases from the prior week and a hopeful trend.

The seven-day average of admissions is 50 -- 5,600, and is just a small increase of 1.6 percent from the prior week.

And the seven-day average of daily deaths has decreased slightly to about 691 per day. Again, a number that's going in the right direction.

Today, I'd like to take a moment and celebrate one of the tremendous milestones we, as a country, achieved this week. As of today, 66 percent of the U.S. population age over -- 65 and over is now fully vaccinated. This is over 36 million Americans who are protected from COVID-19.

And it's so important that we're protecting those over age 65. They have borne the brunt of the pandemic and, without a vaccine, are at high risk for severe disease, hospitalization, and death. We are well on our way to have one of our most vulnerable populations fully protected against this deadly virus, and that is a reason to celebrate.

This achievement has been the result of combined efforts between CDC, FEMA, and among the human -- and the Health Resources and Services Administration or "HRSA"; state governments and private-sector partnerships; and, importantly, you, as individuals who are, one at a time, rolling up your sleeves to get vaccinated.

With ongoing partnerships, we are working as quickly as possible to get the rest of the country vaccinated.

As we look at the data on vaccine coverage, it's important for us to dive deeper into what we are seeing across the country.

We see on this map that vaccine coverage is not uniform across the country. Please note, we have state-level data but not county-level data for Texas and Hawaii.

Otherwise, looking county by county, there are some unsettling gaps in our coverage. Some areas are doing very well with greater than 65 percent coverage for those over the age of 65, as indicated by dark blue; but many areas have far less coverage, less than 47 percent, as indicated by the lightest shaded areas.

Because this virus is an opportunist, we anticipate that the areas of lightest vaccine coverage now might be where the virus strikes next. And, with modest protection of our oldest population, many more deaths could ensure.

So, while we have some reason to celebrate, we also have the potential, indeed, the need to do more to protect more people now.

On the CDC's Data Tracker website, we provide disease data down to the county level. This allows you to join us and learn how the virus might be spreading in your community, and also what percent of your county is vaccinated. Vaccination is about protecting ourselves from COVID-19. It's also about protecting those in your community, our family, our friends, and our neighbors.

Now that everyone is eligible to receive a vaccine, please help turn your count- -- county toward more protection and a darker shade of blue. The healthier our families are, the healthier we will be as a nation.

Moving on, I want to share a new study that was published this week by CDC scientists. On Wednesday, the New England Journal of Medicine published the preliminary findings of post-COVID-19 vaccine surveillance in pregnant persons. Clinical trials of COVID-19 vaccines did not include pregnant people, leaving us with limited data on the safety of vaccination in pregnant people and babies to date.

Through county -- country-wide surveillance, using the CDC v-safe app and the v-safe Pregnancy Registry, as well as the Vaccine Adverse Event sys- -- Reporting System, we were able to follow over 35,000 pregnant people who were vaccinated.

Pregnant people experienced the same side effects as others following vaccination. We were also able to follow, in detail, more than 3,900 pregnant women, and over 800 of whom have completed their pregnancies.

Importantly, no safety concerns were observed for people vaccinated in the third trimester or safety concerns for their babies.

As such, CDC recommends that pregnant people receive the COVID-19 vaccine. We know that this is a deeply personal decision, and I encourage people to talk to their doctors or primary care providers to determine what is best for them and for their baby.

I started today by saying we have many tremendous milestones to celebrate this week. In addition to over 65 percent of Americans over the age of 65 being vaccinated, this is also the week we hit 200 million vaccines in less than 100 days, and the week when all Americans aged 16 and older are eligible for vaccination.

I encourage all younger people to follow the example of older Americans and to get vaccinated. And regardless of your age, please be an ambassador for your neighbors and loved ones by encouraging and assisting them to get vaccinated themselves.

With that, I'll turn things over to Dr. Fauci.

DR. FAUCI: Thank you very much, Dr. Walensky. So, I'll switch topics now from vaccines to therapeutics.

Can I have the first slide, please?

Just three days ago, my colleague and I published a paper in Med, which is a new journal from Cell Press, essentially reviewing the therapeutic landscape. And one of the important points that we made was that the results from one stage of disease should not be extrapolated between disease stages, even though we're getting more and more candidates that have been shown to have some positive effect in clinical trials.

