On Booster Shots for most americans. Were also following dangerous and fastmoving developments out of afghanistan. We just learned Defense Secretary Lloyd austin and the chairman of the Joint Chiefs Of Staff, Mark Milley, will be briefing reporters this afternoon. This will be the first time weve 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 kabuls airport. Reports of taliban fighters opening fire to disperse large crowds. Witnesses reporting protesters being beaten by taliban fighters as well. Cnns Clarissa Ward is on the ground with reporting on the mayhem on the streets near kabuls airport. Well bring that to you in just a moment. We are moments away from a big announcement from President Bidens 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. Cnns 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 . Reporter thats right. We do have this statement already from the biden administrations 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 vaccineinduced protection and prolong its durability. They say were prepared to offer Booster Shots for all americans beginning the week of 20th'>September 20th and starting eight months after an individuals second dose. These Health Officials are saying this is needed because, first of all, they said theyve 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. 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. Obviously by giving third shots to millions of americans who have already gotten two, thats going to perhaps delay for some people Around The World the possibility of getting their first or second dose. Jeremy, thank you for that. For more on the Booster Announcement, joining me is cnn chief medical Correspondent Dr. Sanjay gupta. Hey, kate. Talk to me about, i guess first and foremost, what does this Booster Announcement mean for americans . I think its going to be a tangible thing ultimately, which is eight months after you received your vaccine, you would be eligible for a booster. Its probably going to go in order of people most vulnerable first and then down by eight. It wont all be at the same time. The week of 20th'>September 20th when these shots would become available for people. Sort of more broadly, what theyre hinting at here, is theres data thats going to be presented for the first time when i say for the first time, i mean even other Health Agencies havent seen some of this data, thats 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 cant say that for sure. What theyre saying, kate, is theres enough of a concern here that theyll go ahead and get this Ball Rolling and have this available within the next month. Lets 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. Weve 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 . I think this is a really important point, kate. I dont think youre going to sedate that that has shown a decrease in effectiveness or a significant decrease in effectiveness against Hospitalization And Death. Youre 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 wont be doing boosters. Now what theyre saying is this is a little bit of judgment. Weve seen a waning in effectiveness against mild or moderate disease, were concerned that will influence the waning effectiveness of Hospitalization And Death. Can we get ahead of this . Its not a Slam Dunk. Even over the last couple days at the highest levels of these agencies, people have thought the opposite, we dont need boosters. Listen to recordings from just yesterday from the cdc. We do want to clarify that the need and timing for a Booster Dose has not been established. Other fully vaccinated individuals do not need an additional dose right now. Kate, that was yesterday. Today, it sounds like were 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. It doesnt it doesnt mean that any Confusion Cant 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. Its something you and i have discussed. What are you gathering why this especially this bit theres been so much confusion around the messaging . I think its 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 theyre doing this at the same time as the recommendation so it wouldnt seem a Scatter Shot Sort of approach. Boosters only if x, thats what weve heard. On the other hand, youve talked to people in the world of vaccine makers, look, this is always the plan. Youd always need a booster. Theres 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. Its confusing. There has not been a unified message on this, and i agree with you, hopefully theres clarity today. 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. Do you hear concern among officials about that . 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 youre really not protected until nine months sanjay, im going to cut you off to jump in lets head over. The Coronavirus Response Team is beginning the briefing now. 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, thats the highest Twoweek Total since the beginning of june. Over the past month, weve also seen a 75 increase in the average daily number of 12 to 15yearolds getting vaccinated, particularly important as adolescents begin going Back To School. Once the numbers from today are reported, we will have reached 200-million'>200 Million americans with at least their first shot. 200-million'>200 Million americans with at least one shot. Thats 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 Covid19 Surge Response teams are a Wholeofgovernment 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 Covid19 Emergency Response costs through The End of a calendar year. A threemonth extension of the order he signed on his first full day in office. Importantly, this maintains 100 federal reimbursement for State Deployments of National Guard personnel for critical covid19 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 its 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. Thanks, jeff. Its 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 covid19. 