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The U.S. Department of Health and Human Services and the Department of Defense held a briefing Monday on "Operation Warp Speed" and COVID-19 vaccine distribution.
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operation warp speed and for bringing together all of America, HHS, the military, the private sector in the states toe Make this happen. This week, everyone's work starts to pay off This weekend. Shipment of vaccines is 2.9 million doses, enough to vaccinate 2.9 million people with 2.9 million doses held back and sent in 21 days for people to receive their second dose each Friday. From here on out, we will announce new weekly allocations of vaccine. It's likely that another vaccine may be authorized in the coming days. If it meets FDA is rigorous standards, depending the successful authorization of other vaccine options? We have enough vaccines already purchased to ensure we can meet our goal of vaccinating every American who wants it. By the end of the second quarter of 2021 we continue to negotiate four and purchase more doses to including the announcement of another 100 million doses of Madonna to be delivered in the second quarter of 2021 states and other jurisdictions have decided who will be vaccinated in the early stages, drawing on their own best judgment, their own situation and the recommendations of experts, these jurisdictions will generally be using these first doses to immunize frontline healthcare workers, along with residents of long term care facilities like nursing homes and assisted living facilities. Today, the CDC distributed another $140 million in funding to states to continue planning efforts around allocation. Operation Warp Speed is taking care of the cost of the vaccines themselves, the ancillary supplies like needles and syringes and the cost of distributing the vaccines to jurisdictions while healthcare payers are handling administration costs. So no American faces an out of pocket expense for this vaccine. These jurisdictions have given us the locations where they want vaccine shipped in total 636 sites nationwide, with 145 sites expected to receive vaccine today, 425 tomorrow and 66 sites on Wednesday. As we speak, vaccine is arriving at sites and trucks and planes owned by UPS and FedEx Toe bring these lifesaving products to the places where Americans will receive them. By Wednesday, vaccine will be delivered everywhere from sites here in Washington to the shores of Guam. So the northeastern corner of main here in Washington members of our military, HHS, public health leaders and private sector partners Air running an operation center 24 7, where many of them have been essentially all weekend to ensure these vaccines get where they're supposed to go without delay. Americans who may be in these early categories of healthcare workers or those in long term care facilities should look for information from their state governments like their State Cove in 19 Web page, or for for guidance about where and when vaccinations would occur. We know Americans will want to know how quickly vaccines are being administered and what kind of progress we're making. We want to ensure that any picture we give of this progress is accurate, and we plan to provide more updates in our on our work with states Toe provide as much information as possible in the coming days and weeks. Like so many Americans, I eagerly await the day when I could go receive a safe and effective vaccine and the day when my family conducive that, too, in the coming weeks, and I and all of our public health leaders across the administration will be out making a major push to educate Americans about the incredible safety and effectiveness of these vaccines. This FDA authorized vaccine in each vaccine FDA potentially authorizes will have been through the typical numerous stages of safety review and more. This vaccine has gone through clinical trials much larger than many vaccine trials. It's gone through the drug companies checks. It's gone through an independent data safety and monitoring board. It's gone through. The FDA is Independent advisory committee. It's been subjected to transparent standards at the FDA has published of its requirements, and it's been authorized by FDA. Is career scientific experts at 95% efficacy? This vaccine is extraordinarily effective at protecting you from this virus. Getting vaccinated will help keep you, your family and your country healthy and safe in the meantime, and in the coming months is our country approaches full vaccination. We have to continue taking steps toe. Keep ourselves our loved ones and our community safe. Wash your hands. Watch your distance where your face coverings when you can't watch your distance and avoiding avoid settings where you can't do those things where you may let your guard down. Every sacrifice you make in the coming months will help save lives and ensure that we emerge from this pandemic as soon as possible. Each vaccine administered in these coming days is a tribute to the generosity and genius of this country. The achievements of every American who made operation warp speed possible should be a point of pride for us all. Our war against the virus is not over yet, But this week we're taking a major step toward our eventual victory. With that, I'll hand things over to Dr Moncef