Transcript

Acting Assistant Secretary of Defense for Health Affairs and Director, Defense Health Agency, Provide COVID-19 Update to the Media

March 26, 2021

PRESS SECRETARY JOHN F. KIRBY:  Good afternoon, everybody.  Happy Friday to you.

Today, we're going to focus in on coronavirus, COVID-19, and the department's efforts to distribute and vaccinate our -- our troops and to -- all of the other support issues that we're -- that we're participating in.

And so we have two special briefers to join us today, the acting Assistant Secretary for Health Affairs Terry Adirim, and I think you all know Lieutenant General Ron Place, the Director of the Defense Health Agency.

They're each going to have a few comments to kick it off the top and then we'll start taking your questions.  Again, we'll be alternating between questioners from the phone, as well as those of you here in the room.

So with that, I'll turn it over to Terry.

ACTING ASSISTANT SECRETARY OF DEFENSE DR. TERRY ADIRIM:  Thanks -- thank you, Mr. Kirby.

Good afternoon, everybody.  Thank you for joining us here today and for all of the important work you do communicating with the public.  General Place and I just want to say a few words, as Mr. Kirby said, before we get to answering any of your questions.

DOD is playing a key role in supporting the whole of government approach to defeating COVID-19, particularly in support of vaccinations of our service members and other beneficiaries but also our fellow citizens through the FEMA mission.

As the acting Assistant Secretary of Defense for Health Affairs, it is my responsibility to set health policy for the department.  And under the Biden administration, we conducted a review of all COVID-related policies and force health protection guidance, and have updated several based on newly issued CDC guidance.

For instance, in just this one example, the department rapidly incorporated the CDC guidance for vaccinated individuals to allow them to be exempt from quarantine and testing if they should be exposed to somebody with COVID.

Going forward, as we learn more, and working in close collaboration with the CDC, we will continue to update our guidance to ensure our DOD personnel are safe and can perform their missions.  In the meantime, we are vaccinating our service members and eligible beneficiaries as fast and as safely as possible.

In alignment with President Biden's announcement that vaccine will be available to all Americans in May, we will be ready to open up vaccination to all eligible DOD beneficiaries by May 1st.  We are committed to contributing to the President achieving his goal of 200 million shots in 100 days, and we rely on you to communicate to your readers, viewers, and listeners, especially within our military community, that COVID vaccines are safe and effective.

Like the civilian sector early on, we were aware that some service members were hesitant to accept vaccination, but now we are seeing more and more step forward to get it when it's their turn.  And I want to use this opportunity to thank every service member who has gotten vaccinated.  They are not only protecting themselves but they are also contributing to the safety of their teammates, their families and their communities.

The light at the end of the tunnel is near -- I know you've heard that over and over again -- but it's true.  Vaccination is one critical part of getting our country back to normal, along with continued testing and adherence to public health measures like masking and social distancing.  We just can't let up at this point.

Our DOD personnel have done a phenomenal job.  I'm very proud of all of them.  We've administered more than 1.8 million shots within DOD and more than five million shots have gone into arms by our military service members in support of the FEMA mission.

I'll now turn it over to General Place, who can give more detail about our vaccinations.

LIEUTENANT GENERAL RONALD J. PLACE:  Thanks, Dr. Adirim.

And good afternoon, ladies and gentlemen.  I'll add a few details to what Dr. Adirim has already given you in her overview.

The military health system is administering COVID vaccine at 343 sites around the world.  At the same time, nearly 3,000 military personnel are currently deployed to support Federal Emergency Management Administration-led efforts at civilian vaccination sites around the United States, with more expected soon.

A special thanks goes out to our superbly trained enlisted medical forces carrying out these responsibilities with compassion and with distinction.  While there's some lag in DOD data transmission to the CDC, we've currently administered more than 1.8 million doses of vaccine to over 1.1 million eligible DOD beneficiaries.

We're thankful for those who have taken this step, protecting themselves, their teammates, their families and those most vulnerable.  These figures include service members, military retirees and family members, and certain DOD civilians and contractors.  Over 600,000 of our service members, active, Reserve and National Guard, and of those -- of those 600,000 received at least one dose of the vaccine, representing approximately 30 percent of the force.

The DOD's prioritization balances lowering operational risk to the force along with those most vulnerable to infection.  While military installations have different sized populations with different missions, almost all sites are currently vaccinating those deployed or preparing to deploy -- strategic defense forces, those over the age of 75 and front-line essential workers.  Many are also vaccinating those between the ages of 65 and 75 and those ages 17 to 64 with an increased risk to severe illness if infected.