Next slide.

Taking this from the guidelines panel that I mentioned to this group at a prior press briefing: If you look at the color-coded boxes on the left, they represent disease severity -- from people as outpatients who are not hospitalized, to people who are hospitalized but don't require supplemental oxygen, to those requiring supplemental oxygen, to those requiring high-flow devices or noninvasive ventilation, to the final most extreme of those requiring mechanical ventilation.

And there are different therapies that have either been approved by the FDA or have been given an emergency use authorization or that have common practice like dexamethasone.

So again, as I did before, I encourage physicians to check out the treatment guidelines if you have any questions about treatment.

Next slide.

This slide is interesting because what it tells us -- it is -- it is now, here, plotting the case-fatality rate over time in the United States and throughout the world. Noting here that the case-fatality rate of individuals has come down, very, very likely due to best practices being implemented -- namely, knowing how to -- taking care of patients better, but also the introduction of a number of therapies into the care of individuals.

Next slide.

I showed this at a previous briefing -- when you talk about direct antiviral therapies are being targeted against vulnerable points in the replication cycle. And as I mentioned to you a few weeks ago, there are several of these that are now in various stages of trial.

But I want to mention, just very briefly today, that there are three new clinical trials that have started over the past week.

Next slide.

First is a trial called ACTIV-6, which is a randomized, placebo-controll trial that are looking at seven existing prescription and over-the-counter medications that participants will self-administer. We know this is going on in clinical practice. We're going to try and find out if they actually work. And these include things like vitamin D, fluvoxamine, and others.

Next slide.

The second trial is a Phase II/III called ACTIV-2, which is an interesting trial of a polyclonal antibody that has been derived from the immunization of transgenic cows that will be placed into a therapeutic protocol involving a number of other agents, as shown on the bottom of this slide.

Next slide.

And then, finally, there's a clinical trial of therapeutics for severely ill individuals. It's randomized. It's blinded. It's placebo control. And it's going to study Zyesami -- which is a synthetic version of a vasoactive peptide -- and remdesivir alone and in combination against a placebo.

So, as you can see, there are a number of things going on right now in the area of therapeutics. And as we go along the weeks and months to come, we'll be updating you on not only the clinical trials, but any important results that have come.

With that, I'll hand it over to Dr. Murthy.

DR. MURTHY: Well, thank you so much, Dr. Fauci. And it's good to be with all of you again this morning.

We know that vaccine confidence has been building in our country since the end of last year, early January. And the vast majority of people in the country now are either vaccinated or want to be vaccinated soon.

But with that said, we want to continue very hard our efforts to ensure that we are getting information to people and empowering them with knowledge about the COVID-19 vaccines so that they can ultimately make decisions for themselves and their families and protect themselves from COVID-19.

Today, I want to share with you two updates related to our "We Can Do This" public education campaign. The first -- building on research that we know shows that people want to ask questions about the vaccine directly to healthcare professionals, including their doctors -- we are launching the "We Can Do This: Live," which is an initiative to connect people with facts on vaccines from medical experts in the places where they already consume content online.

So we're pairing doctors, scientists, and health officials with influencers and organizations with accounts that can reach millions of Americans through events like Instagram Live Q&As and social media account takeovers.

Some of the people and organizations who have agreed to share their platforms with us include Barbara Corcoran and Mark Cuban, from ABC's "Shark Tank"; Eva Longoria, the actress; Walter Kim, President of the National Association of Evangelicals; and also organizations including NASCAR, the NBA, and the WNBA, and there are many more in this list as well.

The goal here is to reach audiences who may not be following the news or government accounts or medical doctors or scientists. And if we put doctors and experts directly into their feeds on the platforms that people are already following, we believe we can help get trusted information from trusted sources to people where they already are. It's just one more way that we're seeking to build confidence in the vaccines.

The second update I want to share with you is: Several weeks ago, we launched the COVID-19 Community Corps, which is a nationwide grassroots network of health professionals; community organizations; rural, union, and faith leaders; and Americans from all walks of life. And the goal here was to step up and protect our communities with vaccine education and empowerment, working with local partners.