slowly to provide, uh, update on development. And he will then turn to General Purna who will give us, um, or update in depth update on vaccine distribution. Doctors lobby. Thank you, Mr Secretary. Hello, everybody. Well, just very, very quickly. First acknowledge a historical event last week with the approval of the Pfizer vaccine, I think a great accomplishment by science, Andi. The investment off in basic research. Great accomplishment by academic science by science and development in biotech industry and the pharmaceutical industry and a great public private partnership as a enabled by the US government. So really e think Great job. But yesterday was just the first step with the Pfizer vaccine approval this week, probably tomorrow. The booklet. Former PAC Review Off the Modern A vaccine will be made public, and many of you will have an opportunity to look more in depth into how remarkably aligned with the fighter data. The modern data are also with almost 95% of Dixie against disease, 100% efficacy against severe disease on mawr for you to review tomorrow. That booklet and the vaccine will be reviewed at the very back meeting by the FDA on Thursday. And hopefully, as for fighter diligently followed by potentially an approval of the vaccine and distribution, we have an insured significant commitment in terms off vaccine. Those availability from Moderna with 100 million in the first quarter and the 2nd 100 million announced on Friday in the second quarter of 2021 we are in active discussions with fighter to similarly extend. The number of those is available for the American population, but things don't stop there. You know that we have two other vaccines in phase three trials. The Johnson and Johnson Johnson's vaccine one shot vaccine. We now are almost at 42,000 subjects recruited in this city so slightly more than the cap we announced last last week. The study will stop recruiting later this week. Andi, given the intensity of transmission in the US on did in the other countries where the trial is being conducted, we definitely expect to have first readouts of that trial in the first parts of the month of January and likely potential complete read out of the trial towards the end of the month and a submission oven anyway. Vaccine doses from the J and J Vaccine will, if approved, start to participate to immunizing the U. S population in the month of February and going forward. And because it's a one does vaccine, they can really scale up very quickly the number of US vaccines that would be, uh, uh immunized. The the fourth vaccine that we have in the portfolio that's in phase three trials is the AstraZeneca vaccine. You know that that vaccine has undergone phase three trials in the UK, in Brazil and in South Africa, but also under operation warp speed. We have conducted a clinical trial, mostly here in the US. We have more than 22,000 subjects recruited in that trial. On that trial should also be completing its first ethic, Siri doubt somewhere in the probably second half of the month of January and potentially be ready for an EU a submission later in February and again participating with vaccine does is in the month of March and going forward. These are the reasons why we feel confident, provided that the vaccines performance remains on the path that we are on, that we will be able to have enough vaccine. Those is to immunize the U. S population. There's two points I want to say in conclusions. One is it's very, very important now that vaccines are approved in the U. S. That Americans continue to act in a generous way in that they would continue to participate into clinical trials. It is thanks to the participation off tens of thousands of Americans in the Pfizer a Northerner trials, that we are able to have these vaccines approved today and that we are able to assess their efficacy and their safety, and likewise for the young sense and for the AstraZeneca trial, we have two more vaccines in the portfolio using more classical protein based vaccine platform technology. Please continue to participate in the trial these vaccines are very likely to be as effective as the vaccines that we know already and as safe as those vaccines. It may very well be that participating in the clinical trials could be the fastest way to access vaccination. You know that we are doing the best we can in terms off providing vaccine doses. But these are rolling in the few millions per week Participating in a clinical trial may allow you either immediately to have a vaccine those or immediately on completion of the trial. If you were on the placebo group to have a vaccine injected on the second key point is really to continue our engagement. And all experts, real experts, engagement with the population to explain the data. Now that the data is available in public that demonstrate the efficacy and the safety of these vaccines, it's very important that we increase the number of Americans that, except to be vaccinated based on facts and data and reality, because vaccines on the shelf are useless and unless the majority the large majority of esque it's vaccinated, we will not be able to control this pandemic, stop here and pass on to general partner will tell us more about distribution. How we thank you. And of course, Mr Secretary, thank you for allowing me to be a part of this. Uh, and just come off of Dr Slough is last