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 covid19 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 Covid19 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 covid19 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 were 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 covid19 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 20th'>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 cdcs 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 se seniors. We will also begin delivering Booster Shots directly to residents of longterm 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, well continue to follow the science on a daily basis and will take whatever steps are necessary to protect our nation from covid19. 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 weve 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 covid19. Im 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, 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 covid19 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 covid19, severe disease, Hospitalization And Death. So we are not recommending that you go out and get a booster today. Instead, starting the week of 20th'>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 covid19. That means encouraging our family and friends, our patients and students, our coworkers and neighbors, to get vaccinated. That is our path to ending this pandemic. Ill now turn it over to dr. Walensky, who will walk us through the data that helped inform our decision to take action now. Good morning, everyone. As dr. Murthy mentioned, i want to provide an update on vaccine effect tifrness. Today were releasing three articles with data ill describe that are helping to inform our booster plan. 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 Covid19 Vaccine Series will last. Examining numerous cohorts through The End of july and early august, three points are now very clear. First, vaccineinduced protection against Sarscov2 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 lets jump into the data. On this Slide Youll 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 covid19 tests and linked them to individual Vaccination Status based on the States 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 . In the later months, further from vaccination, Vaccine Effectiveness declined to 80 . These data will be published 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. In this case it declined from 76 to 42 for those who received the Pfizer Vaccine and from 86 to 76 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 covid19 Case Counts r counts were used to evaluate Vaccine Effectiveness over time. These data indicate it declined over time from 75 in march to 53 as recently as august 1st, 2021. This represents a substantial decline in Vaccine Infection among those most vulnerable, including during months when delta was the most predominant circulating variant. Taken together, you can see while the Kpak 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 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 prior to delta to 64 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 Sarscov2 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 Sarscov2 Infection is waning. And even though our vaccines are currently working well to prevent hospitalizations, were 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 vaccineinduced 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 covid19. In these areas the data are showing us that the more people who are in the hospital and tragically more people are dying of covid19. We are currently averaging over 500 covid19 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. Thank you very much, dr. Walensky. What id 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 lets take the first concept, that Antibody Levels decline over time, in this case following two Mrna Immunizations, and thats 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, and what it shows is that a model of vaccine efficacy, in this case based on the Moderna Phase three trial, shows that four weeks after the second dose, that what you have is a Serum Neutralization tighter of one to 100 which goes up from the vertical Red Line that gives you an efficacy of 91 . But if you look at the dark black line going from left to right, as you go further up, you get a higher degree of efficacy. So the higher the neutralization tighter, the higher degree of efficacy of the vaccine in this model. Next slide. Third issue, higher levels of antibody may be required to protect against delta. Im showing you data now both from moderna on the left and a paper in the new England Journal has very similar data from pfizer. If you look at the left panel, what youre measuring is neutralization tighter after two doses of the immunization. And the open circles are the same people as in the pink circles. Youre looking at the fact that the immunization the neutralization tighter required to neutralize the standard Prototype D 614g is clearly much lower, as you see it all goes down in pink when youre dealing with delta. Next slide. The next concept, and that gets to the booster. The booster Mrna Immunization increases Antibody Titers by at least tenfold. These are data from moderna, but pfizer has announced very similar data. The Bottom Line is, if you