Pentagon Briefing on COVID-19 Vaccine Distribution Transcript December 9

Jonathan: (00:00) ... 19 response. We're going to cover five specific pieces of information that are important to the force in the public. The size of the initial DOD allocation, the prioritization schema for the populations received the vaccine. First, our priority plan phases for the distribution, the locations of the initial vaccine distributions and the general allocations and the timeline for initial distribution and next phases of the distribution and vaccinations. Jonathan: (00:26) We have a lot of information to share. We've provided you all with the slides in advance, as well as our press release. Those should be useful documents to follow along with. I will note that a lot of work has gone into the planning and of the distribution of this vaccine, which in itself is a remarkable feat. I asked that as each of you shares this information, keep in mind that our goal is to be transparent with the force about what is happening and to encourage our personnel to use the vaccine. We're fortunate that DOD has weathered the COVID storm better than most, and that is reflected in our allocation and how we are prioritizing our initial doses. We look forward to being able to help the country get through the coming weeks and months as the vaccine is distributed and becomes more prevalent in our communities. So with that, I'll turn the podium over to Mr. McCaffrey. Mr McCaffrey: (01:13) Thank you, Jonathan. And good morning everybody. And we appreciate the opportunity to highlight the Department's plan for the delivery of COVID-19 vaccine. The Department's priorities, as you know, are protecting our service members, our civilian employees and families, safeguarding our national security capabilities and supporting the whole of government response to the COVID-19 pandemic. As such and as we'll outline today, our plan will provide the COVID-19 vaccine to DOD uniform service members, both active and selective reserve components, including members of the National Guard, dependents, retirees, civilian employees, and select DOD contract personnel as authorized in accordance with DOD policy on this topic. I'm extremely confident the Department's plan developed in collaboration with operation Warp Speed and the CDC provides a very clear roadmap to protect our entire DOD population across the globe against the pandemic. Early in the COVID-19 vaccination program, there will be a finite supply of vaccine. Vaccination distribution prioritization with DOD will be consistent with data-driven CDC guidance for national prioritization. Mr McCaffrey: (02:32) In the coming days, we expect the department to receive its first allotment of the vaccine. Initial phases of the DOD distribution and administration plan are based on the expected limited number of initial vaccine doses allocated by Health and Human Services in the CDC to DOD and on the departments need to rapidly validate our processes to support increased distribution as vaccine production increases. At this time, DOD is expected to receive just under 44,000 doses of the Pfizer vaccine as early as next week for immediate use. DOD's plan for distributing this vaccine includes monitoring processes to inform senior leader decisions about distribution capacity, increase distribution administration locations, and our force health protection. Our deliberate and phased approach to distribute and administer this first allotment in future allocations of the COVID-19 vaccine will focus on vaccinating priority population quickly and safely, while simultaneously refining the intricate planning for the delivery of larger volumes of vaccine in future waves. Mr McCaffrey: (03:49) The Department will prioritize DOD personnel to receive the vaccine based on the CDC guidance and on the Department's own COVID task force assessment of unique mission requirements. The DOD prioritization plan is consistent with CDC guidance and prioritizes healthcare providers and support personnel, residents and staff of DOD long-term care facilities, other essential workers, and high-risk beneficiaries to receive the vaccine before other members of the healthy DOD population. As mentioned, the DOD plan calls for a phased approach. The initial phase is what we are calling a controlled pilot. In this phase, we will be distributing the vaccine to priority populations in 16 distinct locations. We will monitor the uptake and make adjustments to our plans going forward as necessary and as lessons learned from this controlled pilot. We will continue with this form of distribution, adding additional prioritized personnel in additional prioritized locations until 60% of our DOD, roughly 11 million personnel, have received the vaccine. At which time DOD anticipates vaccine manufacturing rates to support full-scale, unrestricted vaccine distribution to Department personnel. Mr McCaffrey: (05:09) At that point, our intent is to distribute the vaccine in the same manner the Department conducts its annual influenza vaccine program. If you look at some of the slides we provided, the Department selected initial vaccine distribution sites to best support several criteria. Number one, the anticipated unique supply chain requirements for the initially approved vaccines, a sizeable local DOD population with priority personnel across all of the military services and sufficient medical personnel to administer the vaccines and monitor recipients after initial and second dose administration. In his remarks General Place will provide additional detail on those specific locations. In a recent virtual tabletop exercise led by deputy of defense and senior civilian and military leaders, the DOD COVID task force and the leaders responsible for the first phase of the plan, walked through their processes in great detail to ensure seamless distribution and dissemination of this initial wave of vaccine across our selected sites. Mr McCaffrey: (06:14) The lessons learned from this exercise