Hardtoreachen populations with the goal of ensuring that a safe and effective vaccine is available v for every american o wants one so i want to welcome you for the discussion. I can see and hear you so hopefully the others can as well i want to ask a question about the ongoing surge. Many suspected this to be bad but we are creeping towardsds 200,000 cases per day. Last tuesday we broke the single state record for debt and then the next day we broke it again. Meanwhile ive seen large crowds still going c to the malls and people are all on the street out protesting the closure of bars. There is clearly something going on so how does the cdc and the rest of the American Enterprise go aboutth convincing the public to take this seriously . That is a great question and i dont think that its that people dont take it seriously. I think it is just that people are tired. Just this week i canceled our christmas vacation and i think what folks need to understand is now is the time to really buckle down and follow the rules and if we can all do that in a couple of months we can get ourselves past this. Its a commitment to keep each other safe and the way to do that is to follow the rules and wear a mask. I ask that question because its momentous and theres many more. Its unwinnable for science and the progress of the vaccine. But right now they are seeing much of the data behind the candidates soas how do you go about addressing the concerns that its been rushed out and based on what youve seen so far what makes you confident about the process . Its an important distinction to understand. Sometimes i think that the term perhaps isnt thought through because people seem to interpret that asrp moving fast and sacrificing science and somehow that by going fast we cut short the size and scope of the studies being done but its not that at all. One of the reasons theyve moved so quickly because it didnt come out of nowhere they are built on a Firm Foundation of science that if scientists had been working on this for years when it came time to think about ack vaccine they went back to te platforms they had been working on and said okay can i adapt this quickly. The second thing is what makes it faster is what everybody wants to know and if theres a couple of things. Vaccine studies in general have places where theres a lot of work and then theres additional evaluation or they stop because they cant find the supply. Operation warp speed has taken every single piece of that equation from the beginning until now so theres no time and space between things moving forward. Theyve helped make those Clinical Trials go as ft but ao sacrificing the sizee and scope so the reason i have confidence from somebody that really understands the process. Its the same size and scope of any trial that goes on in the United States. The vaccine is overseen by an independent group of experts that have been called upon. They are the first ones that see the Clinical Trial data and then the fda scientists dont just reveal the detail that they are given, they actually analyze it themselves to make sure they agree with every bit of it. No one goes to the Advisory Committee they review the data and televised and then it comes to the cdc and our scientists review the data and our Advisory Committee reviews it in public so that everybody sees it. This may seem excessive but its a series of checks and balances to make sure nothing falls through the cracks and its also part of our commitment that we are going to be sure they are safe. As you mentioned the vaccines are undergoing review. Weve received this question please explain how the vaccine doesnt change d our human dna. Somebody asked me okay are there plant and animal extracts like do i want to take that. I was wondering if you could justy briefly answer that question and explain some of the fundamentals. Im happy to do this at a high level. Theres something about the vaccines being new and the Technology People sort of find disconcerting but you will roll up your arm and get the vaccine like you get your flu vaccine then when it gets into your muscle what it does basically is gives instructions to the cells to produce something called a spike protein and its similar to whats on ike outside of the virus so it is a way to basically teach your body to produce and response and once it teaches that immune response if down the road weeks and months later you actually get exposed to the virus your body says i recognize that and then you stop the virus in its tracks. Its just a way to sort of teach the body to get exposed to the virus. A. I think along those lines we have another question in the vein of some of the stories we have heard about the reinfection they had we published a story last week on the National Geographic about how they are still rare and we are starting to see more of them and its a little unclear. We got a question from jonathan fox essentially asking that question about the vaccine. Are there any possible adverse effects from taking the vaccine if youve already caught the disease and have a strong immune response. There is a theoretical response. The scientists that know the disease have worried about it and thought about it and dont believe that there is a serious harm. In the Clinical Trial they excluded people that were affected and there were some people in the Clinical Trials thatpa had antibody levels and that certainly the scientists that were going to be reviewing the data were going to be looking for. More importantly is the question of what does this mean down the road, how do i know how long it is going to last and if it is going to protect me forever. We dont know that and this isnt surprising. Theres always things we do not know at the moment a vaccine is authorized and licensed. A Clinical Trial and as big as it is its different than rolling out the vaccine to the entire public andbl thats why its important that we study the vaccine so we are going to carefully study it to see how well it also looking at those important questions. Does it protect you both from getting ill and transmitting and does it protect you longterm were does it wear off in time. Those are the questions that are incredibly important and we have put up a whole series of investigations. I believe there is a followup about those with autoimmune disease. Should they take it at the datao rule in . What we have so far is a Clinical Trial. It doesnt allow us to evaluate all of the individuals decisions. What i would tell anybody is if you have questions or concerns you need to talk to your own Healthcare Provider to help you make a decision. She said im a 76yearold in the vaccine is available and i take these required shots would i be able to be with my children who have