look first at the left panel, the first column is looking at the Antibody Titers just before the third dose and then 15 days after the third dose is shown right next to it that says d15. As you can see, a remarkable increase in titers against the 614g, the b1351, the p. 1 and the pfizer data which you would suspect to be similar to the moderna, is also against the Delta Variant. You get a dramatic increase in Antibody Tighters when you do a third immunization dose. Last slide. So in summary, the current immunological data that indicate that Antibody Levels decline over time, higher levels of antibody are associated with a higher level of efficacy, higher levels of antibody may be required to protect against delta and, as i showed you on this former slide, a booster Mrna Immunization increases Antibody Titers by multiplefold. All of this support the use of a third booster Mrna Immunization to increase the overall level of protection. Well go back to you now, jeff. Thank you drs. Murthy, fauci and walensky. I want to be clear the president s Wholeofgovernment Vaccination Effort is ready to get every american who needs one a Booster Shot. Pending fda approvals, boosters will be available starting the week of 20th'>September 20th. The plan is for the rule to be simple. Get your Booster Shot eight months after you got your first second shot. I apologize. If you got your second shot on february 1st, you can get a Booster Starting on october 1st. If you got your second shot on march 12th, you can get your Booster Starting on November 12th and so on. Thanks to the aggressive actions we have taken to establish our vaccination program, it will be just as easy and convenient to get a Booster Shot as it is to get a first shot today. We have enough Vaccine Supply for every american, and youll be able to get a booster at roughly 80,000 places across the counted, including over 40,000 local pharmacies. In fact, 90 of americans have a Vaccine Site within five miles of where they live. And importantly, boosters will be free regardless of immigration or Health Insurance status. No i. D. Or insurance required. So the Bottom Line is that we are prepared for boosters, and we will hit the ground running. In the weeks ahead, well continue working closely with states, Health Care providers, pharmacies and national and communitybased organizations to ensure americans know they should get a Booster Shot eight months after their second shot. And we will be laserfocused on getting boosters to longterm care facilities to make sure residents and staff get their shots and are safe and protected. Importantly, as we continue to vaccinate americans, we will maintain our focus abroad as we know this virus knows no borders. We have already shipped more than 115 Million vaccine doses to 80 different countries. More vaccine doses donated than all the other countries in the world combined. And just this week we started shipping the half A Billion pfizer doses that the u. S. Pledged to purchase and donate to 100 low and lowermiddle income countries in need. In the coming weeks and months, we will do even more to lead the global vaccination efforts, accelerating our work to build Vaccine Manufacturing and Production Capacity both here in the u. S. And in other countries. Or wartime effort will continue doing everything we can to get even more people vaccinated both here at home and Around The World. We can and must do both at the same time because thats what its going to take to end this pandemic, and we will not stop until we get the job done. With that, lets open it up for questions. Thanks, jeff. As a reminder, please keep your question to one question. There are many today. First lets go to stat news. High, folks. Thanks, as always, for doing the briefing. This is a Mike Ryan Quote from a w. H. O. Briefing earlier today about Booster Shots. If we think about this in terms of an analogy, were planning to hand out extra lifejackets to people who already have lifejackets. Im curious. I know you emphasized All Of You, this is a false choice, vaccinating americans versus vaccinating the rest of the world. Can you explain how there isnt finite Vaccine Capacity and how Booster Shots for americans does not at this moment come at the expense of first or second vaccine doses for folks elsewhere in the world . So let me go first and dr. Murthy, if you want to add anything. Look, to end this pandemic, we have to protect The American people and we have to continue to do more and more to vaccinate the world. Both are critical. And were already proving that we can protect our own people here at home as we help others. Just to give you some data here, in the months of june and july, the u. S. Administered 50 Million shots here in the united states and we shipped more than 100 Million to other countries. As i said, the 115 Million doses that weve already donated is more than all the other countries combined. And during the coming months, when we talk about Booster Shots, we expect to give about 100 Billion boosters in the united states and at the same time we will be donating more than 200-million'>200 Million, twice that number, additional doses, to other countries on our way to donating more than 600 Million vaccines. We are continuing to serve, as the president has said, as an arsenal of vaccines for the world, and youll see us do more and more. This builds on our support of the trips waiver, our commitment to covax where were the largest contributor, of the Quad Partnership which we helped to establish which is on track to produce at least A Billion doses of Covid Vaccine in india, for the Asia Region by The Ends of 2022, and our work to support