helped solidify the Department's plan on the way forward. In terms of next steps, as soon as the FDA issues and emergency use authorization, DOD's allocation will be pre-positioned at our initial locations. Upon issuance of the EUA, the CDC's advisory committee on immunization practices will meet, review the EUA and then vote to recommend the vaccine and how it should be disseminated and who should receive it. We expect to have shots in arms of DOD personnel within 20 to 48 hours from the time the ACEP issues its final recommendation. I want to personally thank the men and women across the Department who have spent countless hours both day and night supporting the development of this plan. Their preparation for the vaccine of millions of individuals across the department in the coming weeks and months will protect our force against COVID-19 and allow us to continue to fulfill our mission to the nation. General Place and I look forward to answering your questions. General Place: (07:27) Good morning. Thank you, Honorable McCaffrey. Our country and our forces should be assured that the Department of Defense is ready to execute a global COVID vaccination plan for our service members, as well as military families, retirees and certain government, civilian and contract staff. Following approval by the Food and Drug Administration and guidelines from the Centers for Disease Control and Prevention, the Defense Health Agency will lead a department wide phased effort to distribute and administer the vaccine. While we await final approval from the FDA, the preliminary data on the safety and effectiveness of the two vaccine candidates is highly encouraging. We're recommending that everyone take the vaccine when it becomes available. Protect yourselves, your families, your shipmates, your wing men, your battle buddies and your communities. As with most vaccines, some people may experience small adverse effects, arm soreness, fatigue, even a fever. The Department will be fully transparent about any adverse effects that are reported and share this information with the CDC. Now as Honorable McCaffrey mentioned, as we begin our vaccination process, the department specifically chose 16 locations, 13 in the United States and three abroad. General Place: (08:43) We selected these locations based on our desire to validate our plan. As such, we chose locations with extra cold storage capability, sizable local populations to vaccinate and medical staff large enough to administer it. We chose locations from each of the military services, including active and reserve components along with the United States coast guard. Finally, we chose locations with an onsite immunization health specialist. As Mr. McCaffrey noted. The good news is that our military medical teams have worked for months to prepare for this moment. And we're eager to begin to deliver on operational Warp Speed's promise. The Department of Defense has decades of experience with conducting global vaccine programs, whether it's the annual flu campaigns or protection against novel diseases around the world. We vaccinate millions of our service members and families and retirees of every age, every year. General Place: (09:37) And we have systems in place to monitor the health of everyone who receives a vaccine. In terms of the next steps. Following FDA approval, the department will receive and begin vaccinations of our high priority populations this month. We've identified the military installations and the military treatment facilities that will receive the initial shipments of the approved vaccines, as Mr McCaffrey noted. We have initiated our staff training protocols for vaccine administration and working closely with our Tri-Care network providers and pharmacies prepare for wider scale vaccinations as the vaccine supply expands. This phased approach to vaccination will take time. We recommend that everyone continue to follow the latest CDC guidelines to include physical distancing, hand-washing and wearing face coverings where appropriate. This has been a challenging year for all Americans and I'm inspired by the perseverance and commitment of the men and women of the Department and the military health system. Together we're working as a team to protect all entrusted to our care. Thank you. Jonathan: (10:40) All right. Thank you. We'll go to the phones. I don't know if Lita jumped on from AP. Lita? All right. So we'll go into the room, Barbara? Speaker 1: (11:03) I think my question is for the general. I wanted to ask on the medical side of this, sir. Could you explain as much as you can about what part of this vaccination program will be voluntary? What part will be mandatory? Just as much detail as you can, and especially for our high priority categories for deploying units for senior leaders, can you walk us through some of that? General Place: (11:35) Yes, ma'am. We anticipate that this will be approved using emergency use authorization, not a fully licensed to FDA vaccination. And as such, the Department's policy will be voluntary for everyone. So there's no if ands or buts about it, doesn't matter, voluntary for everyone. Speaker 1: (11:56) I just don't know how this all works. So it starts with an emergency use authorization. The vaccination is voluntary for everyone, including deploying units, including high priority units. Does it eventually in some way, shift to mandatory once there's full FDA licensure? And how will that on a practical level work, for example, for special operations forces, small units, strategic units, deploying on a team level, if some people don't don't take the vaccine? General Place: (12:34) Well, I don't know if Katherine wants to talk to the full licensure aspect and potential for future. The Department is strongly encouraging everyone to take it. And the reason for that, if you look at the data that are available to all of us, now that Pfizer, at least the one vendor has made available to everyone. If you look at the safety profile of it, the safety