not yet had the vaccine and i suspect you have more access so do we know if they knock out symptoms . I wish i could tell you the day after you get your second shot you could hug your family but the truth is its probably still too t soon to do that. Until we have more time to study and then as soon as possible we will buy them up the guidelines for right now it is too soon. If the vaccine cannot stop the transmission purchase stopshe the symptoms . There are an enormous number of covid cases every day in the United States. If they can protect you from getting ill you can dramatically reduce the number of cases and hospitalizations and the deaths. I believe there will be some protection againstst transmission and distant know if it is complete protection or not. Apparently got vaccinated andd protect ourselves with her own vaccine. And we have another highlevel question along that line what is the mechanism behind the possibility it can prevent symptoms while allowing viral transmission . Think about it this way. The way that your body protects you against symptoms so the virus gets into your nose and throat and it starts there that it moved through the rest of your body. Potentially it could be protecting you from the more harmful parts of covid but so the virus could be in your nose and throat you could transmitib it still. Its a difference between having the virus and to be fully affected go thats one way to think about it there are other vaccines with other diseases where the vaccine protects you from getting sick you still can transmit to someone else. It is not just theoretical. There are reasons to be hopeful it will protect against transmission. We want to be sure before we tell people. What are some examples of those diseases . One example is of the other side of the influenza vaccine based on safety and effectiveness found out vaccinating one population protects others. For example pneumococcal disease actually protects older adults so once we find out those things the way Clinical Trials are set up. And for those vaccine candidates within one year and those safety trials last one year and this will process classes between six and ten years so are we leaving out longterm safety data if we do something to give the vaccine to more people . Is there any more flexibility with the dough seeing regimen or adding a poster on a booster and we have to go back and start the trial over. Allstar with the first part. Safety is one of the most important things we need to do around the vaccine so talk about the checks and balances in place in the moment the vaccine starts to roll out we continue to monitor safety not just for Covid Vaccine but everyone in the United States never stop evaluating the safety of those vaccines were those robust Safety Systems in the entire world to take that seriously and because of the development of those vaccines those systems can enhance them. And then we incorporate them into a single system and look for weaknesses to say if there are weaknesses so the size of the Clinical Trial but if the argument is correct and the time it is ruled out so in that time. Generally dont see the recurrence but there is a caveat we ought tokn know about and to monitor safety after those vaccines are pulled out all the people that are getting the vaccines and then to report to us and what you experience from the vaccine and with that side effect to call back from us we will need everybody to understand the importance and in six months from now and then we really will need the help of those people. And that this discussion we have had so far. And to give to assess the data for themselves how do they make sense as the antibody profiles where should they go for information once the vaccine is approved . And then to get it to the people needed quickly. There are weeks or even months and whether they should getf the vaccine and to educate providers ande the public and then to move much more rapidly but it does shorten the period of time thats why its really important we have information readily available you can find on the website to be updated frankly every other day until we get to a a place to understand the vaccine if you click on covid and vaccine you can find a couple people with educating themselves and that Healthcare Providers into question these days about science and anyone who makes healthcare decisions. And with the cdc Healthcare Providers with any questions they have these can protect the individual can do it by getting people vaccinated for the people who have tuned in to get educated and your families and communities in many ways in addition to the Healthcare Provider and then go to the cdc website try to understand all the information to understand the science and then five more besideses that. But related to that idea of confidence so what do we know side effects from the front runner vaccine . And what happens after the second dose. And the whole reason you get vaccinated it can mean there are side effects go now the precise data in the pfizer vaccinee and those that are scheduled ten days later but what we have seen so far including the data from the earlier studies here is what people should expect some vaccines will have side effects and some people most of those will be mild or moderate lasting a few days the kind we are seeing so far his sore ar arm, muscle aches, fatigue they are even reporting fever for a few days. Most of the data f so far that is more after the second dose them the first. And the followup question with regard to protection if you take one dose and then you take a second dose do we have a good sense with those two stages are like so what is the value of those two doses . To start and end at the same place. That it is a precious commodity you dont want to waste it by not getting a second shot if you get the vaccine then get it again and then to be presented later this week of how much protection there is but that period of time was 21 or 28 but we have no idea afterr the first shot if you have any protection a few months later so its really important to get the second shot a and on time is much as possible if people are a few days late it is limited data so get that on time so to facilitate that the Health Department a lot of them are scheduling you when you get the first dose they will schedule you for the followup appointment and that is a great way to ensure you get it at the right interval. Tracking those two doses i saw a picture of the new card filling out the dates we are not using smart phones are automatic alerts. And what type of tactics or tools . All the things you have mentioned and text messaging. With the modern technologies you could imagine. But if nothing else works if you are not a Technology Person and