comment on Saturday I mentioned I was asked who was going to be the first one to receive the vaccine. Uh, and my comment was we've had over 100,000 people participate in trials. They were the first ones to receive the vaccine. They were the heroes to really help us get going. So I would applaud them to Dr Slavia's point continuous effort. And that will be so helpful. So update, uh, first of foremost Pfizer vaccine after eu A on Friday. Ah, lot of work was happening over the weekend by thousands of people from Pfizer, ups, FedEx and McKesson to ensure that the vaccines were packed on ready to be shipped in a very methodical, disciplined, over watched, uh, approach right. Our goal is every vaccine that goes out, um, is safe and effective upon delivery on. We wanted to make sure that deliveries occurred, uh, in the places where people could receive them on, then begin administering vaccine to the American people. It went incredibly well. A Zai talked to you about a lot of detailed planning and execution to this point. Our goal is our strategy is simple. One, the Pfizer vaccine initial push based on what was available. We wanted to get out to American people right away. I briefed the cadence, uh, that we would, uh, pack on Saturday, that we would relocate on Sunday and we would deliver on Monday. Deliveries have begun. Uh, today, as we speak of the 145 shipments to Secretary referenced, we know that 55 have been received on. We'll track the remaining 95 accordingly. Aziz, we go through the day. We know that the shipments for tomorrow's deliveries have already been packed and checked on. We'll be managing each of those to include Wednesday's shipment. Now, that's this initial 636 shipments that went out for the Pfizer vaccine. We have already, uh, identified the follow on orders for Pfizer vaccine on. There will be an additional 581 shipments that will continue on beyond Wednesday, Thursday, Friday, through the weekend in delivery to the American people. The point being It was the initial push that we were, uh, you know, fully driving execution. And now we're starting our drumbeat of continuous execution of vaccine as it is available. It's allocated to the states. The states tell us what location they wanted on at what quantities we package and we deliver. It is a constant flow of available vaccine. Clearly, the next vaccine that we're looking forward to you A. This week is the modern A vaccine. Uh, and in that light, we know that we're gonna ship just a little bit short of six million doses out to the American people on. We're shipping it to 3285 locations across the country. It will be a very similar cadence. Uh, that was executed this week with Pfizer, where we're hitting initial sites on Monday. Follow on Tuesday and Wednesday. And then by the end of the week, we're just in a routine cadence of execution. I cannot tell you enough, right? What role commercial in the series playing in this right, Pfizer eventually Madonna, right? And the work that they're doing to get the vaccine prepared for final distribution, McKesson in the distribution of all the ancillary kits for the Pfizer vaccine, which included syringes, needles, alcohol wipes, uh, and pollutant. And then they will also be responsible for kidding the vaccine for Madonna, right? So really a remarkable work. And then FedEx and UPS. I just can't say enough to the men and women of FedEx from the leadership all the way down to the person's moving packages, from storage capability onto trucks and planes. And then the pilots who got it out to where we needed it as a secretary said, There is not one part of this country that's not being touched. Uh, today through Wednesday, everybody is receiving fair and equitable distribution of the vaccine on its because of the commercial industry and the role they're playing in the distribution of the vaccine. We're incredibly excited about the strategy. We are continuing to provide states with future forecasts so that they can continue to plan our forecast. Uh, go from, uh, next week through the following six weeks for planning a zay said we will Onley release vaccine once the FDA has approved it s O forecasting helps for planning, but execution is on Lee based on approval. Uh, And then we share those allocations with the States for their planning on a weekly basis. Again, to reinforce it is not a one and done delivery. It is a consistent flow of ordering preparation and delivery. So vaccine continues, it rolls out as vaccines are available and mawr and more people get access to the vaccine every day. Mr Secretary. Thank you, General. Well, open for questions now, so thank you all. Operator, we're ready for questions. A friendly reminder that when asking a question, please state your name and publication and please keep your questions short as possible so that we can get to as many questions as possible. Thank you. Our first question comes from Angelica Levina with Bloomberg News. Your line is open. Be talking with you. Sorry. Can you hear me now? Yes. Okay. Thank you. Um so when the vaccination of long term care facilities begin and if not until the 21st Why wait a week to start those vaccinations, General? Yes, please. Eso Thank you. So of course we're working through the states plans. Right? And the guidance that was put out was long term health care facility slash nursing homes as one, uh, priority, but