profile is very good. And the efficacy of the vaccine, again, short time period, appears to be very good. So in a risk stratification, my advice as a physician is that if everything we do in life, every medication that we take, every surgical procedure that we have is all about risk. And the risk of these vaccines from what we know is much less than the risk of the actual disease process. So our advice to everyone, volunteer basis, our advice to everyone is to take the vaccine just based on risk, Speaker 1: (13:30) [inaudible 00:13:30] Making it mandatory. Mr McCaffrey: (13:30) And that question, I think, as General Place indicated this would be at the normal process when a vaccine is first issued under emergency use authorization, it's typically on a voluntary basis. So we're going to be consistent with that. As it moves, as FDA looks at the experience of the vaccine, real experience that we're seeing in the population and assuming they ultimately grant full licensure at that point, the Department would look at that, and based upon again- Mr McCaffrey: (14:03) ... point, the department would look at that. And based upon, again, risks and benefits, and look at unique requirements from the military departments, from the combatant commands, would make a determination if we believe for military readiness, we should consider making a fully licensed COVID vaccine mandatory. But there's a process that we use based upon data, based upon the FDA's assessment. Mr McCaffrey: (14:23) But I think the other question you raised was, in this interim period, where not all the force is going to be vaccinated in the next month or two, the department's very clear in all of our policy, everything that we have in place right now in terms of our standard mandatory force health protection guidance, in terms of public health mitigation, social distancing, testing before deployments, that will all continue. Even as we, in the early stages of the vaccination effort, we're going to continue all those measures. We have to, because not the entire force, both active duty and civilian, are going to be vaccinated. Mr McCaffrey: (15:04) And then I think as, as General Place indicated, part of our program in terms of communications is, everything we can do to articulate to our people that we have great confidence in the FDA's rigor, and making the determinations about efficacy and safety. And we are going to be, as part of our communication plan, using select key senior leaders to get the vaccination, to demonstrate confidence in that. Much like recently, Governor Hogan himself said, that's what he's going to do in terms of getting the vaccination out to the population of Maryland. He's going to demonstrate, "Yes, this is a safe and effective vaccine, and I'm encouraging everybody to take it." Jonathan: (15:46) All right. David. David: (15:47) Was your allocation based on the same per capita formula that the States were? And is that 44,000 going to be 44,000 shots in arms, or is it going to be 22,000 and hold 22,000 for the second shot? And one more question, those locations up there, there's a lot of geography between all those locations. Are people going to have to come to those locations to get their shot, or are you going to distribute to sub locations? General Place: (16:24) Thanks for the question. So first, we have the same prorata designation as all the other jurisdictions. So it's a small percentage, just like the states are receiving, the department received based on our population, a very, very small percentage. But it's equivalent to the other jurisdictions. General Place: (16:42) In terms of your second question, the almost 44,000 is the initial dose. So one of the things in the process is, you have to demonstrate all parts. You have to receive, you have to administer it and you have to document, before you can order the second dose. So this almost 44,000, is first dose. We contact back with the organization to get our second dose. General Place: (17:03) And then for your third, no travel involved. This is a controlled pilot at these locations. This is to demonstrate that the process that we've developed actually works. Once we validated this controlled pilot, we have really scores of sites, hundreds of sites across the country and across the world that we have locations that a vaccine will be sent to. So it's not, these are the only locations everybody has to come to there. Or, these are the only locations, we take the vaccine from these locations to other outlying locations. This is just the first step in a controlled pilot. Jonathan: (17:36) So Dave, to your question on this, is if you look, there's 16 locations. Our allocation's only 44,000. So the way that the vaccine goes out is in batches of 975 doses. So we have to have locations that have a sufficient population to use all of that dosing there. So that's why one of the criteria for the locations was a large population, or prioritized personnel. So if you look at the listing, you'll see some of our larger medical facilities, some of our larger joint base areas that will be receiving them, because they have those populations there. David: (18:11) So are there 44,000 people at those locations? Jonathan: (18:14) Well, it's just the prioritized personnel. David: (18:16) Yeah, I know. Jonathan: (18:17) So like in- David: (18:18) There's 44,000 people who qualify. Okay. Jonathan: (18:20) Yeah. So, okay. All right. Lucas Tomlinson: (18:23) General, Lucas Tomlinson, Fox News. Is the reason the vaccine is voluntary because there's not enough to go around? General Place: (18:33) No, sir. It's voluntary because it's under an emergency use authorization. Because the FDA is likely to determine, let me be careful about that, the FDA is likely to determine that not full licensure, but under emergency use authorization. And like every medication that we get in our facilities emergency use authorization is different than full licensure. We have to be able to communicate that to our patients when we talk about