Transcript

DOD Officials Provide Briefing on the Department's COVID-19 Vaccine Distribution Plan

Dec. 9, 2020
Assistant Secretary Of Defense For Health Affairs Thomas McCaffery; Army Lieutenant General Ronald J. Place, Director, Defense Health Agency; Jonathan Rath Hoffman, Assistant To The Secretary Of Defense For Public Affairs

ASSISTANT TO THE SECRETARY OF DEFENSE JONATHAN RATH HOFFMAN:   All right, good morning, reporter friends.  Thank you, everybody, for -- for being here and thank you for those who are on the phone this morning.  As we promised about two weeks ago, that we would be giving you regular updates on our COVID response and -- and vaccine distribution plans, that's what we're here to do today.

With me this morning are Tom McCaffery, the Assistant Secretary of Defense for Health Affairs, and Lieutenant General Ronald Place, Director of the Defense Health Agency.  Mr. McCaffery and General Place will be providing key insights to our COVID-19 vaccination and prioritization plan in just a moment.

As many of you know, the Department of Defense has long been planning a phased, standardized, and coordinated strategy for prioritizing, distributing and administering COVID-19 vaccines to protect our people, maintain readiness, and support the national COVID-19 response.

We're going to cover five specific pieces of information that are of importance to the force and the public -- the size of the initial DOD allocation, the prioritization schema for the populations who receive the vaccine first, our priority plan phases for the distribution, the locations of the initial vaccine distributions and the general allocations, and the timeline for initial distribution and next phases of the distribution and vaccinations.

We have a lot of information to share.  We've provided you all with the slides in advance, as well as our press release.  There should be useful documents to follow along with.  I will note that a lot of work has gone into planning in the -- of the distribution of this vaccine, which in itself is a remarkable feat.

I ask that as each of you shares this information, keep in mind that our goal is to be transparent with the force about what is happening and to encourage our personnel to use the vaccine.  We are fortunate that DOD has weathered the COVID storm better than most and that is reflected in our allocation and how we are prioritization -- prioritizing our initial doses.  We look forward to being able to help the country get through the coming weeks and months as the vaccine is distributed and becomes more prevalent in our communities.

So with that, I'll turn the podium over to Mr. McCaffery.

ASSISTANT SECRETARY OF DEFENSE THOMAS MCCAFFERY:   Thank you, Jonathan.

And good morning, everybody.  And we appreciate the opportunity to highlight the department's plan for the delivery of COVID-19 vaccine.  The department's priorities, as you know, are protecting our service members, our civilian employees and families, safeguarding our national security capabilities, and supporting the whole of government response to the COVID-19 pandemic.

As such, and as we'll outline today, our plan will provide the COVID-19 vaccine to DOD uniformed service members, both active and selective reserve components, including members of the National Guard, dependents, retirees, civilian employees and select DOD contract personnel, as authorized in accordance with DOD policy on this topic.

I am extremely confident the department's plan, developed in collaboration with Operation Warp Speed and the CDC, provides a very clear road map to protect our entire DOD population across the globe against the pandemic.

Early in the COVID-19 vaccination program, there will be a finite supply of vaccine.  Vaccination distribution prioritization with DOD will be consistent with data-driven CDC guidance for national prioritization.  In the coming days, we expect the department to receive its first allotment of the vaccine.

Initial phases of the DOD distribution and administration plan are based on the expected limited number of initial vaccine doses allocated by Health and Human Services and the CDC to DOD, and on the department's need to rapidly validate our processes to support increased distribution as vaccine production increases.

At this time, DOD is expected to receive just under 44,000 doses of the Pfizer vaccine as early as next week for immediate use.  DOD's plan for distributing this vaccine includes monitoring processes to inform senior leader decisions about distribution capacity, increased distribution at administration locations, and our force health protection.

Our deliberate and phased approach to distribute and administer this first allotment and future allocations of the COVID-19 vaccine will focus on vaccinating priority populations quickly and safely, while simultaneously refining the intricate planning for the delivery of larger volumes of vaccine in future waves.

The department will prioritize DOD personnel to receive the vaccine based on the CDC guidance and on the department's own COVID task force assessment of unique mission requirements.  The DOD prioritization plan is consistent with CDC guidance and prioritizes health care providers and support personnel, residents and staff of DOD long term care facilities, other essential workers and high risk beneficiaries to receive the vaccine before other members of the healthy DOD population.

As mentioned, the DOD plan calls for a phased approach.  The initial phase is what we are calling a controlled pilot.  In this phase, we will be distributing the vaccine to priority populations in 16 distinct locations.  We will monitor the uptake and make adjustments to our plans going forward as necessary and as lessons learn from this controlled pilot.

We will continue with this form of distribution, adding additional prioritized personnel in additional prioritized locations until 60 percent of our DOD roughly 11 million personnel have received the vaccine, at which time DOD anticipates vaccine manufacturing rates to support full scale, unrestricted vaccine distribution to department personnel.  At that point, our intent is to distribute the vaccine in the same manner the department conducts its annual influenza vaccine program.

If you look at some of the slides we provided, the department selected initial vaccine distribution sites to best support several criteria.  Number one, the anticipated unique supply chain requirements for the initial approved vaccines, a sizable local DOD population with priority personnel across all of the military services and sufficient medical personnel to administer the vaccines and monitor recipients after initial and second dose administration.