as well as the first line medical personnel who are out there. So allocations for vaccines went out to the States to the locations that they directed. And they are identifying, uh, in those populations who is first. Here's what we do know we know that several states are already going to establish are already established and then going into a long term health care facilities, they'll go in there this week. We know that the C. D. C. And collaboration with CVS, Walgreens and the States, uh, created a very elaborate campaign strategy for execution into the long term health care facilities this week. Um, we're doing, um, a scaling start into execution. Four states are ready to go in partnership with CVS and Walgreens to start scaling the vaccine into those facilities. We know on Monday, a week from today, over 1100 long term health care facilities and nursing homes will also begin vaccination. So very in incredibly difficult plan. As we work to touch over 70,000 long term health care facilities and nursing homes, collaborated and prioritize a za states want many tasks have to be achieved before you can actually walk into the door. You have to work through, make sure there's locations in the facilities To do it, you have to make sure that all the patients have a signed consent, which means sometimes you have to reach out to several layers of family. Uh, to get the final approval, we have to ensure that we have the right number of vaccine available, uh, to go into each of the facilities. So we're not going back and forth. We have to ensure that the persons uh, not on Lee, uh, the elderly. But the staff could be inoculated at the same time, so we close the bubble on each facility. So very detailed plan. Very extensive requirement of over 70,000. Uh, states are already executing are gonna execute this week on, and we are executing, uh, scaled. Um uh, scale. Start with CVS and Walgreen this week. The bluff is if they want to do it, we could figure out how to get it done. But we are ready to really take a good, hard right approach, uh, executing and taking care of these great Americans. They're in the elderly category, end up and and just one extra clarification there. You had mentioned the December 21st just by way of background, the CDC and working with CVS and Walgreens and MH had those discussions received feedback that remember the nursing homes had, until, I think, December 7th, to make their final election on contracting with Walgreens, receive yes or MH A for these distribution programs, and then they had to scale. And so they asked us to be sure to give them or, in those discussions, came about to give them headroom to be able toe. Just get the logistics and operations established. But there's no prohibition on distributing and vaccinating sooner. In fact, we encourage it sooner. If Walgreen's CVS MH they are ready to go faster. And as the general said, we expect to see vaccinations and nursing homes this week, um, and literally net by next week, these pharmacy chains should have the ability to execute vaccination programs daily in thousands of long term care and assisted living facilities and progress quite rapidly. Thank you. Next question, please. Thank you. Our next question comes from Evan Brown with Fox News. Good morning. Thank you all for doing the call today. I think this question might be best for the general, but anyone can answer it. Um was mentioned earlier in the call that there could be hiccups and distribution because nothing is ever perfect. Um, what would some of those hiccups actually be that you might have anticipated? And what, What would be the remedy for those and and how how intense would those hiccups be? So, uh, I think that we've worked through many, many situations and I'll give you a couple here in a moment, but they could be everything from a small as, uh, the addresses that were sent in weren't specified correctly. I'll give you an example. You know, for, uh, Collins, write the address that we double checked. I have people working on it because this was a Sarah situation identified. Had f. T. Collins versus F o R T. The system is so delicate that, you know, it needed the exact clarity. There was two spaces, uh, in another state. Um, I forget which one major city. Instead of saying the part of the city and then the second part of the city, there was two spaces which the machine couldn't identify. So that is one we've we've been identified. We're working through it. We know we set up teams to manage that. So that's way over on the left, way over on the right. Could be anything is, you know, catastrophic as an accident on the highway with a truck. Or, you know, you know, God forbid a plane, uh, etcetera. So all the way on the right, Then in the middle, we have things like, I know you've seen the weather report. There's, you know, there's a storm that's coming into the Northeast, uh, corner here on Wednesday, Thursday and Friday. There's a major storm in the Northwest that's coming in Tuesday, Wednesday, and Thursday. Uh, and so anything from you know, whether that could help could be a problem. Uh, the other thing that we're working on and it's a constant, um uh, the reason why we developed a strategy of the initial pushes and then the continuous drumbeat is so that we have the right people at the right place is doing the right work. You need the dedicated