Return to Transcripts main page

At This Hour

Biden Administration to Recommend COVID Booster Shot After 8 Months; Briefing by White House COVID Response Team. Aired 11-11:30a ET

Aired August 18, 2021 - 11:00   ET



ANNOUNCER: This is CNN breaking news.

KATE BOLDUAN, CNN ANCHOR: Hello, everyone. I'm Kate Bolduan.

AT THIS HOUR, we are following two breaking stories.

First, we're moments away from a major announcement from top health officials. New recommendations are coming on booster shots for most Americans.

We're also following dangerous and fast-moving developments out of Afghanistan. We just learned Defense Secretary Lloyd Austin and the Chairman of the Joint Chiefs of Staff, General Mark Milley, they will be briefing reporters this afternoon. This will be the first time we've heard from them since the Taliban seized control of Afghanistan.

This comes as we get a new and clearer view of desperate Afghans trying to get out of the country and a faltering U.S. response despite evacuation flights resuming at Kabul's airport. Reports of Taliban fighters opening fire to disperse large crowds, witnesses reporting protesters being beaten by Taliban fighters as well.

CNN's Clarissa Ward is on the ground with reporting on the mayhem on the streets near Kabul's airport. We're going to bring that to you in just a moment.

But we are moments away from a big announcement from President Biden's COVID response scene, that booster shots will be recommended for the general public. Third doses could begin as soon as next month.

Dr. Sanjay Gupta has learned officials will be releasing data showing waning immunity among vaccinated Americans. President Biden will be speaking to all of this -- about all of this also today.

CNN's Jeremy Diamond is live at the White House to start us off this hour.

Jeremy, there are new details emerging ahead of this briefing already. What have you learned?

JEREMY DIAMOND, CNN WHITE HOUSE CORRESPONDENT: That's right. We do have this statement already from the Biden administration's top health officials who are uniformly recommending that all vaccinated Americans get a third shot. That is for the Americans who got the Pfizer and the Moderna doses.

Let me read you a part of this statement which says, quote: We conclude a booster shot will be needed to maximize vaccine-induced protection and prolong its durability. They say we're prepared to offer booster shots for all Americans beginning the week of September 20th and starting eight months after an individual's second dose.

These health officials are saying this is needed because, first of all, they said they've already seen evidence that there is a decrease in protection from these vaccines, especially in light of the delta variant and that they believe that the current protection against severe disease and hospitalization which is really the hallmark of these vaccines, that that could also diminish in the months ahead. That appears to be what is driving this decision.

Now, we will hear from President Biden himself on this following this coronavirus briefing by these health experts.

One of the things that president Biden is going to have to do is make the case for why Americans who are fully vaccinated, who have gotten two doses, should be allowed to get a third dose when you have billions of people around the world who are still unvaccinated. You can see a flick of that in the statement from the health officials who note they are also at the same time going to continue to increase vaccine donations around the world.

The U.S. is, of course, the number one donator of vaccines around the world. That being said, this is still a zero sum game. So, obviously, by giving third shots to millions of Americans who have already gotten two, that's going to perhaps delay for some people around the world the possibility of getting their first or second dose.

BOLDUAN: Jeremy, thank you for that.

So, for more on the booster announcement coming from the White House COVID team, joining me right now is CNN chief medical correspondent, Dr. Sanjay Gupta.


BOLDUAN: Hey, Sanjay.

Talk to me about, I guess first and foremost, what does this booster announcement mean for Americans?

GUPTA: Well, I think it's going to be a tangible thing ultimately, which is eight months after you received your vaccine, you would be eligible for a booster. It's probably going to go in order of people most vulnerable first and then down by eight. It won't all be at the same time. But the week of September 20th when these shots would become available for people.

Sort of more broadly, what they're hinting at here, is there's data that's going to be presented for the first time -- when I say for the first time, I mean even other health agencies haven't seen some of this data, that's going to show some evidence of waning protection against mild or moderate COVID.