It's important to note that about 60 percent of our military personnel are in that final tier of our vaccination priorities -- that is, generally young without underlying health conditions and not currently required in an operational mission.

We have not yet begun offering vaccinations to those individuals in that tier at most military installations, meaning more than half the force has not yet been offered a vaccine.  This is similar to most U.S. jurisdictions.

Further, the -- the supply chain is working and working well.  We're receiving what we're allowed to order and shipments are arriving on time.  We're administering vaccines as quickly as we -- as we receive them.  As production continues to expand, we expect the supply/demand imbalance to be resolved and in only a few weeks.

The addition of the Johnson & Johnson vaccine bolstered our supply and has been particularly helpful in reaching our overseas population in austere locations because it does not have the ultra-cold storage requirements of other FDA-approved COVID-19 vaccines.

Based upon current supply and vaccination rate projections, I'm confident we'll open vaccinations to every eligible person at almost all military installations on or before May 1st, consistent with the President's March 11th pledge to all Americans.

I speak with military medical commanders around the world every week and work through the issues they are confronting for vaccinations.  We exchange best practices and refine our communications efforts based on what our leaders on the front lines share with us.   As Dr. Adirim mentioned, we're seeing individuals who may have initially been wary about the vaccine now come forward and ask for it.  I expect that trend to continue.

Finally, like Dr. Adirim, I am also a physician and welcome the opportunity to get vaccinated.  I tell my family, several of whom also serve in the military, that these are great vaccines and to get them at their first opportunity and I offer the advice, that I give to my family, to all DOD beneficiaries, and quite frankly, to every American.  These are safe, effective vaccines and are critical weapons in our fight against COVID-19.

All Americans who receive their care from the Department of Defense and would like to be vaccinated will have that opportunity over the next few months, whether abroad or here in the United States.

Thanks to progress in administering these vaccines, combined with our ongoing public health measures and laboratory testing, we truly are turning a corner in our country and in the DOD.

Thanks again for being here this afternoon, I look forward to assisting Dr. Adirim in answering your questions.

STAFF:  Thank you, General Place and Dr. Adirim.

With that, we'll go to questions.  Start by the phone, Idrees, Reuters?

Idrees?

All right, let's go to the next one.  Abraham, Washington Examiner?  I hear somebody.

Q:  Hello?

STAFF:  Abraham?

Q:  Hey, this is Idrees from Reuters, sorry I was on mute.

STAFF:  No worries.

Q:  Super-quick question on the Pentagon reservation.  Firstly, how many cases have there been at the Pentagon itself?  And by what date do you expect everyone at the Pentagon itself to be fully vaccinated?

LTG PLACE:  If we know that answer, I don't personally know it.  But if we know that answer, we'll have to take that one for the record.

In terms of when everyone on the Pentagon reservation, I would -- I'll suggest that that's the same as it is for everywhere else.  There are those in every tier here on the Pentagon reservation, just like any other military installation.  So sometime in the mid- to late-summer is my expectation that all who want to be vaccinated will be vaccinated on the Pentagon reservation.

STAFF:  Thank you.  Meghann?

Q:  You mentioned you're seeing more people take the vaccine now than they were maybe a couple months ago.  Given the Pentagon is not centrally tracking who's saying yes and who's saying no, how do you know that that rate has increased?  Is it because you're administering more, more quickly?  What leads to that conclusion?

LTG PLACE:  Yeah, sure, I'll take that.  So at every location, at every installation, we have everyone -- a collection of people who are in particular tiers.  And as we move through those tiers, we know who accepted and who didn't come in or didn't try to make an appointment, that sort of thing.

But when we know who's gotten it, we circle back to those who haven't, and offer it again on an iterative basis.  And as we re-offer it, many who at first just declined the opportunity, are now taking us up on that opportunity.  That's what we mean by that.

Q:  So that's my follow-up, is if you rejected it the first time around, are you able to get in contact with your health care provider and --

LTG PLACE:  Absolutely, yeah.  I'd be careful about using the word "rejected" for something that's voluntary.  They didn't take up the opportunity the first time, when we asked a second time, then they did take up the opportunity.  And some, it's been the third or fourth time we've offered it, they've taken the opportunity.

Q:  But are they able to -- not just being offered, are they able to call up and say --

(CROSSTALK)

LTG PLACE:  Yeah.