workforce preparing the boxes that know how to do it, right. This is the most valuable asset we have right now, and we don't want people over tired. We don't want new people coming in. We want the right people doing the right things. Uh, the same thing with truck drivers and pilots I read somewhere this weekend. Oh, we've extended beyond this. And beyond that, they're normal hours. Absolutely untrue. We created a steady drumbeat so that it is a predictable execution. And the right people are right Time to deliver, prepare and deliver the vaccine. So we're working a myriad of potential things from all the way to the left, all the way to the right, To the center, my responsibility, uh, to deliver safe and effective vaccines means get ahead of that problem. Uh, eso we're constantly thinking, Where do we need Thio? Where could we possibly be vulnerable? And how do we mitigate it? Great, general. Thank you, Evan. Thanks for the question. Next question, please. Thank you. Our next question comes from Elizabeth. Twice what? Use a today. Hi. Thanks so much for taking my question. Wanted to ask about delivery to rural areas. Focus has been at larger medical centers in this first week. When do you anticipate it's going toe? Get out to less populous areas s sure, Secretary. So I would just I reference it back to the States. Right where we're enabling the states plans, Uh, in their priorities and distribution, we can deliver it to any place, Uh, that that that there's unenrolled vaccine provider. Uh, and that is, quite frankly, as we did. The map is throughout all of our states, uh, territories and mega cities. So the capacity exists to do that? Um, many states are already engaging and working, um, with partners like CVS, Walgreens, and 17 other key pharmacies to help them expand. Uh, but at the end of the day, we're enabling their ability or their plan to execute their priorities. Yeah. And Elizabeth just on on your question about rural distribution again, the governor's air in charge about in terms of where they tell us to ship Thio. One misconception I get asked about a lot by the media Is the Pfizer vaccine in the ultra low, cold chain around that, uh, I just like toe the vice president I met with with Governor McMaster and his health commissioner last week down in South Carolina. His health commissioner. She had a great line. She said, you know, we're not gonna be storing this vaccine. We're gonna be using it. And so we can ship the Pfizer vaccine to rural hospitals, rural health centers, etcetera. It comes packed in dry ice. Five day stable, a refresh five days on the dry ice there. The more complexity actually with Pfizer is that it comes in 975 doses per package right now, whereas the Madonna will be more flexible, smaller package, size and, of course, also regular freezer for storage for storage capabilities. But there's nothing in the nature of the Pfizer vaccine or distribution that prevents use in rural. Just wanna make sure use all those doses within the relevant time frame. So thank you. How about the next question, Operator? Next question, please. Your next question comes from John Cohen. What? Science magazine. Thank you for taking my questions. In keeping with the Secretary is our commitment for radical transparency. Could you please post the dashboard as riel times I and delivery information you reveal exact in Greece. Secretary said work being provided to Pfizer. Can you give us an X amount invested specifically in vaccine? I worked, so you broke up a bit. We certainly are releasing the information about our contractual commitments as much as we're able to consistent with the Procurement Integrity Act. There are obviously some elements of it that are commercial confidential that we just legally aren't able to. But we've tried to post our contracts and other financial commitments fully on. We are also going to be working to provide a dashboard and information to be ableto ensure that you and the American public are able to see the progress on vaccination as we go. I know, General, if you've got any update on what that will look like, so were we created the system. There is no system in America that existed until we came together to bring in all the authoritative data, authoritative data across the country into one system. So now we do have the system and we can see ourselves. Aziz, We are executing the beginning here. We're really just making sure that everything tracks so there's a lot of double phone calls to make sure this says this and it's very good. And then after that, then I have see, based on guidance, well distributed it accordingly. Thank you, General. We have the next question please. Thank you. Our next question comes from Carl O'Donnell. What? Reuters news. Hi, this is Hi, this is Carl. So, uh, I was curious. Just if you could elaborate a little bit on the facilities from which these these doses, they're gonna be shipped. You know, not not just the first tranche, but maybe the, you know, 1st 25 million or so that we've been hearing about from fighters is just gonna be the, uh, U s facilities. Ondas Belgium or is Belgium also gonna play a role in providing supplies? General, are you comfortable talking about? Yes. So, uh, the primary doses for Pfizer come out of Kalamazoo? Um, and that is where they will produce and distribute it accordingly. We did get some initial doses from