Thursday, April 08, 2021

Defense Health Officials Provide a COVID-19 Update to Media

 April 8, 2021

Army Lieutenant General Ronald J. Place, Director, Defense Health Agency; Army Major General Jill K. Faris, Deputy Surgeon General, Army National Guard; Navy Rear Admiral Gayle Shaffer, Deputy Surgeon General, U.S. Navy; Air Force Major General Robert Miller, Deputy Surgeon General, U.S. Air Force; Pentagon Press Secretary John F. Kirby

PRESS SECRETARY JOHN F. KIRBY: Good morning, everybody, and welcome to our briefing this morning focused on COVID vaccinations in overseas destinations and locations. That's what we're hoping to provide some context on for you this morning.

And to help us out, we're very pleased and delighted to have representatives from each of the services, and of course, as you all know, you know General Place quite well, the director of Defense Health Agency. He's going to shortly provide you with an update on vaccine distribution to DOD personnel, again, with a focus on OCONUS (Overseas) vaccination efforts to our troops and -- and beneficiaries. And he's being joined this morning by Army Major General Jill Faris, the interim G357 U.S. Army Medical Command; Navy Rear Admiral Gayle Shaffer, deputy surgeon general of the United States Navy; and Air Force Major General Robert Miller, director of medical operations, Office of the Surgeon General. After they each have a -- a few moments to provide you some context, and then we'll open it up for -- for some -- some Q&A with them.

And with that, General Place, thank you.

LIEUTENANT GENERAL RONALD PLACE: Thanks, Mr. Kirby.

And thanks to all of you for the opportunity to talk about where we are and where we're headed in the coming weeks in regard to our COVID vaccine efforts.

First, some data points on our vaccination program: Four months ago almost to the day, I sat -- well, I stood at a podium right over there and told you that our vaccination program was one of 64 jurisdictions across the United States. I also said that we'd be receiving about 1.3 percent of the total U.S. doses, and that we would begin vaccination the following week with a few thousand doses of vaccines.

Over the course of the holidays, the DOD quickly validated our pilot program and began the expansion process to our current 350 vaccination locations. It took us 70 days to administer the first million vaccines, 35 days for the next million, and with more than a quarter of a million doses administered in the last eight days we're on track for the next million in somewhere between 25 and 30 days.

Further, the department recognizes the limited options of our OCONUS beneficiaries to receive the vaccine in one of our military medical treatment facilities. In order to support our OCONUS beneficiaries, we made the decision to distribute 14 percent of the doses we received to OCONUS locations. That's significant because the OCONUS population is seven percent of our eligible population.

That said, if you're a service member stationed overseas or a family member likewise stationed overseas, and you haven't received the vaccine and you don't know when you'll be able to, these numbers mean nothing, and it's understandably frustrating.

The recent event that caused the loss of about 15 million doses of the Johnson & Johnson, or Janssen, vaccine has affected the DOD allocations, as is true for all United States jurisdictions. We targeted the overseas community for our J&J vaccine supplies, so we're actively exploring other means to offset this temporary shortage of the J&J product.

Now, consistent with the president's announcement on Tuesday that all jurisdictions will begin offering vaccines to all Americans by April 19th, the DOD will also be opening to all tiers beginning that day to any eligible person to make an appointment for a vaccination. In fact, approximately 40 percent of our vaccination sites have already provided at least some vaccinations in this final tier, representing that segment of our population without health risk factors who are otherwise eligible to receive the vaccine.

This step doesn't mean that the prioritized tiers are no longer being used. If individuals in our initial tiers now want an immunization, they still get to the front of the schedule.

Our service members, families, retirees, DOD civilians and contractors, along with their eligible family members are understandably excited to be vaccinated, and we're equally pleased to be opening up availability to everyone. We're administering the vaccine as fast as we receive it. The good news is this week, we're distributing significantly more Pfizer and Moderna vaccine to our sites than in previous weeks.

Our hospital and clinic commanders have prepared for this moment and are expanding their local operations. Depending upon local missions, some sites will even have seven-day-a-week operations in order to make it easier for our beneficiaries to get vaccinated.

