Dr. Rochelle Walensky On Getting People Vaccinated

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CNBC TRANSCRIPT: CDC Director Dr. Rochelle Walensky speaks with Meg Tirrell During CNBC‘s Healthy Returns Summit today

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WHEN: Today, Tuesday, May 11th

WHERE: CNBC’s “Healthy Returns Summit: New Era of Innovation”

Following is the unofficial transcript of a CNBC interview with CDC Director Dr. Rochelle Walensky and CNBC’s Senior Health & Science Reporter Meg Tirrell during CNBC’s Healthy Returns Summit today, Tuesday, May 11th. Full video will be available at cnbc.com/healthy-returns.

CNBC's Interview with Dr. Rochelle Walensky

MEG TIRRELL: Well, I'm so excited to get to talk with Dr. Walensky our first conversation since Dr. Walensky has been CDC Director. Dr. Walensky, thank you so much for being with us for Healthy Returns.

DR. ROCHELLE WALENSKY: Thank you so much for having me, Meg.

TIRRELL: So, we're in such an interesting time in the pandemic in the US right now. There is so much hope right now as case numbers nationally are coming down. The CDC just put out these models saying we could be in for a really great summer, of course, depending on how well we adhere to some of the, the social distancing and masking and also how many people get vaccinated. How are you looking at things where we are right now and where kind of things look over the next few months?

DR. WALENSKY: Thank you. I feel some cautious optimism. On the one hand, you're exactly right, our case rates are coming down. We're at now somewhere in the range of 40,000 to 45,000 cases per day on average which is lower than we've been in a very long time. But still, you know, about twice as high as we were last year at this time. At the same time, we have these vaccines that we know work, we know protect people, we know our hospitalizations are coming down, our death rates are coming down dramatically. What has happened however is we've done an extraordinary job in getting people vaccinated really quickly and now we have the hard work to do of getting more people vaccinated so we know people who have really wanted the vaccine have rushed to get it and now we have to do the hard work of reaching the people who might not have been the first to sign up who might not have, it might not have been this convenient for them initially or they had more questions about the vaccine and that's the hard work that we have ahead. And it is going to be in those people that we really need to get vaccinated and to keep our case rates coming down and so that's the work that the next few months will bring.

TIRRELL: What is your expectation of you know how many teenagers will get vaccinated? We saw Kaiser Family Foundation poll out saying 30% of parents of kids ages 12 to 15 are saying, “Yep, right away, I want the vaccine for my kids.” But about a quarter are saying, “No, definitely not. I do not want this vaccine.” How hopeful are you? What are your kind of expectations for how many folks in that group will get vaccinated and how important it is for kids who are teenagers to get vaccinated?

DR. WALENSKY: Well, maybe I'll first start as a mom of several teenagers, all of whom have really leaned in and wanted the vaccine because they really want their lives back. They've lost periods of time in college and they didn't get to do many of the things that they wanted to do and now with vaccines, they will be able to do so. We have seen that vaccine hesitancy decreases over time, so this happened with adults too. Initially, people, you know, might not have been wanting to be the first to roll up their sleeves, they might not have wanted their teenager to be the first to roll up their sleeves but over time, as more and more people get vaccinated, we've given over 250 million doses of this vaccine and, you know, the safety and efficacy signals are really, really great. And so, you know, over time, I think more and more people will see teens getting vaccinated, we'll see that they are gathering with safely that the vaccine is safe in them and that, you know, they will be encouraged and want to get their teens vaccinated.

TIRRELL: And how will it change school for 12 to 15-year olds if, if a number of them do get vaccinated?

DR. WALENSKY: You know, we have to see where we are both in terms of cases and in terms of rates of vaccination. Of course, you know, middle and high schools will have the opportunity to have their students vaccinated but younger schools, elementary schools will not yet have an opportunity to have their kids vaccinated. Overall, I want to just encourage folks to recognize that I think we should be in full school, full in-person school in the fall. We have vaccinated over 80% of our teachers and educators. In the fall, we will have or, I hope, sooner than the fall will have the opportunity to vaccinate our teens and so, I really am hopeful for a really robust full in-person school year in the year ahead.