Belgium to help us get going, uh, to meet the requirement, as we've made with Pfizer, uh, really is approved accordingly by the FDA. It's on Lee the way we're allowed to distribute it. But most mhm, the remaining vaccines I see coming from inside of the United States as we go forward. Same thing with Madonna vaccine when that eventually rolls on will distribute it from inside the United States. Thanks. Next question, please. Your next question comes from Lisa Krieger with Mercury News. Yes. Thank you for taking my call. So it's great that East Coast immunizations air starting this morning. Can you tell us that the West Coast shipments have gone out when they're arriving in San Francisco? Sacramento in L. A. With statuses. Um, vaccines headed out here, so they're all every all, um, all deliveries will be made today. I was told no later than 1400 hours. Local time, Right? Is that we're working through the time zones on distributing accordingly, So I suspect somewhere in the next 4 to 6 hours, uh, that will be out in the West Coast locations. Uh, if not already there. Thank you. All right. Thank you. Next question, please. Think your next question comes from Make Taurel What? CNBC. So I'm wondering if you guys can walk us through kind of what to expect from Madonna if it gets emergency use authorization around the same time. What are the differences between how the during a vaccine gets shipped as it is part of operation warp speed versus how we've seen the fly, their vaccine get shipped and could you also like a little bit about why there are so many more doses of Madonna's vaccine now? And they're going to so many more locations? Yeah, so? So just, uh, in terms of Madonna Timeline Aziz. Doctor Slough. We spoke about Meg. The advisory committee is on Thursday, and assuming that everything remains on track, we would hope and anticipate FDA action. Comparable to what? We've seen this last week with Pfizer. No guarantees, but we would certainly hope the comparable timeline. Uh, the biggest difference which General Pernik can go into is Pfizer and Madonna are both part of Operation Warp speed. Pfizer chose, however, because of the ultra cold chain storage to ship directly out of their warehouse facilities, using FedEx and UPS to the sites that the governors have asked us to have shipped Thio. Whereas Madonna is using McKesson, the wholesale distributor. So they will deploy from the Madonna manufacturing in the, uh, they will deploy through McKesson also using the logistics companies like FedEx to get the product out there. But generally wanna give a little more detail. Mr. Secretary, you got it exactly right. Pfizer, Just as you said, um, to lessen the transition with the ultra cold went right from, um, their locations to ups, FedEx and then final delivery. Uh, Madonna chose on. We supported, uh, they're gonna use McKesson as their, uh, integrator. So they'll take the fill finished product. Uh, they'll package it in accordance with addresses and quantities on Dale, attach the ancillary kids, and it'll be finally distributed down again. It was just a logistical, um, decision to ensure just a greater transition as we went through. So there's really no big secret there. Uh, FedEx and UPS are the key integrators of the final delivery down to the final location reference, uh, the cadence. You know, let's just, you know, for this conversation, assume we might be on some type of similar timeline. Our goal would be for the modern, a product to be available this time, uh, next week across the United States. So Monday, Tuesday Wednesday, a drumbeat vaccine of the initial push being sent toe all states across the country reference the quantities. The difference in quantities is about what was available when we were doing planning to ensure initial delivery. So, as early as I'm gonna get my dates wrong, but as early as 15 November. I had to snap the chalk. I snapped the chalk line on what was available for Pfizer so that states could do planning to the number. As we're sending out the first doses, we wanted them to have a much time to do planning and realize where they wanted it to go first. On DSO, I snapped the chalk line on what was available at the time, which was, you know, over three weeks ago on that's what went out. Well, I didn't have to snap the chalk line for Modern until a week or 10 days later. Aziz. We saw where they were in the process. So they naturally accumulated mawr vaccine available for the time of final distribution, which allowed me to almost double the availability from Madonna of Madonna over Pfizer. The key is, is that we catch up in our following cadence and allocations. There is no exact number. It's a number. It's available. And, uh, that's what's allocated, you know, s so that we can assure a flow of vaccines going out consistently to the States. Thank you. Next question, please. Thank your next question comes from Candice Choi with a p I, um General Partner, can you explain what the dash for you reference will be showing? Is that gonna be distribution? Is it gonna be uptake? And is it gonna be broken down by region? And then also you reference the 581 shipments from Thursday through the weekend? Are those parts of the first round of 2.9 million doses or are the 2.9 million doses all being delivered through Wednesday? So a lot of questions. First, it's it's part. It's the remaining