it. Because it's under the emergency use authorization, therefore voluntary Speaker 2: (19:05) Mr. McCaffery, you mentioned that some reservists, some guardsman, some spouses, some civilians, some contractors will be in part of this phased approach. How are you determining who is supposed to get the vaccine in those cases? Jonathan: (19:17) Can we actually go back a couple slides? I think there's the one that has the tiering. One more. I think that might be helpful to us. Speaker 2: (19:24) The keyword was some, it wasn't like every dependent, every contractor. So I'm wondering what the- Mr McCaffrey: (19:29) Yeah, so basically, eligibility we've defined in terms of dependents, select contractors, civilian employees. And it's going to be then, how do they match up in terms of the prioritization tiers? We, like the rest of the country, the very, very top priority and initial phase is going to be healthcare workers. So first, those inpatient workers, most close to the patients, the early emergency responders, public security, and then down in terms of outpatients and so forth. But it's going to be, are you eligible, and then where in that schema are you eligible? That's how you're going to get it. Speaker 2: (20:09) So we're talking about dependents, is that because they live with one of these people and so they should be getting a vaccine as well. What are these high priority cases? Mr McCaffrey: (20:16) So for dependents, it will be in the phase with regard to whether you are a high-risk beneficiary or the regular healthy population. Jonathan: (20:25) Okay. We're going to go back to the phones real quick Sylvie? Speaker 3: (20:33) Yeah. Okay. I'll just go. What is your target date for vaccinating the entire force? Jonathan: (20:45) Tom? Mr McCaffrey: (20:50) The target date is going to be contingent upon, again, we're going to be getting an initial, very limited quantity. We don't yet know how much quantity we're going to get then after that first week, as additional vaccines, in addition to Pfizer come out. So it's really going to be contingent upon how much vaccine, which types of vaccines we get over our period of time, that we would be able to tell you, based upon our schema we expect we could do X hundreds of thousands by the end of January versus February. It's hard to give you a timeline now, with so many questions to be determined in terms of which vaccine and how much we get, and when we get it. Mr McCaffrey: (21:36) For us, the important thing is, we've developed a plan program for dissemination, that as we validate it in this, these initial 16 sites, that we are confident we will be able to use our plan to very quickly, as soon as we get those dosage, quickly get it out across the force, according to the prioritization. Jonathan: (21:58) And I'll just add two quick things to that. Because the way it's been explained is that we want to get to a place where we can treat this as we do with our normal flu vaccine distribution schema. When we get to a certain percentage of the force being inoculated, then we will treat it and turn it in, roll it into kind of the general form where we do this every year. When we get to that place, we can get to the whole force. And then just to remember, as I mentioned in the opening with regard to the entire force is, we've been relatively fortunate. A large number of our forces are in age criteria, health status, where we have fared better than others. So that's something we take into account. But we're confident, whether it takes a month, two months, three months, four months, we're going to be able to continue to move forward with all of the DoD missions that we've been entrusted with, the way we have over the last year in the face of COVID. All right. Go ahead, sir. Abraham Mahshie: (22:47) Abraham Mahshie, Washington Examiner. Early on, there was a lot of talk about the phased approach with national security, being a key criteria, the nuclear triad, for example. I don't see that anywhere. Could you address where those important service members come into this, or do they not come into this? Mr McCaffrey: (23:09) They most definitely come in. If you look at, in the tops of Phase 1A and then 1B, Critical National Capabilities, so that would include our Nuclear Deterrence Force, our Homeland Defense Forces, Cybercom, key national strategic leadership. That is in that tier in terms of... and very much mirroring how we did our testing rollout, in terms of the focus on those critical national capabilities forces that are about to deploy within three months, et cetera. Abraham Mahshie: (23:47) Geographically, on the map you showed earlier though, there were no distribution out, for example, for any of the ICBM sites out West. Mr McCaffrey: (23:55) Again, the, the 16 sites we've chose as the criteria, as our way to pilot and validate the processes for the massive distribution over time, the 44,000 that we expect to get initially that we'll be testing through those 16 sites, those are won't even cover the very first section of Phase 1-A, which is going to be healthcare workers. So they're going to come first, like the rest of the national guidance and prioritization. Again, as quickly as we get vaccine, we will then be able to distribute it as quickly as possible based upon those priorities. Jonathan: (24:38) As we mentioned before, all of the processes, procedures that those forces, the missile forces, the bomber crews, the sub crews, have put in place over the last nine, 10 months to protect them from COVID will remain in place. So they have managed to, to develop plans and processes that have allowed them to continue with their missions without any denigration due to COVID. So they're going to continue with that until we do reach a place where we have enough, we've received enough vaccine to get to that Phase 1-B tier of individuals that are going to be inoculated, including those critical national security or critical national capabilities. All right, we'll go back to the phone for a third