DR. ADIRIM:  Yeah.

Q:  Hey, can I get it, I'm eligible?

LTG PLACE:  Yeah, once you've been contacted, you're forever eligible.

STAFF:  Perfect, let's go back to the phones.  Abraham, are you there?

Are you on mute?

(UNKNOWN):  There's two unmute buttons, apparently, so.

(UNKNOWN):  Pandemic, man.

STAFF:  We'll come back to you, Abraham.

Let's go to Jeff, Task and Purpose?

Q:  Thank you.

A question for both briefers.  What data can you share about the numbers of service members who initially declined to get vaccinated and then reconsidered?

DR. ADIRIM:  We don't collect that data centrally, so we don't have that data.  As General Place has said, we do get some suggestion that those who might have hesitated to get it at first or accept it initially, are coming back and getting vaccinated.  But we just don't collect that data centrally.

We're very focused on providing education and as much information as our service members and their families need in order to make the decision and getting vaccines into arms.

Q:  If I could follow up, if you don't have data, how can you make that assertion?  Are you going off of anecdotes?

LTG PLACE:  No, the data that we do have, is those who have accepted it.  So within our tiering system -- so the prioritization schema that we have -- once a particular location has moved through that part of the tier into the next tier, and yet those in the first tier, the numbers go up?  It's not an assertion.  It's -- again, all we track is those who -- who accept it.  But we see the acceptance rates on the initial tiers.

The initial tiers are the first responders, right?  So when we came here three months ago and had this conversation, that's what we talked about.  The health care practitioners, first responders, the police, the fire departments, et cetera.  And over time, the percentage of those who have become vaccinated continues to rise, that's how we know.

Q:  If I could ask, if local commands have this, why are you unable to tabulate and collate it?

LTG PLACE:  Well, so you're talking about local commands, those are service member-specific, some of whom are task-organized, who aren't assigned, necessarily, to the unit, but who are attached to it.

So the systems that we have to keep track of our service members and then the civilians -- who, oh, by the way, we're still responsible for, who aren't necessarily on manning documents, or adding in contractors, whether it be health care contractors or first responder contractors, it's an amalgamation of lots of different systems.  So in order to get information to the department of where we are, we've essentially just added big lists of people on different locations.

Now, the challenge really is, like everywhere else in the world, your personal health information is protected.  We have to be very, very careful about what we share outside of it from a health care delivery part to what we share with anyone else.

So we don't manage it the way that you're suggesting we might manage it.  All we manage is anonymous data.  So you know, when it comes to lists, et cetera, anonymous data.  So we know who's accepted it, but we don't have specific details about whether for example I've accepted it or Dr. Adirim's accepted it, or any other person.  Because that's personal health information.

STAFF:  Perfect.  We'll go back to the room.  Oren?

Q:  Lieutenant General Place, you had said, a few weeks ago, the acceptance rate was about two thirds, based on very early anecdotes or suggestions.  I was wondering if there was an update to that, given what you've just said?

And what do you expect to happen to that number as you open it up to Tier Two, to general military population, which is, A, generally younger, and, B, does not have the compelling reason of a deployment or a front-line worker to get the vaccine?

LTG PLACE:  Sure, so I'll go back to the -- the first.  I don't think I have ever publicly said a number.  The person who may have said the number, I don't know where that number came from because I don't track that number.

As the person who's responsible for the distribution, administration of vaccine within the force, that's not something that I review.  So all that I review over time is where we are, where does the vaccine need to go, where does it fit into the schema, what are the acceptance rates, those sorts of things.

Further, to make sure that those areas that require two doses -- so the first two emergency use authorizations went to the Pfizer and Moderna vaccines, require two vaccinations in a defined period -- to make sure there's enough vaccine to get those second.  Those are the types of statistics that I measure.  So from a -- from a have you accepted or not rate, again, I don't keep track of that.

But to go to the final tiering, the general population, again, we'll go through the operational requirements and we'll go through what's available at a particular location.  So some bases have a bigger population than others in early tiers, and less in later tiers.  So all that factor goes into where we allocate the vaccine for, and then how we follow it.

And in the weekly phone calls that I mentioned that I have, is there are other resources that particular locations need to be able to vaccinate what they're responsible for at this point.  Those are all the factors that I follow centrally as we support the application of the vaccine at these 343 locations.

Does that answer your question?