TIRRELL: So, this sort of outlook we've been looking at that feels so optimistic kind of goes to the summer. And we, we remember last summer when cases were down to 20,000 a day and that felt good even though 20,000 a day is still kind of a lot but it's less than we have now. What happens after the summer do you think? I know it's dependent on a lot of factors but you know, Dr. Gottlieb has talked about fall us seeing potential sporadic resurgences. Do you think this is a seasonal virus? I know I'm asking you multiple questions but what does it kind of look like beyond the summer do you think?

DR. WALENSKY: We have seen other coronaviruses be seasonal viruses and that yet, and yet this coronavirus has not proven to be seasonal. So, I think we'll have to see what happens. But we have been, had to be humble with regard to this in the hopes of this would go away over the summer and then of course last summer, we saw a surge. In terms of what happens in the fall, I really think that this is up to the American people. We can hang in a little bit longer, keep our masks on, get our case rates down and get people vaccinated. If we can get up to 70%, 80% of our population vaccinated by the fall, I think we're in really good shape. However, if we are unable to do so then I think we may have, we may have more pockets of infection. What I think is also really important for people to realize is it's, you know, 80% is an average right an average of the entire country, but this that this virus is an opportunist. And so, if you have a community that is only 40% or 50% vaccinated, then in fact, it's going to land there and that's where you'll have disease. So, we really do need to get not just 70%, 80% of the country vaccinated but we need to get at 70% to 80% of each community vaccinated.

TIRRELL: And what does it look like for those communities that have lower vaccination rates? If they have those, those outbreaks I mean, I would also wonder if people who don't want to get vaccinated may be less likely to adhere to new impositions of mandates and social distancing and closures so how does a country kind of navigate through those?

DR. WALENSKY: Well, I think we have to do this not one community at a time but one person at a time and sort of recognize that even though somebody might live in a community where a lot of people aren’t getting vaccinated, you know, they may be willing to get vaccinated when you understand what those individual hesitancies are about. It's really not at the community level, it's at the individual level. Was it that it wasn't convenient for them? Was it that it was too hard to book an appointment? Was it that they didn't really understand the science behind how we were able to get here so quickly? Are they worried about the safety and we have to meet people one person at a time because once we start getting, making inroads in those communities, you know, community members can then be influential to other community members. I do want to highlight now vaccines are available in many, in many pharmacies by just walk in and more and more we have supply that is allowing pharmacies to provide walk in appointments, people can text, “GetVax,” and find and text their zip code to that to “GetVax” and find a vaccine that is available in many different places near them, you'll get a list of the places you can get vaccine near you. It's easier and easier now to get vaccinated and so we do want to make sure that people recognize that for all those who just couldn't find the vaccine before now it's, it should be at your fingertips.

TIRRELL: Yeah, I've actually done the “GetVax” text, it does work. In terms of, you know, looking at the fall, we're talking about getting people just their first round of vaccines but the drug companies are talking about having booster shots ready for the fall. Do you think we're going to need boosters that soon? Then I've got a lot more questions for you about boosters but when do you think, do you think we're going to have to get boosters?

DR. WALENSKY: The first thing I want people to realize and I think that this hasn't been clear is we are talking boosters but right now, if you have two doses of the vaccine, of the mRNA vaccines, you're protected. You don't need to wait for a booster, you're protected. What we are talking about is thinking ahead. What happens if in a year from now or 18 months from now, your immunity wanes, and that's really our job is to hope for the best and plan for what might happen if we need further boosters in the future, the way we get flu vaccine boosters every year. We don't know exactly when, we don't even know if we're going to need boosters, but we're planning for it just in case. It is the case that the first populations that got vaccinated were our older populations or populations in our long-term care facilities, our more frail populations and those might be the populations who had less immunity to begin with who have weaker immune systems to begin with. So, we want to be prepared for those populations, if that is the case.

TIRRELL: And how do you think it'll make sense to determine if a booster is needed? I mean, obviously, what's going on in the community with infection rates but also will we be checking titers? You know, the same way we check, you know, our, our measles titers still high? Is that something that you think we'll be doing to see who needs a booster and when?

DR. WALENSKY: We're actually doing the science right now on that and checking, you know, checking immunity of people who have been vaccinated months ago, many months ago, early people who were vaccinated. I'm not certain that we're going to be in a place that we're going to do mass serologies looking for immunity. It may likely be that we'll understand at a population level when people's immunity starts to wane and we'll recommend boosters in that period of time.