dont carry a cell phone alone anybody to have any question of what vaccine they got and when they are due again. With the tried and true approacha approach. So to talk about how the vaccine will work and the importance from the university of North Carolina is an interesting question multiple groups have called for a Communications Plan with the vaccine is this something the cdc is working on . With the Communication Campaign cdc focuses on education and providers and Health Department with a vast array of partners to turn around with the population and turning out lots of materials and lots of stuff online and social media for those that can be used all the way down the chain and interwoven quickly and then to find Healthcare Providers have the information they need to educate people before they vaccinate. What is hhs doing they are the first country to get the patch as it rules out from these manufacturers . The negotiations with the pharmaceutical companies is done by operation andei warp speed and are part of the cdc collaborating across the globe to make sure we can take advantage of the Scientific Exchange really important as we roll out the vaccines for thees countries rolling them out early to share the data. If we have a vaccine candidate 95 percent effective and another is 70 percent im sorry talk about efficacy. Talk about how that works how we have access to both so this is complicated so with the fda to authorize the vaccine the effectiveness is best on the Clinical Trial in the risk of getting covid if you are vaccinated in terms of those who are not in the and the effectiveness that is 75 percent versus 95 percent. And especially in the early dates and its not clear if it isdi significant. With a single estimate not in every sector with all the caveats. So thats why its so important with the point of authorization. And to use the differential effectiveness and how do you make the recommendation. And to be in place over 50 years. And with her pediatrics and with the side effects also to have members of the public surrounded by stakeholders with those vaccine recommendations of those are incredibly valuable when we go to the Advisory Committee to say profile the two different vaccines. And this is my followup question was Advisory Committee makes a recommendation how does that affect the availability under medicare or medicaid with those insurance plans that we have . These recommendations in some ways are different issues. What i would say the Us Government purchase the vaccines there is no cost for anybody. In addition they will be free of charge. And we get a vaccine there are two differentci cost one is the actual vaccine within this setting there will bett no cost no copay it is free of charge. I want to have it. To be an important voice and a loud advocate to get the pandemic under control if we could just get the test out to people so what are your thoughts with the cdc for athome use as much as people expectd Going Forward for these test under development . They said it wouldld be important getting back to normal lifes with those experts advocating to be less sensitive and less specific to be an important tool so for me my focus on last six months with the availability of the vaccine with Everything Else going on these are way of life and will be a game changer to rollel them out successfully if people are willing to get then thats the game changer and to focus very much on the vaccine. I want to ask a few questions what 2020 has been like for you. We woke up at to the cdc being int atlanta and looking for an outbreak as a kid. But during the aboveri outbreak the United States response is what i would have expected. We were able to head to africa to apply the decades long history of Public Health we developed. s what has this year been like for you given where we are right now . It has been a hard year. Its hard to live through this i struggle with daily that makes life difficult and was social distancing and then to work differently High School Age kids and to be thoughtful and careful about things i thought were easy and then harder then millions of people who had covid family members and friends died to be seriously ill and those inconveniences seem like nothing in one of the reasons i have been focused i really vaccines are the way to get out of it and of those technical experts and scientist working every day getting ready for that moment we are at now to get us all back to normal as well as friends and family keep me working hard every day i feel like we can all be a part of the solution. So in the hope of getting us through this. I follow you on twitter march thank you to all the Healthcare Workers every day we appreciate all that you do all the Healthcare Workers are about to go through a fairly dark. How do we support them . Healthcare workers are the heroes of this pandemic. It has been a year and they still going to work and put themselves at risk. And then to help them to continue to do their jobs what can we do for them . If you have a Healthcare Worker or neighbor to make all of their lives easier if there are less Covid Patients was hospitalizations the way that we do that we know what works stay at home. In the Healthcare Workers. And just to wrap up closel closely, after march 30th and to think other cdc officialsto what should the public expect from the cdc Going Forward into next year . What are your hopes for next year that have returned to normal. To knoweally want there is a light at the end of the tunnel. What you are looking forward to next year . When i walk into the office at cdc and one of the things it says is based all Public Healthub decisions Scientific Data to benefit society of the institution so cdc and the staff can communicate with all levels of the government and by doing that and the vaccine process we can regain the trust of the American Public through the vaccine process to encourage people to get vaccinated. There is a light at the end of thehe tunnel people do you understand what you might expect that they will not be available to everyone at least until summer so we have to be patient i know thats hard because we are all anxiously awaiting. A virtual cdc 25 years and with a lot of vaccines. We will do everything we can to make sure this rollout as smooth as possible. And then people need to expected. And the longterm care facility and to be medically fragile if we vaccinate on monday and then on wednesday is at a terrible tragedy so i hope people will try to not jump to conclusions and look for other sources of data theat next six months and stick together. I think thats a lovely place to leave it. Thank t you for your Public Service and your work with the cdc this year in the last 25 years. We appreciate you