Now, the Community Corps continues to grow, and I want to highlight for you some stories that we've been hearing about the work from a few of those organizations. One member, Meals on Wheels, is now working with local governments, pharmacies, and other community partners to host vaccination clinics at senior centers and to offer mobile vaccinations to reach those who are homebound.

Another member, the Catholic Health Association, is promoting the acceptance of COVID-19 vaccines through their #LoveThyNeighbor social media campaign, and they're disseminating this also through publications and webinars.

The National Association of Manufacturers and the Manufacturing Institute -- which are both members of the COVID-19 Community -- community -- they have partnered with the University of Florida's Center for Public Interest Communications to research what messages work best to communicate about vaccines with manufacturing teams and communities.

And on Monday, earlier this week, Dr. Ala Stanford, the founder of Black Doctors COVID-19 Consortium, spoke with the Corps and with me about her work in Philadelphia testing, informing, and ultimately vaccinating tens of thousands of people in the Philadelphia area.

All of this is in addition to the initiatives that we've shared with you in the past: the digital and TV and radio campaigns we have to get information out to the public, the more than $3 billion that we are now moving to get to local communities to help support local organizations in their efforts to get people vaccinated.

Look, I know that COVID has separated many of us physically, and what's really encouraging and inspiring to me is just how many people, despite that separation, have actually stepped up to help one another. It's really what we need now to bring this pandemic to an end.

And I know, also, at these briefings, we share with you what the government is doing to address the pandemic, and there's a lot happening in that department. But to truly turn this pandemic around requires more than government action. It's going to require each of us to take action as well, not only to protect ourselves, but to protect other people in our lives.

I mean, ultimately, I believe that this is one of those moments where we have to decide who we are as a country: Are we 300 million people who happen to live in the same place? Or are we fellow Americans who recognize we're stronger when we care for and protect one another?

And my family and countless other immigrants came to this country, whether it was a few years ago or a few generations ago, because many of us believe that America at its best was a community where people looked out for one another, where they were tied together by common values and common concerns. And I still believe that that's who we are at our best.

And that's why I'm urging every person in our country not only to get vaccinated, but to go one step further and help the people you love get vaccinated. Make sure they have an appointment, help them get answers to their questions, and lead by example and show them that you are getting vaccinated too.

If we do this together, we will turn this pandemic around. And I believe, in the process, we will protect our families, our communities, and our country.

Thank you for your time, and we'll look forward to your questions. Back to you, Jeff.

MR. ZIENTS: Well, thank you, Doctors. Let's open it up for questions.

MODERATOR: Thank you, and we only have time for a few questions today, so please keep your questions to one question.

Shannon Pettypiece at NBC.

Q: Hi, so if the pause on the J&J vaccine is lifted but there is this link determined -- the committee does determine that there -- there is a link with this severe adverse event in the J&J vaccine, even if incredibly rare, how do you see the J&J vaccine fitting into your campaign going forward?

Because I know there's going to be some people who say, "Well, there's two vaccines that aren't linked to any rare conditions, so why should we be using the J&J vaccine at all if you have two vaccines that don't have any, you know, even rare side effect associated with them?"

MR. ZIENTS: Dr. Walensky.

DR. WALENSKY: Yeah, thank you for that question, Shannon. So, I'm not going to get ahead of the ACIP. We've been doing a lot of work over the last week to identify any additional cases, and to do -- and to conduct some risk-benefit analysis. And part of that risk-benefit analysis is who would prefer or wouldn't otherwise have access to two-dose vaccines and really wants the J&J vaccine or would otherwise not get it.

That risk-benefit analysis will be presented to the ACIP today. I think the FDA and I both feel strongly -- and the CDC feels strongly -- that we need to act swiftly after that analysis. But I do think that there's plenty of people who are interested in the J&J vaccine, if just for convenience, as well as for a single-dose option.

MR. ZIENTS: Next question.

MODERATOR: Let's go to Tommy Christopher at Mediaite.

Tommy, you're unmuted.

All right, let's go to the next question. We will go to Josh Wingrove at Bloomberg.

Q: Hi. Thank you for taking the time. Jeff, can you give us an update, quickly, on Emergent? Is it day or weeks or months before you think that an EUA is possible there?