time and try this. Sylvie, one last shot here/ Bloomberg? Tara Copp: (25:29) I have a question. This is Tara Copp with McClatchy. On the selection of Madigan in Washington State and Bragg's medical facility, could you talk about how those two locations were selected? Was it because of deploying forces or because of the medical centers there? General Place: (25:51) So it's based on the capability to have ultra cold storage there. So they're one of 83 locations across the Department of Defense that have ultra cold storage. It's because it's a high on the Army's priority list. Each of the services sent them forward. It's because they have way more than 1,000 of the first tiering. By that we mean the military police, the security forces, the ambulance crews, the firefighters, the emergency department staff, and the ICU staff. So even within the healthcare, we're looking at very specific parts of the healthcare that are at highest risk. So it's because of all those factors, those locations were chosen. Depending on what else you're familiar with, if you look at all of those sites, they all have that capability. That's why they were chosen for the controlled pilot. Jonathan: (26:39) And I just want to go through and read these out, just so on the transcript, it has the list of locations. So the initial vaccine sites in the continental United States are: Darnall Army Medical Center, Fort Hood, Texas; Wilford Hall Joint Base, San Antonio, Texas; Madigan Army Medical Center, Joint Base Lewis–McChord, Washington; Womack Army Medical Center, Fort Bragg, North Carolina; Navy Branch Health Clinic, Naval Air Station, Jacksonville, Florida; Base Alameda Health Services Clinic, US Coast Guard Base, Alameda, California; Naval Medical Center, San Diego; and the Naval Hospital Camp Pendleton, which will get its distribution from San Diego; Naval Hospital Pensacola, Pensacola, Florida; and the Army Forces Retirement Home Gulfport, which will be administered from Pensacola. Jonathan: (27:24) Additionally, the Walter Reed National Military Medical Center Bethesda, and under that, the Army Forces Retirement Home in Washington will receive its allocation; Portsmouth Naval Medical Center, which will feed the Coast Guard Base Clinic at Portsmouth, as well; the Indiana National Guard in Franklin, Indiana; and the New York National Guard Medical Command, Watervliet, New York. And then additionally, outside of the United States, Tripler Army Medical Center in Honolulu, or sorry, outside the continental United States, apologies, Hawaii, Tripler Army Medical Center, Honolulu; Allgood Army Community Hospital Camp- Jonathan: (28:03) ... Army Medical Center, Honolulu, Allgood Army Community Hospital, Camp Humphreys, Korea, Landstuhl Regional Medical Center, Germany, Kadena Medical Facility, Kadena Air Base, Japan. All right. Back to the phones. So we got Tara. Tony, did you have a question? Tony: (28:17) I do, John. Where does the DOD leadership fall in terms of the phases? So Secretary Miller and the Patel and Tata, do they fall in Phase 1 or would they be 1b1 then a Critical National Capabilities? Mr McCaffrey: (28:31) So, the senior leaders overall, if you look across the department and that would be a numerous number, that would actually be in phase 1b1, which is the Critical National Capabilities. And again, that mirrors how we did our COVID testing. That said, we do intend as part of this initial phase of healthcare workers, emergency responders, et cetera, have some very small set of very visible senior leaders that will volunteer to take the vaccine, do it in a public way as one way of helping to message the safety and efficacy and underscore that we're encouraging all those eligible personnel to take the vaccine. Barbara: (29:21) No. A little transparency [crosstalk 00:00:29:23]. Can you give us any names of who you are offering that to in terms of very senior leaders and do you also intend then to offer it to General Austin? Mr McCaffrey: (29:35) So right now we'd be looking at current senior leaders and the top four that we are looking at right now would be definitely the secretary, the deputy secretary, the chairman, the vice chairman, and the senior enlisted advisor to the Joint Staff. Barbara: (29:54) Are you considering offering it to General Austin? Mr McCaffrey: (29:56) That is not something that we've talked about. Again, our focus is those top five and then other senior leaders across the services. But we're looking at a number of well below 50 as part of this senior leader effort to get the word out for the vaccine. Jonathan: (30:17) And Barbara, what we're looking at is the department leadership, but also the service leadership, and then the combatant commands in a way so that we can get that message out to as large a population as possible. Because each of those have their own lines of communication and many of them are set up, volunteered already and are looking to- Barbara: (30:35) Are you considering allowing media cover of them getting their shots? Jonathan: (30:39) Part of the intention of doing it is to do that. So as long as... Part of it is... Look, we do not want this to be a... It's not done just for media purposes, but we will likely have some of them on travel to some of the sites where vaccinations are taking place to learn more about it. I'll mention since we've already announced it, Acting Secretary Miller is in Hawaii today. He'll be visiting Tripler Army Medical Center this afternoon at 1300 to receive a tour and a briefing from the MTF commander about the vaccination process out there. He will not be being vaccinated today. But he will be touring the facility this afternoon to learn about the cold storage and the process that they have in place. And we'll be doing that in other locations as well as we go forward. But we'll get back to you on the visibility of how people are getting shots. All right. Let me just go to the people on the phones here for a couple minutes since it's working. Ms. Seligman from POLITICO. Ms. Seligman: (31:44) Hi, thank you for doing this. Can you just go into a little bit more detail about the Critical National Security Capabilities that you mentioned, the nuclear deterrence force, et cetera? Can you just talk a little bit about when that is going to be happening and how that's going to be rolled out and which units are going to be prioritized? Mr McCaffrey: (32:10) And so the way we have identified it, they are part of the initial phase, but even with the initial phase, we have sub tiered it because we recognize we're going to have a limited quantity. So you need to figure out who in that broad first phase are going to get at first. And right now the priority in the first phase, as I mentioned, are going to be healthcare workers, it'll be first responders, security. Then the next part of that first phase is indeed our national critical, what we described our National Critical Capabilities. As I mentioned some examples of that would be our strategic and nuclear forces, our Homeland defense forces, select senior leaders. And then after that, it would be those deploying forces that are going to be deployed within three months. And then after that, all other, what each of the components will be defining as their critical essential staff carrying out critical, essential national capability activities. Jonathan: (33:18) Okay. All right. We'll keep going. Missy Ryan. Missy Ryan: (33:23) Thanks very much. I just have a clarification and then a quick question. So just to build on the last question and forgive me if this has already been explained a number of times, it's a little bit confusing. So the 44,000, is it accurate that they will be distributed among some small group or some group of the healthcare and the Critical National Capabilities? Because obviously those categories of people would be more than 44,000. So you're taking some of the healthcare category people and some of the Critical National Capability people, is that right? General Place: (33:59) So of those 44,000, the huge majority of them will be for first responders, critical healthcare people and a very, very, very, very limited number to Critical National Capabilities, in this first traunch. Assuming this all gets approved and the EUAs, et cetera, and we get resupplied, then we'll get into more of the Critical National Capabilities. But in the initial 44,000, a huge majority is for first responders, the emergency department staff, et cetera. Jonathan: (34:35) Okay. Patricia of Military.com. Patricia: (34:43) Thanks for taking my question. Can you tell me the 44,000 vaccines, what percent of the Phase 1a personnel total in the department will be vaccinated? And then also when you talk about high-risk beneficiaries, how are you going to prioritize them? What is the definition of high-risk and how will you be prioritizing them? General Place: (35:11) Sure. Thanks for the question. The 44,000 against the entirety of the medical workforce, first responder workforce, et cetera, is somewhere in the eight or 9% of that total staff. That said, we also don't know what percentage of that staff are actually going to receive the vaccination because it's voluntary. So we have to plan for all and then readjust as some decide that they don't want it to, or hopefully for us all decide that they will. I forgot the second part of the question. Jonathan: (35:47) You would say it again, Patricia. Patricia: (35:49) Part of the question was [inaudible 00:35:52] how are you going to define that and have you defined it in terms of health care or pre-existing conditions, that kind of thing? General Place: (36:06) The great things about our military health system and our ubiquitous electronic health record is that we're able to monitor every single one of our beneficiaries for their medical problems. Now, that's all protected so none of you can see that, but inside the system we can and our programs allow us to see according to the risk factors, according to the CDC of what are the risk factors for disease or for severity of disease with COVID, we know what those are, and we could bounce that against our database to see who has those particular challenges. And that's how we get to the highest risk population. The very highest risk also comes from age, medical problems and congregate locations, where people are congregating together. And that's why as Mr. Hoffman mentioned the very highest risk beneficiaries to us are in our armed forces retirement homes where the average age is 85. And they're all in the same location altogether. So they're the very, very, very, very highest risk of our non-healthcare population, which is why they've been categorized in the very first traunch of vaccinations that we hope to receive. Mr McCaffrey: (37:11) And then Patricia, just wanting to add, just so you know, when we are defining for our population, the high risk, we're basically taking the CDC's definition that they're using for the all of nation distribution. And so for example, they cite very specific things like those that are over 65, those with cancer, those with COPD, heart conditions. And so we are using that same definition to apply to our population. Jonathan: (37:39) Okay. Nick Schifrin, PBS. Jeff Schogol, Task & Purpose. Jeff Schogol : (37:51) Thank you very much. Are there any repercussions or consequences for troops who decline to get vaccinated? Will they receive administrative action or listed as not deployable? Mr McCaffrey: (38:06) No. As we mentioned, this is standard practice for an EUA. It is voluntary. It's going to be voluntary for our forces and those who do not get vaccinated, they will be adhering to all of the existing public health mitigation measures that have been in place for months and that have allowed the department to carry on its mission. Jonathan: (38:28) And at some point, if the FDA does determine to license, as fully license the vaccination, at that point, the voluntariness may change to mandatory as determined by the department. So that is a possibility