part of that, right? So we we states are ordering to their priorities and and where they want it first. And as they did their initial planning, they wanted it in very certain places, uh, upfront to do certain things. Then they quickly as their plans, you know, matured wrong, wrong, wrong choice of words. Um, as they enacted their plans right then they immediately went in and ordered mawr to follow on ess. Oh, we got the initial push. And now we're in continuous effort from there that this is what we want so that vaccines go to the right place at the right time. Aunt could be executed. The first part Dashboards, You know, e No, it's maybe sound complicated, but we do this in Army tactical operation centers all over the world. We do it. And every time we're on the battlefield to when we're actually training it is about seeing yourself, um, and understanding what is happening so that you can identify and get ahead of problems and make sure that the plan is working accordingly. So, you know, we're looking at everything from the dashboards are the work we've We've been tracking trials, you know. You heard Dr SLA. We talk about how many people are participating in trial. We're tracking locations where trials are and what the enrollment is and what the type of enrollment. Then we're tracking manufacturing. We know all 25 facilities. We know where how much work has been done. How much people is there, what the supply requirements are, what their equipment uses. What is the rate of execution so that we can track and see all of that? Then the last dashboard is the final distribution. It's our ability to know what what's available. Where is it available? What is actually moving from point A to point B to point C. Uh, and when does it arrive at its final location? Uh, and then, yes, we can track uptake of vaccine not by individual, but by quantity of what has been, um, administered daily, weekly monthly, accordingly. Uh, we want to do this so that we can ensure the right flow of vaccine at the right time to the right places. Uh, in support of the states again. Reminder. This dashboard has never existed in our lifetime. Uh, to do this type of national view, uh, to really, um, Mission command execution, uh, from development trials to manufacturing and now final distribution. Great. Thank you. Next question, please. Thank you. Our next question comes from Tom Howell with Washington Times. Hi. Thanks for doing the call. I know it's early, but have you had any problems yet That would require you to tap into that reserve of 500,000 doses. And also, do you have a rough estimate of how many people might get vaccinated nationwide today? Thanks. So absolutely no situations that's required me to tap into the safety stock on DSO. You know, we manage that, you know, hourly daily, weekly. Accordingly. I don't not underst I don't know what the uptake would be. Mr. Secretary, we'll have 2.9 million doses this week. But that's really gonna be a matter of the progress of the different, uh, sites for administration and how quickly they're able to administer vaccines. So it would be impossible to project any any particular number for this week or even today. Next question, please. Next question comes from Alicia Old with Medscape Medical News. Yes, Thank you for taking my question. My question follows up on the last one a little bit. I'm wondering General Purna, if you could tell us if there are any plans toe hold back any of the modern A vaccine? Yes, there is. I mean, it's the same. It's the same, uh, situation. It's two different vaccines, you know. I can't We're not gonna enter. Of course, like that's a decision. The two vaccines have to be treated separately. So 1st and 2nd dose Pfizer. You know, Thio, an individual 1st and 2nd dose, uh, thio for Madonna. Uh, and our goal is to make sure that all vaccine, uh, is available for both 1st and 2nd doses on then the safety stock is I alluded to would be to mitigate a situation that could potentially occur. You know, whether it be weather accidents, uh, etcetera. So, yes, the answer is we are, uh, not ask, but I'm gonna share. Um, this is about making sure we're prepared to mitigate situations as our process matures, both in manufacturing and in distribution. Azi, I've said before the safety stock will go down significantly. Our goal. The guidance I've been giving is vaccine. Sitting on a shelf is not effective, right? We have the we have back to vaccines that air highly efficacy. The efficacy is high on. We want to get into. The American people were just taking prudent steps to ensure that the American people have access to the vaccine 1st and 2nd dose on that we remain capable of ensuring everybody across the United States gets fair and equitable distribution. Confidence will grow every day and allow us to reduce, uh, the safety stock accordingly. And, uh, and I wanted thio also explain something that's come up in some media questions around the whole back of vaccines and the approach given that this is this is a two dose regimen on both the Pfizer and the Moderna vaccines. So, as the general has explained for both Pfizer and Madonna, certainly in these early weeks of distribution, he's taking a bit of safety stock off the top. As you mentioned, the half a million on Pfizer, half of that safety stock there just just as a just for contingencies unknown and then distributing