Vaccine Manufacturing in africa by providing financing to a South African Business to bolster Manufacturing Capacity to produce more than 500 Million doses. Were just going to keep going and going and going. So this is a situation where were going to do both. Were going to both protect The American people, and were going to do more and more to help vaccinate the world. Dr. Murthy. Thanks, jeff. Good to hear your question. Appreciate it. Look, i do not accept the idea that we have to choose between america and the world. We clearly see our responsibility to both and weve got to do everything we can to protect people here at home while recognizing that tamping down the pandemic we know that. We see that clearly. We know we have to work on both fronts. But when we sedate that that is giving us essentially indications that protection is starting to diminish in terms of mild and moderate disease when we recognize that, if this trajectory continues, that people who are well protected today may see more vulnerability in the future, we have to act. The science tells us that. Our clinical judgment tells us that, and that was a collective decision of the top Public Health and medical experts in this administration. Again, we will do everything possible to protect people in our country. Thats why were announcing this booster plan, but we will also continue to accelerate our efforts to vaccinate the rest of the world. We take that responsibility very seriously. Next question, please. Tran haslet at abc news. Hi. Thanks for taking my question. How realistic is that 20th'>September 20th Launch Date given that we havent seen the official request from Pfizer Or Moderna yet . That is the date were working toward. As weve said, that is obviously pending both the Fdas Approval and the acips recommendation. That is the date that were prepared for, beginning the week of 20th'>September 20th. Next question. Cnn. Thanks for taking my question. First of all, why did you guys decide not to limit this to older and more atrisk americans and simply say that all vaccinated people will need a Booster Shot after eight months . Secondly, you say in the statement that the protection against severe disease, Hospitalization And Death could diminish. How certain are you about that . Are you saying over time that you do not believe these vaccines will continue to be highly effective at preventing Hospitalization And Death . Thanks. Lets start with you, dr. Murthy. Thanks, jeremy, for that question. First i would say, when we look at the data, we see a reduction in protection against mild to moderate disease across Age Groups. That was an important part of why we made this recommendation for all adults. We want to protect all adults in our country from the worst effects of covid19, but our plan does prioritize the most vulnerable. If you look at how we began vaccinating people, jeremy, at the beginning of the vaccination effort, we prioritize Health Care workers, longterm Care Facility residents and the elderly. Those are exactly the same populations that we will be starting with. So we do prioritize the most vulnerable. We think thats going to be essential in our goal to ultimately protect the country and save the most lives. Next question. All right. Weve been listening to this important announcement from the White House Coronavirus Response Team about boosters, and theyre now recommended after your second months eight months after your second shot. A lot to get through. Theres a lot of information that was just offered up. Back with me, cnns Sanjay Gupta as well as dr. Peter hotez, professor from baylor medical College And Dr. Mardi from florida international university. Sanjay, your reaction and take on what we just heard. Well, theyre making the case theres some evidence that theres waning effectiveness of these vaccines against mild and moderate symptoms. So not severe symptoms, not severe enough to get you in the lopt. Theres still a lot of protection against that and preventing people from dying. What they seem to be saying, and its an interesting sort of discussion here, theyre saying were trying to get ahead of this. Because were seeing evidence this is u. S. Data from Nursing Homes, hospital systems, large number of people in the general population, theyre saying since were seeing this decreased effectiveness against mild or moderate disease, were worried that will start to lead to decreased effectiveness against hospitalizations and death. Havent seen that yet, but thats a concern. Its an interesting point, kate. It will be a subject of significant discussion. For so long, the message has been until we see decreased effectiveness against Hospitalization And Death, and thats clear, we wont be recommending Booster Shots. Other people have said, look, Booster Shots were always going to be part of the plan. The messaging has been confusing, kate, i can tell you. You wonder, as we see how long it takes for people to go out and get a shot. Maybe theyre trying to see i dont know. They can see the danger ahead. Theyre trying to meet it there with these Booster Shots and rolling it out. I thought it was interesting exactly what you pointed to when they said they wanted to stay ahead of it. We had a graphic of what they showed that probably best sums up the decrease in the Vaccine Effectiveness that is leading them to this conclusion, right . Prior to delta, you see 92 effectiveness against infection, and now theyre looking at 64 effectiveness against infection. Can you put this into english, what this means that theyre seeing . What do you see with this, sanjay . Sure. Its a really important point, decreased effectiveness against infection. I