And broadly, can you talk a little bit more about the President's remarks earlier this week about sharing vaccine doses with other countries?

I'm sure you've seen, in particular, India is on -- is having a terrible time right now. That is a country that has been shipping AstraZeneca doses to other nations, now has quite a problem in its own backyard. Will the U.S. consider now sharing its AstraZeneca doses -- which are, of course, not authorized for use here yet -- with either countries that would have expected them otherwise from India or to India directly? Thank you.

MR. ZIENTS: So in terms of Johnson & Johnson and the Baltimore facility: You know, as we've talked about, Josh, this is a process between the FDA and the companies, and we expect J&J to work through this with the FDA. You know, our vaccination program was never built on one vaccine. We have plenty of vaccine supply of Pfizer and Moderna. There are tens of millions of doses already out in the country -- of Moderna and Pfizer -- ready to be administered. And now, as we've talked, about all adults -- all individuals 16 and over are eligible for a shot. So we have plenty of vaccine supply to have all adults get vaccinated.

As to India, I will first have Dr. Fauci comment on the -- on the situation, which I know is a difficult situation -- a very difficult situation in India.

Dr. Fauci.

DR. FAUCI: Yeah. Thank you, Jeff. Yes, obviously, India is going through a very terrible situation right now. They've had, yesterday, the largest number of cases that has ever been reported by any country. They have a situation there where there are variants that have arisen. We have not yet fully characterized the variants and the relationship between the ability of the vaccines to protect, but we're assuming, clearly, that they need vaccines.

The CDC is helping out by consulting with them -- as they have in other countries in which there are situations -- and giving technical assistance. But it is a dire situation that we're trying to help in any way we can. We just have to see how things go.

And obviously, they need to get their people vaccinated because that's the only way we're going to turn that around.

MR. ZIENTS: Yeah, I'll just add that we have a longstanding commitment to India's public health and are, as Dr. Fauci said, working closely with them in the COVID-19 response. The Quad partnership and team is providing assistance across government to the country.

And, you know, this is a global pandemic, and India demonstrates the risk of what can happen if we don't get the pandemic under control everywhere. And it's why we made the biggest investment in COVAX and we are committed to sharing vaccine supply. As our confidence around our supply increases, we will explore those options.

Next question.

MODERATOR: Last question --

DR. FAUCI: The thing, Jeff, that's important is that early on, when we were not seeing countries in the -- lower- and middle-income countries that didn't have as many infections, that people would say, "Maybe there's something special about climate, about this, about the youth." I think what this is telling us -- in Africa and in India -- that when you have a global pandemic, it is a global pandemic and there are no countries that are really safe from it.

MR. ZIENTS: Next question.

MODERATOR: Last question. Let's go to Brenda Goodman at WebMD.

Q: Hi. Thanks for taking my question. Jeff, you described a lot of the things that the government is doing to try to help make vaccinations more accessible for people. And I'm wondering if there's been any discussion as -- speaking in economic terms, as the market kind of becomes saturated for vaccinate -- for vaccines for people who want them, if you've discussed offering any incentives, financial or otherwise, to help kind of move the movable middle -- people that might be on the fence?

MR. ZIENTS: Well, I think the -- the incentives here are clear: These vaccines save people's lives. And we talked about the decrease -- the 80 percent decrease in deaths for people over 65. That's so critical because, sadly, people over 65 accounted for 80 percent of COVID deaths. There's also been a 70 percent decrease in hospitalization. So we need to make sure that vaccines are accessible and easy to find and to get your shot -- convenient.

At the same time, we need to continue to build vaccine confidence, as Dr. Murthy talked about; answer questions about safety and efficacy; and make sure that we continue to have equity at the center of everything that we do. But I think the case for getting vaccinated is compelling. We need to make sure that people have the information that they need to make that decision, and that hopefully people get vaccinated as soon as possible now that it is everybody 16 and older's turn to get vaccinated.

Thank you for joining today. And we look forward to briefing next week.

11:32 A.M. EDT

To view the COVID Press Briefing slides, visit https://www.whitehouse.gov/wp-content/uploads/2021/04/COVID-Press-Briefi...

Joseph R. Biden, Jr., Press Briefing by White House COVID-19 Response Team and Public Health Officials Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/349643

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