Q:  Well, and follow -- follow-on:  Based on the rates you're seeing now in terms of the vaccines you're getting and the vaccines you expect to get, when might the force -- or everybody who wants it in the force be vaccinated?  Do you have an estimate on that?

LTG PLACE:  Well, again, it's going to depend on uptake rates, right?  So if most want it, it's going to take longer.  If less want it, it'll take less time.

Based on the projections that we have, both supply-side and vaccination-side, we -- we do fully expect to be open to all American -- or all of our DOD eligible populations on or before the first of May, and at current uptake rates for those who -- who want to get it, we think by the middle of July or so, again, assuming the -- the vaccine supply continues as it is, and assuming nothing else takes away from our -- our vaccinators.  So again, projecting just where we are now, middle of July, we think the -- the department will be vaccinated.

Q:  Any consideration of trying to create some sort of incentive, once you open it up to everybody?

DR. ADIRIM:  No.  No plans to do that.

STAFF:  Thank you.  Back to the phones.  Peter?

Q:  Hi, yes.  Thank you very much.  Peter Loewi with the Asahi Shimbun.

A -- a -- a couple weeks ago, a congressman complained in a hearing about troops and families overseas getting a vaccine which he called inferior.  And General, you mentioned a minute ago that the J&J bolstered your supply because it doesn't have the same cold chain requirements, but cold chain requirements does -- don't mean very much to the troops and family members who are getting it.  What are you doing to ensure that those deployed overseas don't feel like they're being treated as second-class?  Thank you.

DR. ADIRIM:  Yeah, you can have that cold chain --

LTG PLACE:  Well -- well, the -- the first part, the -- that I'll answer to that is every single one of these vaccines are shown, through rigorous clinical trials, to be safe and effective.  And second, none of these vaccines have been truly measured in -- in the exact same circumstances.  So we would really caution anyone from comparing any efficacy, or safety, or -- or any other factor of any of the vaccines against each other because it's not been done.

But if you look at them all, all three of them in general -- all three of them in general are very safe, all three of them in general are -- are very effective, and all three of them have some advantages.  And the one really unique -- well, two unique advantages to this third vaccine is first, doesn't require that cold chain requirement; and second, only requires one dose, all of which make its efficacy -- I mean, the actual effectiveness at the operational force to be greater.  So we think this is a better vaccine for the circumstances in those austere environments.

STAFF:  Perfect.  Back to the room.  Lucas?

Q:  General Place, where do you think this virus came from in China?

LTG PLACE:  Well, that's way outside my area of expertise.  I have -- I have no idea.

Q:  Okay.  The former CDC director, Robert Redfield, said he thinks it escaped from a lab in Wuhan.  Is there any reason to think he's wrong?

LTG PLACE:  I have no information to -- to -- to speak one way or another on it.  I'm sorry.

Q:  Do -- do you think it's important that we find out?

LTG PLACE:  I -- I think it's good to have information about lots of things.

Q:  And do you rule out that it was a bioweapon?

LTG PLACE:  I have no basis to answer that question.  I'm really sorry.

STAFF:  Back to the phones.  Let's see -- Carol, New York Times?

Q:  Thank you.  Ma'am, sir, can you provide the science or public health explanation for placing fully-vaccinated people arriving at Guantanamo Bay in a 14-day ROM?  And what is the tipping point for when that will no longer be necessary?

DR. ADIRIM:  We are constantly reviewing and working with the CDC to look at the science to determine whether we need to ROM -- on how long we need to ROM for those who are fully-vaccinated, and we post these Force Health Protection Guidances on our website, and we are constantly reviewing them and determining what the best measures are for ensuring the safety of our service members and the people that they work with and their communities.

Q:  So the standard is fully-vaccinated people get a 14-day ROM on arriving at the base.  Is that consistent with the rest of the deployed locations?

DR. ADIRIM:  We are currently looking at this.  We're working with the CDC to determine what the best way to handle ROM for travel.

STAFF:  Thanks, Carol.  Next question?

Q:  Thank you.  Thank you both for you.  Now the U.S. troops, everybody knows that he has, like, they are -- have a great -- things about the vaccinations, on how they distribute the -- that vaccination, on health, that people even -- that this is the people who side with the United States.  So do you have any plan to share that experience with your partners outside overseas, like especially with the countries that already hosted the U.S. troops like Iraq, like South Korea?  Do you have any planning about that, please?

DR. ADIRIM:  I don't have any information at this time with what we may be doing, as what -- as -- as you described.  The services may be doing some of that type of work, but I'm not aware.  We can take that back.