In his remarks, General Place will provide additional detail on those specific locations.

In a recent virtual tabletop exercise led by deputy secretary of defense and senior civilian and military leaders, the DOD COVID Task Force and the leaders responsible for the first phase of the plan walked through the processes in great detail to ensure seamless distribution and dissemination of this initial wave of vaccine across our selected sites.  The lessons learned from this exercise helps solidify the department's plan on the way forward.

In terms of next steps, as soon as the FDA issues an Emergency Use Authorization, DOD's allocation will be pre-positioned at our initial locations.  Upon issuance of the EUA, the CDC's Advisory Committee on Immunization Practices will meet, review the EUA and then vote to recommend the vaccine, and how it should be disseminated and who should receive it.  We expect to have shots in arms of DOD personnel within 20 to 48 hours from the time the ASIP issues its final recommendation.

I want to personally thank the men and women across the department who have spent countless hours, both day and night, supporting the development of this plan.  The preparation for the vaccine of million -- of millions of individuals across the department in the coming weeks and months will protect our force against COVID-19 and allow us to continue to fill -- fulfill our mission to the nation.

General Place and I look forward to answering your questions.

LIEUTENANT GENERAL RONALD J. PLACE:  Good morning.  Thank you, Honorable McCaffery.

Our country and our forces should be assured that the Department of Defense is ready to execute a global COVID vaccination plan for our service members, as well as military families, retirees, and certain government civilian and contractor staff.

Following approval by the Food and Drug Administration and guidelines from the Centers for Disease Control and Prevention, the Defense Health Agency will lead a department-wide, phased effort to distribute and administer the vaccine.  While we await final approval from the FDA, the preliminary data on the safety and effectiveness of the two vaccine candidates is highly encouraging.  We're recommending that everyone take the vaccine when it becomes available to protect yourselves, your families, your shipmates, your wingmen, your battle buddies, and your communities.

As with most vaccines, some people may experience small adverse effects:  arm soreness, fatigue, even a fever.  The department will be fully transparent about any adverse effects that are reported and share this information with the CDC.

Now, as Honorable McCaffery mentioned, as we begin our vaccination process, the department specifically chose 16 locations, 13 in the United States and three abroad.  We selected these locations based on our desire to validate our plan.  As such, we chose locations with extra cold-storage capability, sizable local populations to vaccinate and medical staff large enough to administer it.  We chose locations from each of the military services, including active and reserve components, along with the United States Coast Guard.  Finally, we chose locations with an on-site immunization health specialist.

As Mr. McCaffery noted, the good news is that our military medical teams have worked for months to prepare for this moment, and we're eager to begin to deliver on Operation Warp Speed's promise.  The Department of Defense has decades of experience with conducting global vaccine programs.  Whether it's the annual flu campaigns or protection against novel diseases around the world, we vaccinate millions of our service members and families and retirees of every age every year, and we have systems in place to monitor the health of everyone who receives a vaccine.

In terms of the next steps following FDA approval, the department will receive and begin vaccinations of our high-priority populations this month.  We've identified the military installations and the military treatment facilities that will receive the initial shipments of the approved vaccines, as Mr. McCaffery noted.  We have initiated within our staff training protocols for vaccine administration, and we're working closely with our TRICARE network providers and pharmacies to prepare for wider-scale vaccinations as the vaccine supply expands.

This phased approach to vaccination will take time.  We recommend that everyone continue to follow the latest CDC guidelines, to include physical distancing, handwashing and wearing face coverings where appropriate.

This has been a challenging year for all Americans, and I'm inspired by the perseverance and commitment of the men and women of the department and the military health system.  Together, we're working as a team to protect all entrusted to our care.  Thank you.

MR. HOFFMAN:  All right, thank you.  We'll go to the phones.  I don't know if -- if Lita jumped on, from AP.  Lita?  From AP?

STAFF:  (inaudible)

MR. HOFFMAN:  All right.  So in the room.  Barbara?

Q:  I think my question is for the general.  I wanted to ask about the medical side of this, sir.  Could you explain as much as you can about what part of this vaccination program will be voluntary?  What part will be mandatory?  Just as much detail as you can, and especially for high priority categories, for deploying units, for senior leaders.  Can you walk us through some of that?

GEN. PLACE:  Yes, ma'am.  We anticipate that this will be approved using Emergency Use Authorization, not a fully-licensed FDA vaccination, and as such, the department's policy will be voluntary for everyone.  So there's no if, ands, or buts about it -- doesn't -- doesn't matter.  Voluntary for everyone.

Q:  So does the -- I -- I just don't know how this will work.  So it starts with Emergency Use Authorization.  The vaccination is voluntary for everyone, including deploying units, including high-priority units.  Does it eventually in some way shift to mandatory, once there's full FDA licensure?  And how will that, on a practical level, work, for example, for Special Operations forces, small units, strategic units deploying as -- on a team level if some people don't get it, don't -- don't take the vaccine?