Based on current projections of supply of medical personnel available to perform vaccinations and the current interest of individuals wishing to be vaccinated, we expect that we will be able to deliver at least an initial dose to every eligible OCONUS person who wants one by the middle of May. The safety and efficacy of the vaccines approved for use under EUA grow more impressive with each passing week.

The military beneficiary population is a microcosm of the American populations and the trends that we see in the larger population are being mirrored in the DOD. Our people are paying attention and coming in for vaccination. We're thankful for those who've taken this step, protecting themselves, their families, their teammates and those most vulnerable.

Now, as I noted at the press conference two weeks ago, we continue to see many individuals who were taking a wait and see approach now coming in for the vaccine. I'm proud of the exceptional work our military medics are doing both on military installations and in support of vaccination efforts at FEMA sites around the country.

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

Thanks for being here today. Along with my colleagues, I look forward to your questions.

MR. KIRBY: General Faris

MAJOR GENERAL JILL K. FARIS: Thank you, Mr. Kirby.

Good morning, everyone. I -- I really thank you for the opportunity to discuss our Army's efforts to combat COVID-19 and the administration of the vaccines.

The Army understands the situation that our families overseas are in because of the limited access to vaccines. We have shipped more vaccine in proportion to stateside locations to try to address those challenges with access to the vaccines.

Moderna has been the primary vaccine shipped to Europe because of the difficulty of shipping Pfizer vaccine overseas due to the ultra cold storage requirements. As the supply of Johnson & Johnson's single dose vaccine becomes more readily available, the U.S. Army Europe and Africa will receive an additional distribution of vaccine to soldiers who are in remote locations around Europe, where we don't have Army medical treatment facilities.

As Lieutenant General Place has just stated, there are expected increases in the supply in the coming weeks and Army Medicine will ensure that all individuals will be eligible for the vaccination. We have roughly 12,000 allocations arriving this week and should have a similar number, if not increases, arriving in the subsequent weeks.

We are working in corporation with the Department of Defense to support the presidential initiative to get America vaccinated against COVID-19. The Johnson & Johnson vaccine should allow us to increase the flow of vaccines to our soldiers and their families outside of the United States.

As of this week, U.S. Army Europe and Africa has administered at least 37,000 COVID-19 vaccine doses and -- and to 17,000 to fully vaccinated members in Europe. The number of active duty soldiers in Europe is more than 50,000 and there are roughly 150,000 eligible people in the Army military community in Europe, and that would include active duty, their family members, civilians, contractors and their eligible family members.

Based upon the projections that Lieutenant General Place has shared with you, we should be able to vaccinate at least 100,000 beneficiaries in the coming weeks. Army Medicine is committed to ensuring when the vaccine is available, we will be ready to administer to all our eligible Army family members.

Thank you.

MR. KIRBY: Admiral

REAR ADMIRAL GAYLE SHAFFER: Thank you, Admiral Kirby, for the opportunity to be here today.

Protecting, you know, our sailors, Marines, our civilian employees, our contractors, our families in -- in the Department of the Navy is our North Star.

Having served overseas myself for almost a third of my career, you know, I certainly understand the fact that when you're serving overseas, you rely solely on the local military treatment facility for that care, and the -- with that in mind, the Department of the Navy leadership recognized this from the very beginning and therefore focused additional vaccine to all of our overseas locations in accordance with the DOD's vaccine prioritization schema.

For our European locations, over 50 percent of the Department of the Navy's population, which includes family members, it also includes civilians, contractors and those from the host nation who are eligible to receive it, they have all received at least -- we have 50 percent of those individuals who have received at least one dose of the vaccine, and we also have more vaccine operations occurring daily.

To make things a little easier for our sailors, our families, our Marines, those who are -- are going overseas, the Navy released a Navy administration -- administrative message last week which prioritized service members and their families moving overseas for the COVID-19 vaccine prior to transfer. So if they needed overseas screening, they come into the military treatment facility, we can certainly give them the vaccine prior to going overseas. Our goal would be to have as many fully immunized prior to transfer.

And then just lastly, I want to quickly thank all of our Navy and Marine Corps personnel that are currently serving at FEMA vaccination centers across the country. We have over 1,000 personnel out there working with the whole of government, providing -- so far have provided more than 500,000 vaccines in support of our state and federal partners. So we're glad to be a part of that effort.

And that's all I have right now. Thank you.