TIRRELL: That makes sense. Another question that I get a lot from people and I, I don't actually know the answer. If you got one shot the first time if you got Moderna or Pfizer or J&J and we do end up needing a booster a year from now or whenever, will you be able to take a different shot then you got the first time around? And what kind of testing do you think should be required of the companies just to know, you know, what happens when you get a Pfizer after a J&J or whatever?

DR. WALENSKY: Really great question. So right now, we are recommending that if you get your first shot as a, as a Pfizer, you get your second shot as a Pfizer. If you got your first shot as a Moderna, you get your second shot as a Moderna. We all understand that that is going to be complex to do over time if we need boosters so the companies, in fact, right now are doing what we call the crossover studies. What if you got one and then you, then go and get the other? And so the studies are actually ongoing, and I'm hopeful that it we can sort of go down a path of getting something else, but we'll wait and see what those studies show.

TIRRELL: And looking outside the US, it almost seems like, you know, we’re talking about all this optimism here in the US but then you turn on the news and you see what's happening in India and it's just horrifying and I wonder how you're looking at how this pandemic is likely to keep playing out around the world as we see vaccination rates where they are and vaccine access where they are in many other countries. What is this going to look like, this sort of we're not in a bubble in the US, but in some ways it feels like, like we are but we're not. So how does this look to you?

DR. WALENSKY: Right, so we have, we've had one of the highest mortality rates of this disease anywhere around the world and so we had a responsibility to what I say put on our own oxygen masks before helping others but we're, we've done so and now I think really is the time to focus and make sure that we're helping others as well. Here's what we know, we know that the more virus that circulates, the more it mutates. The more it mutates, the more likely we will get a variant and the more possibility that a variant could evade our protection from, from vaccines. We know that there are numerous variants circulating here in the United States, the B117, otherwise known as the UK variant, is now the predominant virus that is circulating here in the United States, over 72% of sequences are related to that variant now. And so, what we really need to do is decrease viral replication, not just here in the United States, but really around the world. I think we now recognize that this is a global pandemic and what is global has the potential of coming to the United States. And so, I think those efforts are our key to controlling not just around the world but here at home.

TIRRELL: Do you think that waiving IP on the vaccine as the Biden administration has now expressed support for doing will accomplish greater vaccine access, and any sort of timeframe that could be helpful with the pandemic?

DR. WALENSKY: You know, I'm going to defer to the Office of US Trade Rep, the Office of the US Trade Representative who made that announcement but I will say that I do think it is an important step to ensuring vaccine access. I also think we need to recognize that there's a lot that we can do now in terms of helping these countries, not just with vaccine, but with oxygen supply, drug supply, and we at the CDC have been providing an amount of technical support in testing strategies, use of personal protective equipment, surveillance strategies and others.

TIRRELL: I want to ask you also about drugs for COVID. The antibody drugs, I heard you say, just as you were coming into the, the job of CDC director that, you know, they're, they're just too hard to really be a panacea for the pandemic, what's your take on them? I mean, is it still the same now and would new delivery mechanisms for the antibody drugs be helpful if you could give them as a subcutaneous shot, you know, right on the spot, rather than having to set up an IV infusion? Would that help? How helpful can these drugs really be in the US and around the world do you think?

DR. WALENSKY: There have been numerous logistical challenges in scaling up the antibodies around the country. I think that people who've been trying to do that recognize that, certainly, and there have also been variant challenges. Some of the variants have been able to evade the antibody so, so we've been focusing now more on antibody cocktails than a single antibody. Certainly, further delivery methods like subcutaneous that you don't need to set up an IV infusion and I know that a lot of, a lot of health care centers have been working on how we could roll out larger scale antibody delivery mechanisms. I think it does speak to the broader need for not just antibody infusions, but we, you know, we need a, we need an outpatient drug for this virus, right. We don't, to treat it, everybody's focusing on vaccination, we do need to focus on vaccination but once we recognize that we may not get cases down to zero, there will be cases and, you know, we need a plan that is not an IV plan for how we treat this virus. I know NIH’s key focus is on that, one of their key focuses is on that. And I know that, you know, that the research world is looking towards not just inpatient treatments, but outpatient treatments.

TIRRELL: Are you optimistic about any of the programs that you've seen for antiviral drugs? I know Pfizer has one in hopes to have perhaps data by the end of the year and even applying for emergency use authorization if those data are good. Merck has the Ridgeback molecule, which seems to be progressing more slowly than I think a lot of people expected. Are you hopeful? And it's also just been so hard to get oral antivirals for, or antivirals for viral diseases obviously, it's just been a tough class.