Now, the concern is will that ultimately translate to waning effectiveness against more severe COVID? They can't say that for sure. What they're saying, Kate, is there's enough of a concern here that they're going to go ahead and get this ball rolling and have this available within the next month.

BOLDUAN: Let's talk about this data. All along we have heard from top officials and very smart doctors saying booster shots are not needed until the data tells us it is. We've seen data from overseas, data from Israel that we know folks have been following closely.

What do you think is going to come out in this data that is so significant? And is this really what is driving this change?

GUPTA: Yeah, and I think this is a really important point, Kate. I don't think you're going to sedate that that has shown a decrease in effectiveness or a significant decrease in effectiveness against hospitalization and death.

You're quite right. I think for a long time the message coming out was, until we hit certain criteria, triggers an evidence of that decrease in effectiveness against hospitalization and death, we probably won't be doing boosters.

Now what they're saying is this is a little bit of judgment. We've seen a waning in effectiveness against mild or moderate disease, we're concerned that will influence the waning effectiveness of hospitalization and death. So, can we get ahead of this?

I mean, it's not a slam dunk. Even over the last couple days at the highest levels of these agencies, people have thought the opposite, we don't need boosters. Listen to recordings from just yesterday from the CDC.


DR. NEELA GOSWAMI, MEMBER, CDC VACCINE TASK FORCE: We do want to clarify right away that the need for and timing of a COVID-19 booster dose has not been established.

DR. KATHLEEN DOOLING, MEMBER, CDC VACCINE TASK FORCE: Other fully vaccinated individuals do not need an additional dose right now.


GUPTA: Kate, that was yesterday. Today, it sounds like we're going to hear a very different message.

That gives you an idea of how, this is not a slam dunk decision but also the lack of communication even among the highest health agencies in the country. BOLDUAN: It doesn't -- it doesn't mean that any confusion can't be

clarified, right? That might be exactly what today is about is offering clarity on what they know and what the recommend decision is now and going forward.

But it has been confusing, Sanjay. You just played some of that audio. It's something you and I have discussed. What are you gathering why this -- especially this bit -- there's been so much confusion around the messaging?

GUPTA: I think it's been a constant issue, Kate. The messaging in this particular case, it may be that some of this information leaked earlier because some of these documents were obtained and leaked to news organizations. They were always planning on presenting the data to bolster why they're doing this at the same time as the recommendation so it wouldn't seem a scatter shot sort of approach. Boosters only if X, that's what we've heard.

On the other hand, you've talked to people in the world of vaccine makers, look, this is always the plan. You'd always need a booster. There's very few shots where you would not get a booster. The first two shots were considered sort of the prime. This shot would be considered the boost. Again, some are saying that was always the plan. It's confusing. There has not been a unified message on this, and I agree with you, hopefully there's clarity today.

BOLDUAN: And part -- one of the challenges that come along with confusion or even just explaining to the American public about what the booster means is the fear it could undercut efforts in getting the tens of millions of Americans who are still resistant in getting the first shot, to go out and get that shot.

Is that -- do you hear concern among officials about that?

GUPTA: I do. This was a big topic of discussion in my background conversations I had with people at the highest levels here. This is something we talked about a bit. Will the message now seem to people that you're really not protected until nine months --

BOLDUAN: Sanjay, I'm going to cut you off to jump in -- let's head over. The coronavirus response team is beginning the briefing now.

JEFF ZIENTS, WHITE HOUSE COVID-19 RESPONSE COORDINATOR: Walensky and Fauci in just a moment.

First, I want to provide a brief update on our fight against the virus. We continue to see a rise in cases driven by the more transmissible delta variant with cases concentrated in communities with lower vaccination rates.

So this remains a pandemic of the unvaccinated.


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. 7 million, that's the highest two-week total since the beginning of June.

Over the past month, we've also seen a 75 percent increase in the average daily number of 12 to 15-year-olds getting vaccinated, particularly important is adolescents begin going back to school.