MR. KIRBY: Thank you.

General Miller, sir

(CROSSTALK)

MAJOR GENERAL ROBERT MILLER: -- the Department of the Air Force appreciates the opportunity to address your questions regarding the COVID-19 vaccination process. As of 7 April, the Air Force has delivered 499,683 vaccines to over 125 sites worldwide and we've vaccinated 444,083 individuals.

Our OCONUS commands, the United States Air Forces Europe, or USAFE, and the United States Pacific Air Forces, PACAF, have been prioritized for vaccine distribution over the past three weeks, resulting in the highest percentage of personnel receiving vaccine compared to other major commands.

In fact, as of 4 April, 2021, of the 53,000 eligible DOD personnel in USAFE, approximately 35 percent of those individuals have received at least one vaccine dose and 22 percent have been fully vaccinated. Of that 109,000 eligible DOD personnel in PACAF, approximately 26 percent of these individuals have received at least one vaccine dose and 20 percent have been fully vaccinated.

As we immunize individuals in accordance with the DOD population schema, we are ensuring timely vaccinations of personnel were critical to executing the mission, to include front-line and essential workers and those with known health risks, which includes family members.

Understanding that off-base opportunities for COVID-19 vaccinations do not exist for overseas DOD-eligible personnel, OCONUS locations will continue to be a focus for vaccine distribution. I'm happy to report Moderna shipments for OCONUS sites have been increasing. For example, in USAFE, we've increased from six -- 6,500 doses in February to 7,700 doses in March and are now up to 11,000 doses in April.

In addition, the Johnson & Johnson vaccine continues to be prioritized for OCONUS. Finally, we're also working plans to ship Pfizer vaccine to OCONUS to vaccinate 16- and 17-year-olds, given the age requirements of other vaccines. The readiness of our force, including our Air and Space Force families is our number one priority. And we'll continue to advocate for increased OCONUS allocations of vaccine as nationwide supplies increase.

MR. KIRBY: Thank you, General.

Okay, we'll take some questions. Meghann, go ahead.

Q: So overall what's the total of service members OCONUS who have been vaccinated, either gotten a dose or gotten both doses?

GEN. PLACE: Megan that's a great question.

I'm not prepared to answer specifically to the total OCONUS versus CONUS and what that might look like. Each of the different geographical combat commands are a little bit different. The service members at each of those locations and the commands can talk about it.

But in general, the OCONUS uniformed personnel are vaccinated at somewhere between, I don't know, 10 or 15 percent higher rates than the continental United States at this point. But remember, that fits to the schema that we've talked about before. Deployed forces, for example, in particular those that are there actively employed in missions in the CENTCOM area of operations or any of the COCOMS.

But it is significantly higher in OCONUS locations than it is here in the United States.

MR. KIRBY: Okay.Oren Liebermann, CNN.

Q: Hey, thanks for doing this.

I was just wondering about where OCONUS stands in relation to CONUS with the tiering system, because as I think you've mentioned, CONUS has moved through one-alpha, one-bravo, one-charlie even perhaps, and some have started tier two, if I understood you correctly. Is OCONUS in the same position or are they still behind in terms of one-alpha or one-bravo. Could you compare those two?

GEN. PLACE: Sure.

So in general there are more OCONUS locations that have migrated into tier two than CONUS-based locations. That said, there are some CONUS locations that have also migrated into tier two. Again, it depends on the mission set and also depends on the acceptance rate or the ability of those in tier one-bravo, or specifically tier one-charlie to be available to be vaccinated on a day that the particular vaccination site is offering them.

Remember, voluntary vaccine. So each of these local clinic commanders or vaccination site commanders are doing everything they can to use every single moment of every single vaccination minute to get a vaccination into somebody's arm. And so if the mission set requires everybody who would otherwise in the schema be eligible today, they're not available today, they're going to vaccinate somebody else, and then go back and offer again to those in tier one-bravo or tier one-charlie et cetera.

So it's mission dependent, but OCONUS and CONUS have moved into tier two.

GEN. FARIS: If I many answer from an Army perspective, our acting secretary of the Army has asked the Army to go shoulder to shoulder on our tiers. So let me give you an example. So let's say one location is getting -- has moved through an area of the tier and the schema and moving on to the next, we will slow down distribution to that location because we want to get the entire Army as close to being on-line as possible with the tiers.