GEN. PLACE:  Well, I'm not going to -- I don't know if Honorable McCaffery wants to talk to the full-licensure aspect and potential for future.  The department is strongly encouraging everyone to take it, and the reason for that -- if you look at the data that are available to all of us now, that -- that Pfizer at least, the one vendor has made available to everyone, if you look at the safety profile of it, the safety profile is very good and the efficacy of the vaccine, again, short time period, appears to be very good.  So in a risk stratification, my advice as a physician is that if -- everything we do in life, every medication that we take, every surgical procedure that we have is all about risk.  And the risk of this -- or these vaccines, from what we know, is much less than the risk of the actual disease process.

So our -- our advice to everyone -- volunteer basis.  Our advice to everyone is to take the vaccine, just based on risk.

(CROSSTALK)

Q:  (inaudible) quickly about making it mandatory (inaudible) --

(CROSSTALK)

MR. MCCAFFERY:  So on that question, I think as General Place indicated, this is -- this would be the normal process when a vaccine is first issued under Emergency Use Authorization.  It's typically on a voluntary basis, so we're going to be consistent with that.

As it moves, as FDA looks at the experience of the vaccine, you know, a real of experience that we're seeing in the population, and they ultimately -- assuming they ultimately grant full licensure, at that point the department would look at that and based upon, again, risks and benefits and look at unique requirements from the military departments, from the combatant commands, would make a determination if we believe for military readiness we should consider, you know, making a fully licensed COVID vaccine mandatory.  But there's a process we use based upon data, based upon the FDA's assessment.

But I think the other question your raised was in the interim period where, you know, not all the force is going to be vaccinated in the next month or two, the department's very clear in all of our policy, everything that we have in place right now in terms of our standard, mandatory force health protection guidance, in terms of public health mitigation, social distancing, you know, testing before deployments -- that will all continue.  Even as we -- in the early stages of the vaccination effort, we're going to continue all those measures.  We have to, because not the entire force, both active duty and civilian, are going to be vaccinated.

And then I think as -- as General Place indicated, part of our program in terms of communications is everything we can do to articulate to our people that we have great confidence in the FDA's rigor and making the determinations about efficacy and safety and we are going to be as part of our communication plan, you know, using select key senior leaders to get the vaccinations to demonstrate confidence in that.  Much like recently Governor Hogan himself said that's what he's going to do in terms of getting the vaccination out to the population of Maryland; he's going to demonstrate, yes, this is a safe and effective vaccine and I'm encouraging everybody to take it.

Q:  Was your allocation based on the same per capita formula that the states were?  And is that 44,000 going to be 44,000 shots in arms or is it going to be 22,000 and hold 22,000 for the second shot?

And -- and one more question, those locations up there, there's a lot of geography between all those locations.  Are people going to have to come to those locations to get their shot or are you going to distribute to some locations?

GEN. PLACE:  Yes, sir.  Thanks for the question.

So first, we have the same pro-rata designation as all the other jurisdictions.  So it's a small percentage -- just like the states are receiving, the department receives based on our population, a very, very small percentage.  But it's equivalent to the other jurisdictions.

In terms of your second question, almost 44,000 is the initial dose, so one of the things in the process is you have to demonstrate all parts, you have to receive, you have to administer and you have to -- you have to document, before you can order the second dose.  So this almost 44,000 is first dose; we contact back with the organization to get our second dose.

And then for your third, no travel involved.  This is a controlled pilot at these locations.  This is to demonstrate that the process that we've developed actually works.  Once we validate it, this controlled pilot, we have really scores of sites, hundreds of sites across the country and across the world that we have locations that vaccine will be sent to.

So it's not these are the only locations, everybody has to come to there, or these are the locations, we take the vaccine from these locations to other outlying locations.  This is just the first step in a controlled pilot.

MR. HOFFMAN:  But, Dave, to your -- to your question on this, if you look, there's 16 locations.  Our allocation is only 44,000.  So the way that the vaccine goes out is in a batches of 975 doses.  So we have to have locations that have sufficient population to use all of that dosing there.  So that's why one of the criteria for the locations was a large population of prioritized personnel.

And so if you look at the listing, you'll see some of our larger medical facilities, some of our larger joint base areas that will be receiving them because they have those populations there.

Q:  So they have 44,000 people at those locations?

MR. HOFFMAN:  Well, it's just the prioritized personnel.

Q:  Yes.

MR. HOFFMAN:  So like, in --

Q:  Forty thousand people who qualified, okay.

MR. HOFFMAN:  -- Yes.  So okay, all right.

Q:  General, Lucas Tomlinson with Fox News, is the reason the vaccine is voluntary because there's not enough to go around?

GEN. PLACE:  No, sir.  It's voluntary because it's under an Emergency Use Authorization.  Because the FDA is likely to determine -- let me be careful about that -- the FDA is likely to determine that not full licensure but under Emergency Use Authorization.  And like every medication we get in our facilities, Emergency Use Authorization is different than full licensure.  And we have to be able to communicate that to our patients when we talk about it -- because it's under the Emergency Use Authorization, therefore, voluntary.

MR. HOFFMAN:  All right, Meghann.

Q:  Mr. McCaffery, you mentioned that some Reservists, some Guardsmen, some spouses, some civilians, and some contractors will be in part of this phased approach.  How are you determining who is supposed to get the vaccine in those cases?