Once the numbers from today are reported, we will have reached 200 million Americans with at least their first shot, 200 million Americans with at least one shot. 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. Our COVID-19 surge response teams are a whole-of-government effort with experts, personnel and resources from HHS, CDC, FEMA, the department of defense and the department of veterans 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 ambulance 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.

And we will continue working closely with states to do all that we can and to match resources to their needs. Just yesterday President Biden directed FEMA to continue fully reimbursing states, tribes and territories for all eligible COVID-19 emergency response costs through the end of a calendar year. A three-month extension of the order he signed on his first full day in office.

Importantly, this maintains 100 percent federal reimbursement for state deployments of national guard personnel for critical COVID-19 missions. President Biden committed to the American people that he would do everything in his power to end this pandemic. And from his first day in office, the president has marshaled a wartime effort to do exactly that. We have 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. Be guided by the science and always, always stay one step ahead of the virus.

Now let me turn it to Dr. Murthy to discuss our booster plans and then Drs. Walensky and Fauci to discuss the science behind the plan . Over to you, Dr. Murthy.

DR. VIVEK MURTHY, SURGEON GENERAL: Thanks, Jeff. It's good to be with all of you today. Today I want to update you on where we are regarding boosters for fully vaccinated individuals. Our top priority has always been protecting people and their families from COVID-19. We have been fortunate to have safe and effective vaccines that offer outstanding protection against the worst outcomes of this virus, severe disease, hospitalization and death. The COVID-19 vaccines authorized in the United States have been remarkably effective, even against the widespread delta variant.

We know even highly effective vaccines become less effective over time. Our goal has been to determine when that time might come for the COVID-19 sack scenes so we can make a plan to take proactive steps to extend and enhance the protection the vaccines are giving us. Having reviewed the most current data, it is now our clinical judgment that the time to lay out a plan for COVID-19 boosters is now.

Recent data makes clear that protection against mild and moderate disease has decreased over time.


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're seeing will continue in the months ahead which could lead to reduced protection against severe disease, hospitalization and death.

That is why today 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 September 20th, 2021.

I want to be very clear. This plan is pending the FDA conducting an independent evaluation of the safety and effectiveness of the 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.

The plan ensures that people 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 senior 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 of the timely plan for J&J booster shots.

I want to emphasize that this decision was not made lightly. It was made with careful consideration by the top medical and public health experts in 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. As always, we'll continue to follow the science on a daily basis and will 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've already committed to donate globally. We understand well that global pandemics require a global response and strong leadership. And 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 a family member to this disease, and hearing stories of people whose lives have been upended, and forever altered COVID-19, 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. So here is what you need to know. If you are fully vaccinated, you still have a high degree of protection from the worst outcomes of COVID-19, severe disease, hospitalization and death.

So we are not recommending that you go out and get a booster today. Instead, starting the week of September 20th, fully vaccinated adults could begin getting their booster shots eight months after their second shot of an mRNA vaccine.

And finally, 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 co-workers and neighbors, to get vaccinated. That is our path to ending this pandemic.

I'll now turn it over to Dr. Walensky, who will walk us through the data that helped inform our decision to take action now.


DR. ROCHELLE WALENSKY, CDC DIRECTOR: Good morning, everyone.

As Dr. Murthy mentioned, I want to provide an update on vaccine effectiveness. Today we're releasing three articles in MMWR, with data I'll describe that are helping to inform our booster plans. 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.

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. Third, vaccine effectiveness is generally decreased against the delta variant.

So let's jump into the data. On this slide you'll see two studies, one from New York and one an analysis of data from the Mayo Clinic. From may 3rd through July 25th New York examined COVID-19 tests and linked them to individual vaccination status based on the state's vaccine records. This allowed New York to study vaccine effectiveness against infection over time for more than 10 million New Yorkers of all ages.

Vaccine effectiveness in May, early during the vaccine rollout in the state, was 92 percent. In the later months, further from vaccination, vaccine effectiveness declined to 80 percent. These data will be published in MMWR today.