out to the states where the states have asked us to send half of the remaining doses so that that's where you get to. The 2.9 million doses of fights are being distributed this week. One of the questions that's come up is well, should you be distributing even mawr of that vaccine to get first dose vaccinations and people? Well, we've actually modeled. This is out this out quite carefully week by week, based on the expected release of additional production from both Pfizer and Madonna. Here's the issue. We need to make sure that if we vaccinate someone a first time that we expect there to be a vaccine for the booster on the 21st day or the 28th day, either from a held back supply at the federal level or from ongoing new production from the manufacturer that would credibly be releasable and available for that person on that date the clinical trial studies or for the first dose plus the booster, the data shows. That's what's needed. That's what we have to be able to support. So if we increase too much the number of first vaccinations in December, you not only have to be able to provide the booster in January, but you have to be able to continue first dose vaccinations of ongoing populations. So you're managing a flow of 1st and 2nd dose vaccinations, as well as a flow coming from manufacturers, which is the general's talked about were manufacturing protein biologics here on DSO there. You wanna make sure, especially in the early weeks of production, that you build enough safety into it because you want to make sure you get to a point where there is a rhythm and predictability on the quality of manufacturing and lots that air coming off. So that's what we've managed to. We are pushing to the maximum the number of people to get vaccine. Obviously, that's our party's getting as many people back then. It is possible, but we do have to be able to ensure there's a second dose available either from from what we held back or from realistically expected ongoing production, so that that's come up. I wanted to give that clarification. Um, if we could have one last question, please. Thank you. Our last question comes from sharing what? New York Times. Thank you for taking my question. General Purna indicated on Saturday that 20 million doses would be distributed by the end of the year. On Sunday, Doctor slowly gave a lower number of 14 million, which is the right number. And if it went down, can you please explain why? Uh, yeah, I explained that 20 million people will be immunized. I always said that in the month of December, before the end of the year, I'm not sure about the 14 million. Maybe the 14 million is actually the the border of magnitude off. A number of those is coming out of Pfizer or modern between the two. There will be in a vaccine doses to immunize 20 million people in the month of December and give them a second does in the month off January and immunize an additional 30 million people in the month of January. Yeah, just so just to be clear, with all three of us sitting here, Uh, by the end of December, we believe there will be enough vaccine distributed to get a first dose vaccination for 20 million people. Then, as Dr Slow, we just said by the end of January to add another 30 million first dose vaccinations. And then by the end of February, we actually believe we could have 100 million vaccine shots in arms that will have been that will have been done between first dose and booster shot vaccinations of individuals and, as Dr Slowly has said, uh, by the end of But that's by the end of the first quarter. By the end of March, 100 million actual individuals who have had at least a first does vaccination correct. Doctors like yes, actually, way plan to have 200 million doses of vaccine by the end of the first quarter. So by the end of March, which would be enough to have immunized the handed million people on depending on the performance of the Johnsons vaccine and the AstraZeneca vaccine, phase three programs and emergency use authorization, we expect a significant number of those is potentially from the young sense vaccine in February already and even more in March. And, of course, there's a single dose regimen. Those air vaccination equals person vaccinated at that point. So s So that's why we're so confident in the flow on the vaccine schedules that we've talked about. But I think very consistent in what we've tried to present to you all eso we will continue to do these briefings. Uh, I'm gonna be going shortly Thio g w hospital where I'm gonna get to see, uh, several of the first individuals getting vaccinated are heroic. Frontline healthcare workers here, uh, get to see them getting vaccinated and see the process underway. Very comprehensive program that G W hospital set up toe organized and allocate vaccine among their health care of their frontline healthcare workers. Eso We'll be doing a lot of that this week. As our leaders try toe, make sure that the American public CR complete confidence in the process usedto to get to these vaccines to have a credible scientific determination by the FDA on encourage all those who are designated by their states governors to, uh to go ahead and get vaccinated, please. So thank you very much. And, Caitlin, if you don't close us, thank you all very much. Please send in any follow up questions to a press office at media at HHS dot gov. Thank you.