in the future. All right, let's go, Courtney. Courtney: (38:49) Hey. I'm still unclear on when exactly you think you're going to get... I know it's hard to say, because you don't know when the emergency authorization is going to come through. But when exactly do you think that you might start getting these 44,000? And is it fair to say that they'll all be distributed equally among the 16 locations? So I'm not going to even try to do the math on that, but that's how many... It'll go equally to the 16 locations. Sorry, my kid's here. Mr McCaffrey: (39:17) It's okay. I understand. I will let General Place speak to that last issue. But in terms of your question about in terms of the initial 44,000- Jonathan: (39:32) When it'll happen. Mr McCaffrey: (39:32) Oh, when it'll happen. So I can't give you a definitive, I can give you, this is our understanding, our expectation. So our expectation is tomorrow the FDA will meet- Jonathan: (39:45) I think it's maybe push. Mr McCaffrey: (39:45) Yeah. I mean, it could be tomorrow, it could be the next day. But so kind of rough estimate. The next couple days, FDA meets, they review the data, they make their decision as to, are we going to approve this vaccine and under what conditions we are anticipating, it will be under an emergency use authorization. So once that happens, the manufacturers are allowed at that point to actually distribute their vaccines to locations across the country, again, per the national prioritization, per our prioritization. Mr McCaffrey: (40:23) But the next step is once the FDA issues that EUA, the CDC's advisory committee on immunization practices, and this is standard for any vaccine, they review the EUA and what's in it, the data that was used for the FDA to make that decision, and then they make a recommendation or they vote and say, yes, we recommend the population, use this vaccine under X conditions, who should get it. And once that happens and that could happen, could, over the weekend, it could happen Monday. Again, it depends on when they meet and when they make their decision. But once that committee issues its final recommendation for our 16 sites, we are comfortable, we are confident within 24 to 48 hours from that advisory committee decision, we will actually have shots in arms. But in terms of how that 44,000 is being allocated to one or the other of the 16 I'll need to defer to General Place. General Place: (41:29) So again, it's on a pro rata basis. So depending on how big or small these initial sites are, that's how it's being determined. The particular maker is distributing it in lots of 975 doses. So if you're wondering, why are we coming up with these weird numbers and why is it almost 44,000? It's actually a little bit less than 44,000 because they come in batches of 975. So some of the locations will get 975 doses. The largest one will get... Take 25 away from six... Jonathan: (41:59) 5,875. General Place: (42:00) 5, 000- Jonathan: (42:00) 875. Jonathan: (42:01) 5875. General Place: (42:02) Yeah, 5875, whatever that number is. So I'm not going to do public math in front of you, but it's assortments of 975 doses pro-rata depending on how big these locations are, that's how it was determined. Jonathan: (42:15) And just as you look at the sites, you'll notice some of the ones are larger, some are smaller. For example, I think the national guard facilities are going to be somewhat smaller in that uptake. Whereas Walter Reed, the San Diego medical facility, Fort Hood, Trippler, those are some of our larger facilities, medical facilities that have a larger presence of that population. So you'll see a larger allocation go to those locations. Let me just finish up with a couple more on the phone and we'll come back into the room. Keith, from Al-Jazeera. Courtney. Courtney: (42:51) You just called on me. Jonathan: (42:58) I didn't have an X next to your name there. So, that's my fault. Did Sylvia ever get to ask a question? No. All right. All right, we tried. Lita, did you jump on? Lita: (43:13) Now that the CDC has revised its quarantine rules, is there any decision made about the quarantining of sailors and soldiers before they deploy? Mr McCaffrey: (43:24) Yeah. So the question is in reference to the recent, it was last week, where CDC revised their guidance about what to do if you've been in close contact with a positive case. And their recommendation under certain circumstances, whether you test or not, their revised guidance is going from a 14 day self quarantine or self isolation to 10 days if you don't test. They are comfortable that if you test 48 hours before the seventh day after being notified that you've been in close contact, they are comfortable with you then getting removed, so to speak, from self isolation. So we're taking that guidance as we've done throughout the last nine months. And we are now revising our own force health protection guidance accordingly to ensure that we match up where appropriate, but while we're also though managing our mission capabilities and readiness, but we haven't finalized our revisions. Lita: (44:26) Redeployment for warship crews? Mr McCaffrey: (44:29) Yes, correct. Speaker 4: (44:30) Are you encouraging people who've already had COVID to get the vaccine? Mr McCaffrey: (44:35) Yes we are, because we know more about the virus than we did nine months ago, but we're still learning more. So our recommendation would be, even if you have been previously infected, you might've been infected eight months ago, we don't know, there's not enough science that says just because you were infected that you have immunity. So we would be recommending even those folks to get vaccinated. Jonathan: (45:02) We'll do a quick round here. And then... Speaker 5: (45:04) Can I follow up on one thing, when you were talking about mainly healthcare, but then you said a very, very small group sort of defined as a national capability. Is that a particular unit? Can you tell us what unit that is? Mr McCaffrey: (45:19) No. What we were