The Mayor Clinic information looked at the Pfizer and Moderna vaccines among over 80,000 vaccinated and unvaccinated individuals across all age groups with data through July 18th. Like we saw in the New York, data, vaccine effectively against infectious declined over time.

In this case it declined from 76 percent to 42 percent for those who received the Pfizer vaccine and from 86 percent to 76 percent for those who received the Moderna vaccine. These data are currently available on a preprint server.

Today, CDC will also publish data from our national health care safety network. A nursing home cohort where we analyzed more than 85,000 weekly reports from more than 14,900 facilities.

Weekly COVID-19 case counts were used to evaluate vaccine effectiveness over time. These data demonstrate that vaccine effectiveness declined over time from 75 percent in March to 53 percent as recently as August 1st, 2021.

This represents a substantial decline in vaccine effectively against infection among those most vulnerable, including during months when delta was the most predominant circulating variant. Taken together, you can see while the exact percentage of vaccine effectiveness over time differs depending on the cohort, 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 vaccine effectiveness against hospitalization remain relatively high during times when the delta variant was surging.

CDC will also publish today in the MMWR data from the ivy network which examines data over 3,000 adults admitted to 21 hospitals across 18 states between March and mid July. This report compares vaccine effectiveness against hospitalizations early after vaccination, within two to 12 weeks and later after vaccination between 13 and 24 weeks and found vaccine effectiveness against hospitalization remained high. However, in this study only about 7 percent 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.

As we make decisions about boosters though, we also have to look at vaccine effectiveness in the specific context of the delta variant.


Preliminary data through August 6th from two of our vaccine effectiveness cohort studies that include more than 4,000 health care personnel, first responders and other frontline workers in eight locations across the country show waning effectiveness against symptomatic and asymptomatic infection in the context of the delta variant. From 92 percent prior to delta to 64 percent with delta.

Notably this analysis did not show difference over time which suggests effectiveness is also decreased against delta independent of when you were vaccinated. These data suggest full vaccination in the context of the delta variant may be correlated with less protection against SARS- CoV-2 infection than against prior variants.

To be clear, our top priority is to save lives and prevent severe infections. The data we will publish today and next week demonstrate that vaccine effectiveness against sars-cov-2 infection is waning. And even though our vaccines are currently working well to prevent hospitalizations, we're seeing concerning evidence of waning vaccine effectiveness over time and against the delta variant. Additionally, reports from our international colleagues, including Israel, suggest increased risk of severe disease amongst those vaccinated early.

Given this body of evidence, we are concerned that the current strong protection against severe infection, hospitalization and death could decrease in the months ahead, especially among those who are at higher risk or who are vaccinated earlier during the phases of our vaccination rollout. In the context of these concerns, we are planning for Americans to receive booster shots starting next month to maximize vaccine-induced protection. Our plan is to protect the American people and stay ahead of this virus.

Before I turn things over to Dr. Fauci to ensure the immunologic data, I want to emphasize one final thing. Our vaccines continue to offer the best protection against severe COVID illness. 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. 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.

We are currently averaging over 500 COVID-19 deaths per day, and these remain largely preventable. If you are still unvaccinated, please get vaccinated. The single best action you can take to protect yourself and others is to simply get vaccinated in the first place. And now I will turn things over to Dr. Fauci.


What I'd like to do over the next couple of minutes is provide you with the immunological basis that would support a third booster mRNA immunization. I will make four points and show you representative data from each of these.

First, antibody levels decline over time. Second, higher levels of antibody are associated with higher levels of efficacy of the vaccine. 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.

Next slide. So let's take the first concept, that antibody levels decline over time, in this case following two mRNA immunizations, and that's regardless of the variant. So if you look at the horizontal axis, at day 29 is when you get your second shot. You can see the level of antibodies go up at 43 days, but look what happens at 119 and 209 days. Regardless of the variant involved, the antibody levels against those variants decline over time.

Next slide. Next concept, that higher levels of antibody are associated with higher levels of vaccine efficacy. This is often referred to as an immune correlate. This is a paper recently published in a preprint server.