MR. HOFFMAN:  Thomas, can we actually go back a couple slides?

MR. MCCAFFERY:  Yes.

MR. HOFFMAN:  I think there's the one that has the -- the tiering.

Q:  Yes.

MR. HOFFMAN:  One more.  I think that might be helpful to --

Q:  The keyword was some.  It wasn't, like, every dependent, every contractor.  So I'm wondering what the --

MR. MCCAFFERY:  Yes, so basically the eligibility we defineed in terms of, you know, dependents, select contractors, civilian employees, and it's going to be then how do they match up in terms of the prioritization tiers.

We -- like the rest of the country, the very, very top priority in an initial phase is going to be health care workers.  And so, kind of, first those inpatient workers most close to the patients, the early emergency responders, public security, and then down in terms of outpatient and so forth.  But it's going to be:  are you eligible, and then where in that schema are you eligible?  And that's how you're going to get it.

Q:  So when talking about dependents, is that because they live with one of these people and so they should be getting a vaccine as well, one of these high-priority cases?

MR. MCCAFFERY:  No, for -- so for dependents, it will be in the phase with regard to whether you are a high-risk beneficiary or the regular healthy population.

MR. HOFFMAN:  Okay, and we're going to go back to the phones real quick.  Sylvie?

Q:  Yes?  Okay, I'll just go.  What is your target date for vaccinating the entire force?

MR. MCCAFFERY:  So, the target date is going to be contingent upon, again, we're going to be getting an initial, very limited quantity.  We don't yet know how much quantity we're going to get then, after that first week, as additional vaccines in addition to Pfizer come out.

So it's really going to be contingent upon how much vaccine, which types of vaccines we get over a period of time that we would be able to tell you based upon our schema -- you know, we expect we could do -- you know, X hundreds of thousands by the end of January versus February.  So it's hard to give you a timeline now with so many questions to be determined in terms of which vaccine and how much we get and when we get it.

For us, the important thing is we’ve developed a planned program for dissemination that as we validate it in this -- these initial 16 sites -- that we are confident we will be able to use our plan to very quickly -- as soon as we get those doses, quickly get it out across the force, according to the prioritization.

MR. HOFFMAN:  And I'll just add two quick things to that, to the way it's been explained is that we want to get to a place where we can treat this as we do with our normal flu vaccine distribution schema.  So when we get to a certain percentage of the force being inoculated, then we will treat it and turn it in -- roll it into kind of the general form where we -- we do this every year, and when we get to that place, we can get to the whole force.

And just remember, as I mentioned in the opening, with regard to the entire force is we've been relatively fortunate a large number of our forces are in age criteria, health status where we have -- we've fared better than others.  And so that's something we take into account but we're -- we're confident, whether it takes, you know, a month, two months, three months, four months, we're going to be able to continue to move forward with all of the DOD missions that we've been entrusted with the way we have over the last year, in the face of COVID.

All right, go ahead, sir.

Q:  Abraham Mahshie, Washington Examiner.

Early on, there was a lot of talk about the phased approach, with national security being a key criteria, the nuclear triad, for example.  Don't see that anywhere.  Could you address where those important service members come into this or do they not come into this?

MR. MCCAFFERY:  They most -- they most definitely come in.  So if you look at -- in the top, through Phase 1A and then 1B, critical national capabilities -- so that would include our, you know, nuclear deterrence force, our homeland -- homeland defense forces, CYBERCOM, key national strategic leadership.  That is in that -- in that tier in terms of -- and very much kind of mirroring how we did our testing roll out, in terms of the focus on those critical national capabilities, forces that are about to deploy within three months, et cetera.

Q:  Geographically on the map you showed earlier, though, there were no distribution out, for example, for any of the ICBM sites out west.

MR. MCCAFFERY:  So again, the -- the initial 16 -- initial 16 sites we've chose as the criteria, as our way to pilot and validate the processes for the -- the massive distribution over time.  The 44,000 that we expect to get initially, that we will be testing through those 16 sites, those are -- won't even cover the very first section of -- of Phase 1A, which is going to be health care workers.

And so they're going to come first, like the rest of the national guidance and prioritization, and again, as quickly as we get the vaccine, we will then be able to distribute it as quickly as possible, based upon those priorities.

MR. HOFFMAN:  And as I mentioned before, all of the processes, procedures that those forces – the missile forces, the bomber crews, the sub crews have put in place over the last nine, 10 months to protect them from COVID will remain in place.

So they have managed to develop plans and processes that have allowed them to continue with their missions without any denigration due to COVID, and so they're going to continue with that until we do reach a place where we have enough -- we've received enough vaccine to get to that Phase 1B tier of individuals that are going to be inoculated, including those critical and national security -- or critical national capabilities.

So -- all right, we'll go back to the phone for a third time and try this.  Sylvie?  One last shot here.  Bloomberg?

Q:  Hi there.  I have a question -- this is Tara Copp with McClatchy.

On the selection of Madigan in Washington State and Bragg’s medical facility, could you talk about how those two locations were selected?  Was it because of deploying forces or because of the medical centers there?