dont know if you noticed, when you listened to dr. Walensky, she stressed that, against infection. When we say infection, we know there are people that may have infection and have mild or even no symptoms. There are people who have infection and have significant symptoms. They didnt really stratify that out. Just in general, we know that graph basically shows that the Likelihood Someone could test positive and have no symptoms all the way to test positive and be in the hospital could be reflective of that number. It would be nice to know how much of it is in each population, how much decrease was there really in terms of protecting against severe disease. What we know is from the other studies, besides this one, it seems pretty protective still against hospitalizations and deaths. So the majority of decrease in efficacy has been against mild or moderate disease. Thats what that really means. I will say that the Delta Variant seems to have accelerated some of that decrease in protection. Thats another point they made. Dr. Marty, what sticks out to you from this briefing . Thank you so much. First of all, i have boots on the ground, and i can tell you exactly whats happening. Right now in miamidade county, 20 of the people in hospital are people who are fully vaccinated. So i need to make it very clear of course, that does reflect that we have a high percentage of individuals who are highrisk for a variety of reasons, especially a lot of elderly people that live in our community, a lot of the transplant patients, except, the vaccinated group thats most likely to be in hospital. We have to be very clear. Also, being a Lab Director for a high complexity lab, which is another hat i wear, i can tell you that i have seen the Ct Values on fully vaccinated individuals with mild and moderate disease and they are sky high. So this decision and the presentation made by dr. Fauci, dr. Walensky and dr. Murthy were outstanding and incredibly valuable. But we very much need to be giving these third doses to those individuals who absolutely didnt get an initial first rise thats the group that was talked about last week, and we need to give boosters to those of us whose immunity is waning. Dr. Hotez, i want to get your take on this. I believe what dr. Fauci said is that the increased Antibody Levels by the third dose are by at least tenfold. Talk to me about what that actually means. You know, i think they actually missed some good opportunities to communicate this more effectively and to actually show The American people that theyre more on top of this. When these vaccines were rolled out back in december and january, and im sure dr. Marty and sanjay dr. Gupta remember this. It was done at a three to fourweek interval. The reason this was done, the first dose and the second dose three to four weeks after, Fiez Erz and moderna, the reason is because we were in crisis. We had 3,000 hospitalizations a day. We had to vaccinate vulnerable people as fast as possible. We did that and that was extremely successful. At that time we knew that was a Crumby Vaccine Schedule forgiving long lasting protective immunity. The minute that s thats how i think it should be framed, that this was predicted and predictable. It was just a matter of watching when we were going to see a big bump in Breakthrough Cases and Breakthrough Hospitalizations that we pulled the trigger on giving the booster. Weve seen data come out of the Mayo Clinic. Theyve showed the protection against infection has gone down from 95 down to 40 to 50 . They made the statement they havent seen the Breakthrough Hospitalizations. Were hearing about quite a number of Breakthrough Hospitalizations. I think the whole point was this could have been framed as something that we knew we were anticipating. We were getting ready for it. Now the data is showing up. Now is the time to do it. Where we cut off before the briefing started, im wondering if you think they effectively conveyed and explained this enough in order to not contribute to further skepticism amongst those who are still resisting to get the first shot. I think thats a concern that they raised when i talked to some of these officials, that was something that they were concerned about. This was always sort of part of the plan. But i dont think that was communicated. I dont think people thought that was always part of the plan. Theres no imminent booster needs. All of this just been the last few days weve heard that. This obviously is different. Its not been communicated well. Going forward, the idea of what this means, you know, in terms of how people are going to get their shots, who should get their shots, i think they have to be very clear on that. Also the fda and the Cdc Need to weigh in on this. The fda needs to authorize this, safety data, all that they look for typically. We also have Breaking News just in to cnn. Defense Secretary Lloyd Austin as well as the chairman of the Joint Chiefs Of Staff general Mark Milley, theyre at the White House, briefing President Biden on the situation in afghanistan that has been unfolding and deteriorating for days now. It comes hours before those leaders are set to brief. Reporter those military leaders are going to brief reporters and President Biden is going to do an interview with abcs george Step Steph anopouls stephanopoulos. This is a critical moment for the president. As bad as three Ese Images look far from afghanistan, the worst has not happened yet. The decisions he makes right now with the advice of those military leaders is going to determine whether that remains the case. They said theyre ramping up evacuations of u. S. Allies. It appears that we are