referring to, I think in the prior discussion, was the notion of the secretary, the deputy secretary, the chairman likely... Speaker 5: (45:30) Oh, so that's what this very other small group is? Mr McCaffrey: (45:30) Correct. Speaker 5: (45:30) Thank you. Jonathan: (45:32) I think in that first batch, you'll see the retirement homes, the medical community, and a handful, a couple dozens of senior leaders for leadership and messaging purposes. Speaker 5: (45:44) Got it. Jonathan: (45:44) Okay. Speaker 6: (45:44) The 44,000 number, that could be updated next week, couldn't it? When another vaccine comes up for approval? So this number could be changed. And also are you coordinating with the VA on this? Mr McCaffrey: (45:55) So the VA actually will be, like us, will be getting its own allocation in proportion to all other entities that are getting it. And so in terms of the vaccination program itself, there's not really a lot that we need to coordinate with them. They work directly with CDC. On the issue, what was the... Speaker 6: (46:17) The numbers, they can be revised. Mr McCaffrey: (46:19) Oh yeah. So the 44,000 is just, that's what they're saying our initial allocation is going to be. We expect that shortly after that, again, I can't be definitive, is it a week, is it 10 days? We will get a subsequent allocation, a little bit larger, and then we will get that out. And then so on and so forth. And then you've got Moderna coming in, a different vaccine which will be going through the same process, EUA, ACEP review and recommendations. And as those come forward, we will get those out. Jonathan: (46:50) And just to be clear on this is, this plan is intended to be scalable. So we have a, what you could describe as a control pilot with these first 16 locations with that initial batch so that we can, one of the things as General Place mentioned is, having an immunology healthcare specialist on location so that we can ensure that the process is working as we scale up. So make sure that we're tracking the records, make sure that we're tracking any reactions, seeing if there's any improvements to the process as we expand it out. But the intention is that the whole process is scalable. And as we get more additional vaccines, we can go to additional locations or do additional people at these first few locations. Speaker 5: (47:29) Do you have to repeat the pilot with each EUA for different vaccines? Like when you get Moderna, do you then have to start this pilot all over again? General Place: (47:38) No, ma'am, the pilot is to measure the process. That's all. Speaker 5: (47:42) Thank you. Jonathan: (47:43) Did you have [inaudible 00:47:44]. Okay. All right. Well, I'm going to close out here. I just got a couple things. First off, I appreciate everybody. It's an important issue. We want to get the message out that this is taking place. Workforce needs to understand this, the force needs to understand it. And we want to encourage people about the safety of the vaccine and encourage people on the uptake. So we will be continuing with that messaging as this rolls out in the next few days. Jonathan: (48:07) Two quick, non COVID related issues. We've been providing updates on the transition. And so I just wanted to read you a couple new numbers from the transition that I have received just literally as I walked in here this morning. So as of yesterday evening, we've completed 43 transition interviews. We're averaging about seven a day. Total officials in this 43 interviews is just under 100. And we have 35 interviews scheduled over the rest of next three days. Jonathan: (48:40) Requests for information that have come in, we've already completed 45 of those, 13 of which are classified. And we've got another 34 or that the lawyers are noodling with before we'll be sending those out the door. Transition books, we've got 43 of the transition binders, so those are each of the team binders and policy binders are complete. Seven of the intel agency ones are complete. We've released 2200 pages of documents, and 250 pages of classified documents. This week's interviews included the deputy secretary, Seq AF, Chief of Staff of the Air Force, Chief of Space Operations, Secretary of Army, the Chief of Staff of the Army, the CNO, the Commandant, Chief of the National Guard Bureau, a number of the undersecretaries, PNR, INS, Comptroller, RNE, it goes on and on from there. I think health affairs. I don't know if you've had your interview yet. Jonathan: (49:34) We've got a couple other ones that are scheduled. You're scheduled tomorrow. I know I'm scheduled to meet with them on Monday. Of particular interest, NRO site visit took place on Monday, met with 10 officials, including the director and deputy. DIA site visit took place on Monday, 16 officials including the director and deputy. NSA site visit took place yesterday, 11 officials including the director and deputy. And the NGA site visit took place yesterday, 10 officials including the director and deputy. So we're going to continue supporting the transition fully and professionally and we will keep updating you as we go along. I know you guys get emails from Sue Golf on a regular basis with some of these updates. And so we'll seek to include more information. Jonathan: (50:20) And then finally, just take a couple minutes to express sincere condolences to both the family of a general Chuck Yeager, an American and Air Force hero. He's a fighter ace, a test pilot who was the first to fly faster than the speed of sound. And he was a legend in the Air Force. And so we lost him this week, I think at the age of 98. And then a little more closer to home here, condolences to the family of Jim Lotts who passed away this weekend. Jim was a well-regarded member of the secretary of Air Force Public Affairs family, and was by all accounts an exemplary public service and a proud veteran and committed family member. So his family and friends of both individuals are in our thoughts and prayers. All right, thank you guys.