STAFF:  Let's go back to the phones.  Raj?

Q:  Yes, thank you.  Actually, I -- the gentleman before me just asked that question, but let me just rephrase that question.

In -- in Syria, and particularly, the SDF, your partner that are fighting ISIS, are you -- is there any plans to help them to get some sort of vaccination, as we know vaccination is probably important in the fight against ISIS?  But also, what is the status of your troops' vaccinations in Syria and Iraq, in particular?

DR. ADIRIM:  (inaudible).

LTG PLACE:  The second part?

DR. ADIRIM:  Yeah.

LTG PLACE:  Yes, so from the -- from the second part, the -- we're not going to release, at least centrally, any -- any vaccination statistics for any particular combatant command.  That -- that they feel comfortable releasing, we'd refer you to -- to CENTCOM.

But what I can tell you is that as I mentioned in my opening comments, the amount of vaccine that's going to the geographical combatant commands is significant, and is being prioritized through that -- that schema for our critical national defense forces.  So they're receiving a significant amount of vaccine, and -- and are utilizing it as fast as we can get it to them.

Q:  Any comment on the first part of the question, if there is any help to -- any -- any ways that you guys are thinking in terms of helping the SDF in particular to get vaccines?

LTG PLACE:  I -- I -- I don't think either of us are -- are aware of anything that's either happening or not happening that -- but we're happy to take that for the record and get you whatever answer we can.

STAFF:  Yeah, we'll take that question.  Back to the room, sir.

Q:  (Gary Renall?) here with the (Diplomatic?) Times.

The Pentagon announced this week that they're going to allow migrant children to be housed at a Texas military base, if I have my information correct.  How does the Pentagon vaccination program apply to these migrant children, and who's going to administrate it?

LTG PLACE:  Sure.  The -- the entire system is under Health and Human Services.  So you're right.  It's on military bases, but their entire care, feeding, et cetera and medical care, vaccinations -- whatever it might be will be under Health and Human Services.  So we're partnering with them to provide the location, but every aspect of it will be handled by HHS.

Q:  Okay.

Q:  Just a follow up to that, is there any unease with the -- potentially having children on a military base that have not been vaccinated?

LTG PLACE:  Potential unease?  Boy, there's a -- there's a lot of variables in that.  I -- I -- I think that people can be uneasy about lots of different things, but the department's position, as well as HHS's position, is we understand that we're in this as a partnership, we're providing the location for them, but the protocols for -- for separating our forces, our families from -- from that particular population -- significant effort is going into that to -- to -- to, you know, take into account that potential uneasiness of those two particular locations.

So yes, we understand it, yes, we're aware of it.  We're going to great efforts so -- to keep them separate.

Q:  Thank you.

STAFF:  Come back to the phones.  Ellen, from Synopsis?

Q:  Hi, thank you so much for doing this today.

I have a quick question about -- are you tracking, in the number of DOD beneficiaries who have been vaccinated, are you tracking those who might have been vaccinated as part of the FEMA sites?  For example, family members who might have gotten a leftover dose at the end of the day?

DR. ADIRIM:  We're not tracking that data -- we're -- we're not -- we're not tracking that data.  We wouldn't have any way to -- to track it unless they were to report it back, but no.

LTG PLACE:  Right, and so -- so all of that said, specifically where they get it, no, but any family member, any DOD beneficiary who gets it outside of our system, we've asked for them to bring that information and put it into our electronic health record system so that we're aware of it.

That said, it requires their voluntary movement to do that, but we've asked for it.  That would be the level of information we have and that would be it.

Q:  Okay, thank you very much.

STAFF:  Thank you, Ellen.  And I think that is -- I think that's it.  All right, well thank you very much again --

Q:  Maybe one more?  Back to Oren’s question, just a quick follow up on incentivizing troops, how about, like -- like, an extra day of leave, or what civilians would call a day of vacation?  Is that being considered for troops to get vaccinated?

LTG PLACE:  So individual commanders, because they have command responsibility, anything that's in their legal purview for incentives, they have that opportunity to do that.  But there's no central incentive that's being considered within the department right now.

STAFF:  But I think you know the Secretary and the department is taking this concern seriously and taking efforts to raise awareness about the importance and efficacy of the vaccine itself.  All right, well with that, thank you, General Place, thank you, Dr. Adirim.  If you have any further questions --

LTG PLACE:  My pleasure.

STAFF: -- contact OSD Public Affairs.  Thank you.