And so that's a technique that the Army is employing as we get after the schemas.

MR. KIRBY: Thank you.

Idrees, from Reuters

Q: Thanks, John.

Two questions. Firstly, for each of the services, could you give us a percentage of how much your service has been vaccinated? And secondly, do you believe there will be a time when you will know or publicly be able to say how many service members turned down the emergency use vaccines? Or is that something that you don't think will be tracked or made public in the future?

GEN. FARIS: Thank you for the question.

From an Army's perspective, we administer -- of -- of the vaccine, it -- it's centrally managed and allocated to the various locations. We have over 80 locations globally in the Army that we make distribution to.

Of the vaccines that we have been given, we have administered every week, on average, about 94 percent of what gets shipped to us, gets into the arms. And currently, as of yesterday, we have over 688,000 vaccines that have been administered. Now, some of those are -- are first dose and second dose but fully vaccinated of -- people with second dose, of the vaccine given, we have about 67 percent of those individuals.

We do not keep track of declinations -- those are people that have had the opportunity to sit down with a medical provider, ask their questions about the emergency use vaccine and make a determination of -- about whether or not they choose to take the immunization at that time, but what we have learned over time is as the vaccines have been around, as people have been getting vaccinated, we are having -- seen an increase of -- of the take of the vaccine and we have people from previous tiers in the schema that have come forward to get vaccinations, and we believe that that's due in large part to the education and the materials we put out and the information that our clinicians are able to push out via social media, getting information in town halls and -- and pushing it to the commanders for questions that our service members have.

Thank you.

ADM. SHAFFER: So from a -- a Navy perspective -- a Department of the Navy perspective, I think we have roughly 35 percent, last I checked, of the active force that's been vaccinated. Greater -- we've delivered, administered over 650,000 doses and recognizing that we're also trying to balance not only getting the active force vaccinated but also following the schema of ensuring that those who are 65 and older have an opportunity to go into an MTF and receive a -- a vaccine, along with those who may be medically compromised.

So it's a balancing act but we're certainly trying to do the best we can to distribute this as efficiently and equitably as possible.

GEN. MILLER: In the Air Force, I can tell you as of 5 April, for dose one, we have vaccinated 11.1 percent, and dose two is 7.2 percent. As -- as I mentioned, we do track these by different major commands and that's why the -- the percentages I shared -- for example, with USAFE, 35 percent for one dose and 22 percent -- that's -- that's kind of an in comparison.

Regarding declinations, that -- that is something that is always a little bit challenging to track but there has been an overall trend, seeing it in a positive way with more people accepting vaccine, and it does appear to be that the educational efforts are -- are working and -- and we feel strongly that once someone has been notified, appreciating that that is an individual choice, that it's -- it's so important that they understand what the vaccine is all about and -- and the potential benefit and the risk.

And -- and the only other thing I would mention is I'm very happy to report, you know, as far as once we get vaccine in the Air Force, we're getting shots in arms, and the execution rate has generally been well above 90 percent. So that will continue to be the focus moving forward.

Thank you.

MR. KIRBY: Thank you.

Abraham, Washington Examiner

Q: Can you hear me?

MR. KIRBY: Yes, we've got you Abraham --

Q: Can you hear me? Yeah, terrific, thank you.

So my question is about -- so I understand the Janssen vaccine spoilage caused a problem, but you were also ahead 10 to 15 percent in vaccination -- vaccination rates. So can you -- can you talk about how that compares with CONUS vaccinations? And are you trying to catch up with -- with Janssen, or are you trying to channel some of the other vaccines into OCONUS in order to catch up? And then where -- and -- and I apologize, because I had some bad audio. Where do beneficiaries stand in -- in -- in their vaccination rates?

Thanks so much.

GEN. PLACE: Sure. Thank you.

So yes, the -- as -- as General Miller mentioned before, there's some challenges with the Pfizer vaccine and its truly ultra-cold storage requirements and the requirement for us to have an American emergency use application or certification on every vial that we use. Getting the Pfizer vaccine overseas is a challenge for us.