DR. WALENSKY: Antivirals certainly are a tough class. I've, we've, we've seen many, just in the last several decades, and we've seen many for flu now we have several for flu now, influenza now. So, I am hopeful that with all hands-on deck in the medical and research community, in the, in the pharma industry, that we will get to an antiviral. Certainly, we needed to focus on people who are dying, we have Remdesivir now that we can use in people in the hospital. We needed to focus on vaccine and now we really need to focus in the outpatient area.

TIRRELL: You know, Dr. Gottlieb, who's a CNBC contributor so I'm citing him quite a number of times here, but he mentioned last week, he thinks it's almost appropriate even now to think about lifting indoor mask mandates as vaccination rates get higher and numbers improve. What do you think about that? It seemed like a big step even to go the outdoor route, what about indoor mask mandates?

DR. WALENSKY: You know, we at CDC have the responsibility of providing guidance and recommendations for individuals and for the public and for areas of high vaccination and low disease as well as for areas in this country that have high disease and low vaccination rates. So, we still have about a third of counties in this country that have over 100 cases per 100,000, very high transmission rates, and many counties and areas in this country that have less than 20% vaccination rates. So, in that context, we are keeping our public health guidance to recommend that, recommend masking for people who are vaccinated, but if you look at our guidance that was just last release, we are saying that it is safe to do all of those things that you want to do if you're vaccinated. We do still recommend that you mask but you don't need to distance and you really can get back to going to the gym, going to museums, going to all the places that you want to be.

TIRRELL: And, you know, I want to ask you a little bit about your experience coming in as director of the CDC at this incredibly unusual time. It almost seemed like you had this kind of dual mandate. One was work on the pandemic. Another was that you talked about was increasing morale within the CDC, which had just been devastated I think over the last year or so or maybe even longer. On that second one, restoring morale within the CDC, are things changing? Do you feel like it's getting better? I mean, the CDC in many ways is still a punching bag like Michael Lewis' book just came out it does not portray CDC very well. There are a lot of criticisms that the CDC has been slow on things like aerosol declarations as a main way that the virus spreads. How does, how does morale look there now and are you transforming things in the agency?

DR. WALENSKY: Well, I think you'd have to talk to the people within the agency to how, to see how they're feeling. I kind of feel like both of those missions go hand in hand because what the agency really needed to have was to have their scientific voice back. And so, I have spent a lot of time talking with them about ensuring that is the scientific message that is getting out that that is what we will convey to each other, to the public and that is what will drive our recommendations and our guidance. So, I do think that in my communications with them about making sure that they understand the science speaks, in my communications with the public and making sure that the public knows that the science is speaking again, I think that both of those things have lifted morale. I think people, you know, people are tired. They've been working on behalf of the public, on behalf of public health, for their careers, but really all hands-on deck for this past year. So, so, people are definitely tired. But I do think morale is improving.

TIRRELL: And my last question for you is just kind of a personal one. What has this experience been like for you? I imagine you knew it was going to be a lot of political pressure. I mean, just hearing from what Dr. Fauci has dealt with and sort of the backlash to, to saying things like, we still need to wear masks and things like that and I remember the day that you said that you were scared about the rates right now and what could happen and you had a sense of impending doom and there must have just been an incredible amount of backlash to that. What, what has this been like for you? Is it worse than you expected in terms of that?

DR. WALENSKY: You know, it's been extraordinary. I will say I came into the CDC on January 20th having spent a year on the frontlines at hospitals, watching what was happening with disease and with people dying and with stress in the health care system, people worried for their own health. It's been an extraordinary, extraordinarily difficult year even before I got to the CDC. So, you know, my, I find my job, there's pressure, every job has pressure, the pressure that I feel most is to make sure that I protect the public. And as long as I know every day that I close my day knowing that I have let the science speak, I have deferred to the subject matter experts, and that when I've read that science and defer to those experts, that I am doing my absolute best to protect the public. That's what I sort of go to bed with every day and that's my plan every morning when I get up.

TIRRELL: Alright, Dr. Walensky, we really appreciate you taking this time with us. Thank you so much.

DR. WALENSKY: Thanks for having me.