doing so at the taliban leaders allowing safe passage. Whether thats for their own need for positive international relations or because of something the united states has over the taliban. We dont know. How they can sustain that operation is going to be critical to how The American people view the ultimate outcome of this withdrawal from afgha afghanistan. John, thank you. Ahead of the briefing from the Defense Secretary as well as the chairman of the joint chiefs this afternoon, i have learned from a source familiar with this Speech Planning that general milley does plan at least to take questions after his Remarks Today. There are plenty of questions that he will be facing about the situation on the ground there. Im told that part of his message that he wants to convey is in part a message to the troops. He wants to speak to the force. He wants to say that despite the difficult images and the difficult reality on the ground, he is very proud of The American military, what they are doing. He will be providing an Open Ra operational update in these remarks. The airfield is now up and running once again. He will essentially make the case that the way forward is to now keep at it. He is prepared to say in his remarks that their intention is still to get everyone out of afghanistan and out of Harms Way by that August 31st deadline. Joining me is susan glasser, a cnn global Affairs Analyst and Staff Writer for the New Yorker. Just your reaction to seeing the Defense Secretary and Mark Milley at the White House with President Biden ahead of what will be their Remarks Today as well as what im learning a little bit of a preview of what we will hear from general milley today. Its very important. We havent heard from him. Theyre overseeing this operation. Theyre accountable for the on the Ground Execution and the questions surrounding the lack of preparation for it, as well as the bigger debate that has once again been were the statements to The American people about the mission in afghanistan. It was always like just a few months away from success. Im sure those questions will come up as well. It strikes me that there are a number of extremely important and unanswered questions. What youre hearing from washington is a classic example of Washington Truth being different from ground truth. In washington the idea is that The Americans have the situation Under Control at the airport. Then youre airing reports from the ground in kabul. Its very clear that those american citizens and others who might be eligible to flee the country are not finding it easy to get to the airport. The taliban is in control of the city of kabul while we were at the airport. I think theres a lot of big operational questions if they can finish this by The End of august, which remains President Bidens stated timetable. Its not clear at all. The disconnect, i think, is very real. I appreciate the way you say it, susan, because you always see thEse Images like what we have seen from l. A. Times photographer marcus lamb. Theyre brutal. Men, Women And Children Brutalized and beat by taliban forces is what he waitnessed as they were trying to make their way to kabuls airport. He spoke to Anderson Cooper about seeing people assaulted on the streets by the taliban. I think we can safely say there is nothing new or enlightened about this taliban despite what theyre trying to say now. I wonder why are we kidding ourselves . Is the biden administration, do you think, being cleareyed enough about this . Look, those who follow the region very closely for the last couple decades, you know, that ive spoken with are not at all convinced this is some kind of kinder, gentler taliban. Many people believe the origins of this disastrous exit from Afghanistan Lie in the february 2020 deal that President Trump made with the taliban. It was supposed to be conditions based, but my view is that again and again the taliban did not abide by conditions for the reduction of violence and the u. S. Continued to draw down anyways in a way that may have enabled this situation to unfold as it did. So why are we trusting the taliban is a key question. Right now you have several thousand u. S. Troops at the airport, but thats the only territory they control. This is a very delicate situation. I would imagine Thats Part of the reason why you didnt see President Biden more critical of the taliban, in part because the Security And Safety of those u. S. Troops depends on not breaking into outright conflict with the taliban in order to evacuate as many civilians as possible, which seems to be the goal of this mission. Real quick, i just wanted to get your take if you were surprised. The Nato Secretary General said he hasnt spoken to President Biden, that bidens only spoken to boris johnson. Does that surprise you . It does. Jake sullivan was doing a briefing and he said that President Biden had not spoken to a single leader. Later in the day it was advised that biden then spoke with british prime minister boris johnson. They werent consulted really by the biden administration on this pullout. Thank you for being here. We have a lot of Breaking News we are covering right now. Im kate bolduan. Thank you for joining me at this hour. Inside politics with John King starts now. Hello, everyone. Welcome to inside politics. Covid briefing just wrapped up. Yes, most of you will need to get a third shot, some as early as next month. Plus, Rage And Desperation in afghanistan. Thousands of americans are still stuck in the country, plus thousands more afghans who trusted american promises to get them out. Now both must rely on the taliban to clear an exit path. Failure, catastrophe, flawed