So we are making up the -- the -- the delta, the difference between what we thought we were going to get with the Johnson & Johnson, or Janssen vaccine with Moderna, while still not overly-decrementing any other area of operation, geographic area of the operations. But the -- that will be the -- the large majority of how we make it up.

Now, from the -- the family member, the beneficiary population, let's be careful about different -- different categories. So other beneficiaries, family beneficiaries can be retirees, and those -- some of those retirees are over 65 and over 75. And according to our schema, that puts the over-75 in one Bravo. So all of them have been approached one way or another with the opportunity to be vaccinated.

On the other hand, if you're -- you are a young, otherwise-healthy family member, that makes you in tier two, and so those locations that have gotten to tier two, they would have been notified of the potential for them to make an appointment to be vaccinated. But as I mentioned, if -- if 40 percent of our operations have at least touched into tier two, that means fully 60 percent of our locations have not, which means family members at over 60 percent of our locations have not yet been notified of their potential eligibility to be vaccinated at this point.

If you recall from my initial comments, however, by the 19th of April we anticipate opening up eligibility to make an appointment for a vaccination at every location, meaning 100 percent of locations would then be open to potential appointments for all beneficiaries, to include our young, healthy active-duty family members who are in our -- our final scheme.

I hope that answers the question. Over.

MR. KIRBY: Okay, next --

Q: May I have a follow-up, please?

MR. KIRBY: -- Patricia Kime, Military.com

Q: Yeah, thanks for -- thanks for taking my question.

So there's reopenings going on across -- across the services in terms of, like, mess halls and gyms to vaccinated people. And I'm wondering, you know, like, if they have to share their vaccine cards to get in. I'm -- I'm wondering if you could comment, sort of, on, given that the vaccine is voluntary, you know, is this sort of the equivalent of a vaccine passport? And can you comment on this -- this way of reopening?

GEN. FARIS: Thank you for the question. General Faris for the Army.

So local commanders make determinations on how they want to open up their installations. At each installation, we have health force protection levels. It's managed by what we see prevalent in the environment around where our installation is at, what we've seen on the installation for COVID positive, how many people have been vaccinated. So the determination in the prescribed location is done wholeheartedly by that senior mission commander, and the senior mission commander through the advisement of their public health officer, as well medic -- as well as medical officers, will make the determination about what it is they feel comfortable from a -- a medically-informed decision to begin opening up installations. So I couldn't speak specifically to each location because that is a senior mission commander's prerogative.

ADM. SHAFFER: Okay, from a Navy perspective, that's what General Faris just mentioned. That's -- that applies to Navy and Marine Corps installations, as well.

GEN. MILLER: And -- and same for the Air Force. I think, you know, you will see that it's a very collegial approach. I mean, the teams are working very closely with the DHA and all the services so that in general, we have a fairly consistent response. We're all very attuned to what the CDC is recommending and -- and making sure that our -- our beneficiaries -- it really shouldn't matter, you know, where they're assigned. They -- they -- ideally, it's a very similar response, especially in a joint base setting.

MR. KIRBY: Thank you, sir.

Okay, our final question today comes from Carol Rosenberg from the New York Times. Carol, do we have you on audio?

Q: Actually, do you hear me now?

MR. KIRBY: We've got you, Carol.

Q: Thanks, Admiral.

Recognizing that you cannot currently compel vaccination, is there a discussion of not deploying people who don't take the vaccine?

GEN. FARIS: General Faris from the Army.

So currently, it is a voluntary vaccination. However, prior to deploying, we provide the opportunity for all individuals to have access to be able to be vaccinated. It is not a -- a -- a mandatory requirement for readiness, and so we will have soldiers that will make the determination whether or not they choose to get the voluntary vaccine at this time. So yes, in fact, we would have potentially people deploying that are not vaccinated.

ADM. SHAFFER: And the same goes for Navy and Marine Corps. And, you know, what we would do is if we're deployed on board a ship, you know, we still continue to do all of the public health measures that we've been doing for the last year -- wearing masks, socially distancing, that type of thing. So they still would go on deployment.

GEN. MILLER: And -- and a very consistent response from the Department of the Air Force also.

MR. KIRBY: Okay. Thank you. I think that's all the time we have for today. Appreciate you all coming. Thank you all very much for -- for doing this session. I think really important discussion, and we're grateful for your time and your expertise.

Thanks, everybody.

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