GEN. PLACE:  So it's based on the capability to have ultra cold storage there.  So they're one of 83 locations across the Department of Defense that have ultra cold storage.  It's because it's high on the Army's priority list each of the services sent them for it, it's because they have way more than 1,000 of the first tiering -- and by that, we mean the military police, the security forces, the ambulance crews, the firefighters, the emergency department staff, and the ICU staff.

So even within the health care, we're looking at very specific parts of the health care that are at highest risk.  So it's because of all of those factors those locations were chosen.  And depending on what else you're familiar with, if you look at all of those sites, they all have that capability.  That's why they were chosen for the controlled pilot.

MR. HOFFMAN:  And I just want to go through and read these out, just so on the transcript it has the -- the list of locations.  So the initial vaccine sites in the continental United States are Darnall Army Medical Center, Fort Hood, Texas; Wilford Hall, Joint Base San Antonio, Texas; Madigan Army Medical Center, Joint Base Lewis-McChord, Washington; Womack Army Medical Center, Fort Bragg, North Carolina; Navy Branch Health Clinic, Naval Air Station Jacksonville, Florida; Base Alameda Health Services Clinic, U.S. Coast Guard Base Alameda, California; Naval Medical Center San Diego and the Naval Hospital Camp Pendleton, which will get its distribution from San Diego; Naval Hospital Pensacola, Pensacola, Florida; and the Armed Forces Retirement Home Gulf Port, which will be administered from Pensacola.

Additionally, Walter Reed National Military Medical Center Bethesda, and under that, the Armed Forces Retirement Home in Washington will receive its -- receive its allocation; Portsmouth Naval Medical Center, which will feed the Coast Guard clinic base -- Coast Guard base clinic at Portsmouth, as well; the Indiana National Guard in Franklin, Indiana; and the New York National Guard Medical Command, Watervliet, New York.

And then additionally, outside of the United States, Tripler Army Medical Center in Honolulu -- or I'm sorry, outside the continental United States, I -- apologies, Hawaii -- Tripler Army Medical Center in Honolulu; Allgood Army Community Hospital, Camp Humphreys, Korea; Landstuhl Regional Medical Center, Germany; Kadena Medical Facility, Kadena Air Base, Japan.

All right?  Back to the phones.  So we got Tara.  Tony, do -- do you have a question?

Q:  I do, Jon.  Where does the National -- where does the DOD leadership fall in terms of the phases?  So, like, Secretary Miller and -- I -- Patel and Tata, do they fall in phase one or would they be 1B1 then, a -- critical national capabilities?

MR. MCCAFFERY:  So the senior leaders overall, if you look across the department -- and that would be a numerous number -- that would actually be in -- in Phase 1B1, which is the critical national capabilities -- and again, that mirrors how we did our COVID testing.

That said, we do intend, as part of this initial phase of health care workers, emergency responders, et cetera, have some -- a very small set of very visible senior leaders that will volunteer to take the vaccine, do it in a public way as one way of helping to message the safety and efficacy and encourage -- and underscore that we're encouraging all of those eligible personnel to take the vaccine.

Q:  (inaudible) -- a little transparency, sir.  Can you give us any names of who you are offering that to, in terms of very senior leaders, and do you also intend then to offer it to General Austin?

MR. MCCAFFERY:  So, right now, it would be -- we'd be looking at current -- current senior leaders and the top four that we are looking at right now would be definitely the secretary, the deputy secretary, the chairman, the vice chairman, and the senior enlisted advisor to the Joint Staff.

Q:  Are you considering offering it to General Austin?

MR. MCCAFFERY:  That is not something that has been brought up in -- that we've talked about.  Again, our focus is those top five and then other senior leaders across the services.  But we're looking at a number of well below 50 as part of this senior leader effort to get the word out for the vaccine.

MR. HOFFMAN:  And Barbara, what we're looking at is the Department leadership but also the service leadership and then the combatant commands in a way -- so that we can get that message out to as large a population as possible because each of those have their own lines of communication.  And they have -- many of them have -- are –- have stepped up and volunteered already and are looking to --

Q:  And you're considering allowing media coverage of them getting their shots?

MR. HOFFMAN:  Part of the intention of doing it is to do that.

(Laughter.)

So as long -- as long as -- part of it is, look, we do not want this to be a -- you know, it's not done just for media purposes.  But we will likely have some of them travel to some of the sites where -- where vaccinations are taking place to learn more about it.

I'll mention since we've already announced it, the Secretary -- Acting Secretary Miller will be -- is in Hawaii today.  He'll be visiting Tripler Army Medical Center this afternoon at 1300 to receive a tour and a briefing from the -- the MTF commander about the vaccination process out there.  He will not be getting vaccinated today.  But he will be touring the facility this afternoon to learn about the cold storage and the process that they have in place.

And we'll be doing that in other locations as well, as we go forward.  But, we'll get back to you on the visibility of how people are getting shots.

So all right, let me -- let me just go to people on the phones here for a couple minutes, so -- since it's working.

Ms. Seligman from Politico?

Q:  Hi, thank you for doing this.

Can you just go into a little bit more detail about the critical national security capabilities that you mentioned, the nuclear deterrence force, et cetera?  Can you just talk a little bit about how that's -- when that is going to be happening, and how that's going to be rolled out and which -- which units are going to be prioritized?

MR. MCCAFFERY:  Yes, and so the way we have identified it, they are part of the initial phase.  But we -- even with the initial phase, we have sub-tiered it because we recognize we're going to have a limited quantity.  So you need to figure out who in the broad first phase are going to get it first.

And right now the priority in the first phase, as I mentioned, are going to be health care workers, it'll be first responders, security.

It will be -- the next -- then the next part of that first phase is indeed our national critical -- what we described, our national critical capabilities.  As I mentioned, some examples of that would be our strategic and nuclear forces, our homeland defense forces, select senior leaders, and then after that it would be those deploying forces that are going to be deployed within three months.

And then after that, all other -- what we -- what each of the components will be defining as their critical, essential staff carrying out critical, essential national capability activities.

MR. HOFFMAN:  Okay, all right, we'll keep going.

Missy Ryan?

Q:  Thanks very much.  I just have a clarification and then a quick question.  So just to build on the last question -- and forgive me if this has already been explained a number of times, it's a little bit confusing.

So the 44,000, is it accurate that they will be distributed among, you know, some -- some small group or some group of the health care and the critical national capabilities?  Because obviously those categories of people would be more than 44,000, so you're taking some of the health care category of people and some of the critical national capability people.  Is that right?

GEN. PLACE:  So of those 44,000, the huge majority of them will be for first responders, critical health care people and a very, very, very, very limited number to critical national capabilities in this first tranche.  As we get -- assuming this all gets approved and the EUAs, et cetera, and we get resupplied, then we'll get into more of the critical national capabilities.  But in the initial 44,000, a huge majority is for our first responders, emergency department staff, et cetera.

MR. HOFFMAN:  Okay.  Patricia, Military.com?

Q:  Yeah, thanks for taking my question.  Can you tell me the 44,000 vaccines -- you know, what percent of the phase 1A personnel, like, total in the department will be vaccinated?  And then also, when you talk about high-risk beneficiaries, how are you going to prioritize them?  What is -- what is the definition of high-risk, and -- and how will you be prioritizing them?

GEN. PLACE:  Sure.  Thanks for the question.  The 44,000 against the entirety of the medical workforce, first responder workforce, et cetera is, oh, somewhere in the 8 or 9 percent of that total staff.  That said, we also don't know what percentage of that staff are actually going to receive the vaccination because it's voluntary.  So we have to plan for all, and then -- and then readjust as some decide that they don't want it or hopefully for us, all decide that they will.

I forgot the second part of the question.

MR. HOFFMAN:  You going to say it again, Patricia?

Q:  Part of the question was -- was (inaudible).  How are you going to define that?  And do you -- have you defined it in terms of, you know, health care or -- or pre- -- preexisting conditions, that kind of thing?

GEN. PLACE:  The great things about our military health system and our ubiquitous electronic health record is that we're able to monitor every single one of our beneficiaries for their medical problems.  Now, that's all protected so none of you can see that, but inside the system we can, and our programs allow us to see, according to the risk factors, according to the CDC of what are the risk factors for disease or for severity of disease with COVID, we know what those are and we can bounce that against our database to see who has those particular challenges.  And that's how we get to the highest-risk population.

The very highest risk also comes from age, medical problems and congregate locations, where people are congregated together.  That's why, as Mr. Hoffman mentioned, the very highest-risk beneficiaries to us are in our Armed Forces retirement homes, where the average age is 85 and they're all in the same location all together.  So they're the very, very, very, very highest risk of our non-health care population, which is why they've been categorized in the very first tranche of vaccinations that we hope to receive.

Tom?

MR. MCCAFFERY:  And then, Patricia, just wanting to add, just so you know, when we are defining, for our population, the high risk, we are -- we're basically taking the CDC's definition that they're using for all -- for the all-of-nation distribution.  And so for example, they cite very specific things like those that are over 65, those with cancer, those with COPD, heart conditions.  And so we are doing that same -- using that same definition to apply to our population.

MR. HOFFMAN:  Okay.  Nick Schifrin, PBS?  Jeff Schogol, Task & Purpose?

Q:  Thank you very much.  Are there any repercussions or consequences for troops who decline to get vaccinated?  Will they be -- receive administrative action or listed as non-deployable?

MR. MCCAFFERY:  No.  As we mentioned, this is -- this is standard practice for EUA.  It is voluntary.  It's going to be voluntary for our forces, and those who do not get vaccinated, they will be adhering to all of the existing public health mitigation measures that have been in place for months, and that have allowed the department to carry on its mission.

MR. HOFFMAN:  And at some point that the FDA does determine to license as -- fully license the vaccination, at that point, the voluntary may change to mandatory, as determined by the department.  So that -- that is a possibility in the future.

All right, let's go -- Courtney?

Q:  Hey.  I'm still unclear on when you -- exactly you think you're going to -- I know it's hard to say, because you don't know when the Emergency Use Authorization is going to come through.  But when exactly do you think that -- that you might start getting these 44,000?  And is it fair to say that they'll -- they'll all be distributed equally among the 16 locations.  So I -- I'm not going to even try to do the math on that, but -- but that's how many --

(UNKNOWN):  Mom, I need it.

Q:  Shhh!

But that's how many -- it'll go equally to the 16 locations?

(UNKNOWN):  (inaudible).

Q:  Sorry.  My kid's here.

MR. MCCAFFERY:  That's okay, I understand.  I will let General Place speak to that -- that last issue.  But in terms of the -- with the question about the -- in terms of the initial 44,000 --

MR. HOFFMAN:  When it will happen.

MR. MCCAFFERY:  Oh, when it will happen.  So I -- I don't -- I can't give you a definitive.  I can give you, this is our understanding, our expectation.  So our expectation is tomorrow, the FDA will meet.

MR. HOFFMAN:  So maybe push the -- yeah.

MR. MCCAFFERY:  Yeah, it -- it could be -- it could be tomorrow.  It could be the next day, but -- so have rough estimate.  The next couple of days, FDA meets.  They review the data.  They make their decision as to, are we going to approve this vaccine, and under what conditions?  We are anticipating it will be under an Emergency Use Authorization.  So once that happens, the manufacturers are allowed at that point to actually distribute their vaccines to locations across the country, again, per the national prioritization, per our prioritization.

But the next step is once the FDA issues that EUA, the CDC's Advisory Committee on Immunization Practices -- and this is standard for any vaccine -- they review the EUA and what's in it, the data that was used to -- for the FDA to make that decision, and then they make a recommendation, or they vote and say, "Yes, we recommend the population use this vaccine under X conditions, who should get it."  And once that happens -- and that could happen -- could -- over the weekend.  It could happen Monday.  Again, it depends on when they meet and when they make their decision.  But once that committee issues its final recommendation, for our 16 sites, we are comfortable, we are confident within 24 to 48 hours from that Advisory Committee decision we will actually have shots in arms.

But in terms of how that 44,000 is being allocated to one or the others of the 16, I'll need to defer to General Place.

GEN. PLACE:  So again, it's on a pro-rata basis.  So depending on how big or small these initial sites are, that's how it's being determined.  The particular maker is distributing it in lots of 975 doses.  So if you're wondering, "Why are we coming up with these weird numbers, and why is it almost 44,000?"  It's actually a little bit less than 44,000 because they come in batches of 975.  So some of the locations will get 975 doses, the largest one will get -- take 25 away from 6 --

MR. HOFFMAN:  5,875.

GEN. PLACE:  Well, -- yeah, 5,800 --

MR. HOFFMAN:  875.

GEN. PLACE:  -- 875 -- whatever that number is.  So I'm not going to do public math in front of you but it's in assortments of 975 doses, prorated depending on how big these locations are.  That's how it was determined.

MR. HOFFMAN:  And -- and just as you -- as you look at the sites, you'll notice some of the ones are larger, some are smaller.  For example, I think the -- the National Guard facilities are -- are going to be somewhat smaller in that uptake, whereas Walter Reed, the San Diego Medical Facility, Fort Hood, Tripler and -- those are some of our larger facilities -- medical facilities that have a larger presence of that population, so you'll see a larger allocation go to those locations.

Let me just finish up with a couple more on the phone and we'll come back in the room.  Keith, from Al Jazeera?  Courtney?

Q:  You just called on me.

MR. HOFFMAN:  I didn't have an X next to your name there, so that's -- that's my fault.  Did Sylvie ever get to ask a question?  No?  All right -- all right, we tried.  Lita, did you jump on?  Lucas?

Q:  Now that the CDC has revised its quarantine rules, is there any decision made about the quarantining of sailors and soldiers before they deploy?

MR. MCCAFFERY:  Yeah, so the question is in reference to the recent -- it was last week where CDC revised their guidance about what to do if you've been in close contact with a positive case.  And their recommendation under certain circumstances, whether you test or not, they're going -- their revised guidance is going from a 14 day self quarantine or self isolation to 10 days if you don't test.  They are comfortable that if you test 48 hours before the seventh day after being notified that you've been in close contact, they are comfortable with you then getting removed, so to speak, from self isolation.

So we're taking that guidance, as we've done throughout the last nine months, and we are now revising our own force health protection guidance accordingly to ensure that we match up where appropriate while we're also, though, managing our mission capabilities and readiness, but we haven't -- we haven't finalized our revisions.

MR. HOFFMAN:  Okay.

Q:  And does that include redeployment, like, for warship crews to --

MR. MCCAFFERY:  Yes, correct.

Q:  All right.

Q:  Are you encouraging people who've already had COVID to get the vaccine?

MR. MCCAFFERY:  Yes, we are because what -- what we know -- we know more about the virus than we did nine months ago but we're -- it's -- we're still learning more.  So our recommendation would be even if you have been previously infected, you might have been infected eight months ago, we don't know, right?  There's not enough science that says just because you were infected that you have immunity.  So we would be recommending even those folks to get immune -- to get vaccinated.

MR. HOFFMAN:  All right, we'll do a quick round here and then --

Q:  Can I follow up on one thing?  When you're talking about mainly health care but then you said a very, very small group of sort of defined as a national capability, is that a particular unit?  Can you tell us what unit that is?

MR. MCCAFFERY:  No, what we were referring to, I think, in the prior discussion was the notion of the Secretary, the Deputy Secretary, the Chairman likely --

Q:  -- so that’s what this very other small group is.

MR. MCCAFFERY:  Correct.

Q:  Thank you.

MR. HOFFMAN:  I think in that first batch you'll see the retirement homes, the medical community and a very -- you know, a handful -- couple dozens of senior leaders for leadership and messaging purposes.

Q:  Got it.

MR. HOFFMAN:  Okay.  Abraham?

Q:  The 44,000 number, that could be updated next week, couldn't it, when another vaccine comes up for approval?  And so this number could be changed.  Oh, and also, are you coordinating with the VA on this?

MR. MCCAFFERY:  So the -- the VA actually will be -- like us, will be getting its own allocation, you know, in proportion to, you know, all other entities that are getting it.  And so in terms of the vaccination program itself, there's not really a lot that we need to coordinate with -- with them.  They work directly with CDC.

On the issue -- what was the --

MR. HOFFMAN:  The numbers.

(CROSSTALK)

MR. MCCAFFERY:  Oh, well yeah.  So the 44,000 is just -- that's what they're saying our initial allocation's going to be.  We expect that shortly after that -- again, I -- I don't -- I can't be definitive, you know, is it a week, is it 10 days -- we will get a subsequent allocation, a little bit larger, and then we will get that out, and then so on and so forth, and then you've got Moderna coming in, a different vaccine, which will be going through the same process -- EUA, ACIP review and recommendations, and as those come forward, we will get those out.

MR. HOFFMAN:  And -- and just -- you know, to be clear on this -- is -- the -- the plan has -- intended to be scalable, so we have a -- what you could describe as a controlled pilot with these first 16 locations, with that initial batch so that we can -- one of the things is -- as General Place mentioned is having an immunology health care specialist on location so that we can ensure that the process is working as we scale up.  So make sure that we're tracking the records, make sure that we're tracking any reactions, seeing if there's any improvements to the process as we expand it out, but the intention is that the whole process is scalable and as we get more additional vaccines, we can go to additional locations or do additional people at this initial -- this -- these first few locations.

Q:  Do you have to repeat the pilot with each EUA for different vaccines?  Like, when you get Moderna, do you then have to start this pilot all over again?

GEN. PLACE:  No, ma'am, the -- the pilot is to -- to measure the process.

Q:  Oh, thank you.

GEN. PLACE:  That's all.

Q:  Thank you.

MR. HOFFMAN:  Yeah.  Did you have a follow up, ma'am?  Okay.  All right, well I'm going to close out here.  I've just got a couple things.  First off, I appreciate everybody, it's an important issue.  We want to get the message out that this is taking place.  Work force needs to understand this, the force needs to understand it, and we're -- we want to encourage people about the safety of the vaccine and encourage people on the uptake.  So we will be continuing with that messaging as this rolls out in the next few days.

Two quick non-COVID-related issues.  We’ve been providing updates on the transition.  And so I just wanted to read you a couple new numbers from the transition that I have received just literally as I walked in here this morning.

So as of yesterday evening, we've completed 43 transition interviews, we're averaging about seven a day.  Total officials in those 43 interviews is just under 100 and we have 35 interviews scheduled over the rest of -- next three days.

Requests for information that have come in -- we've already completed 45 of those, 13 of which are classified, and we've got another 34 that are -- the lawyers are noodling with before we'll be sending those out the door.

Transition books -- we've got 43 of the transition binders.  So those are each of the -- the team binders and policy binders -- are complete, seven of the intel agency ones are complete.  We've released 2,200 documents -- pages of documents and 250 pages of classified documents.

This week's interviews included the Deputy Secretary, SecAF, Chief of Staff of the Air Force, Chief of -- the Chief of Space Operations, Secretary Army, the Chief of Staff of the Army, the CNO, the Commandant, Chief of the National Guard Bureau, a number of the undersecretaries -- PNR, INS, Comptroller, R&E.  It goes on and on from there.

I think -- Health Affairs, I don't know if you had yours -- interview yet -- we've got a couple of the ones that are scheduled.

MR. MCCAFFERY:  Tomorrow.

MR. HOFFMAN:  You're scheduled tomorrow.  I know mine's -- mine was scheduled to meet with them on Monday.  Of particular interest, NRO's site visit took place on Monday, met with 10 officials, including the Director and Deputy.  DIA site visit took place on Monday -- 16 officials, including the director and deputy.  NSA site visit took place yesterday -- 11 officials, including the director and deputy, and the NGA site visit took place yesterday -- 10 officials, including the director and deputy.

So we're going to continue supporting the transition fully and professionally, and we will keep updating you as we go along.  I know you guys get e-mails from Sue Gough on a regular basis for some of these updates, and so we'll seek to include more information.

And then finally, just take a couple minutes to express sincere condolences to both the family of General Chuck Yeager, an American and Air Force hero.  He's a fighter ace.  He's the test pilot who was the first to fly faster than the speed of sound, and he was a legend in the Air Force.  And so we lost him this week, I think at the age of 98.

And then a little more closer to home here, condolences to the family of -- of Jim Lantz, who passed away this weekend.  Jim was a well-regarded member of the Secretary of the Air Force's Public Affairs family and was, by all accounts, an exemplary public service and a proud veteran and committed family member.  So his family and friends of both individuals are in our thoughts and prayers.

All right, thank you, guys.