good wednesday morning, i'm kris jansing. buckle up for a busy hour. any second now the white house covid response team will hold a critical briefing and we will take you there when it starts. in just the last 30 minutes we learned that booter shots are likely coming for all americans. they will offer the boosters starting september 20th.

it comes eight months after you got a second dose of moderna or pfizer. now what is clear is that the urgency is palpable as the pandemic intensifies at devastating speed. they could diminish in the months ahead. twice this month it took just eight days to notch one million new covid cases in the country. hospitals are filling up, the alabama association said there is more patients there than there are icu patients to treat them. texas requested five mortuary trailers in anticipation for an influx of bodies. we're also keeping a close watch on the rapidly developing situation in afghanistan. there is good news because planes full of people, mostly u.s. military and contractors

have arrived back to the united states. just this morning, hour, up to 15,000 americans are still stuck in that taliban controlled country. first, booster shots coming for all americans. mike memoli is at the white house. kerry sanders is in tampa floor, both of them covering real problems that schools are having. mike, let's start with what we're about to hear, that briefing is coming up any moment. all of the top health officials in this administration we're expecting to be there. walk us through what we know about this plan so far. >> well, kris, the officials that we're about to hear from

are the same as those that issues this significant recommendation. it is as soon as september 20th. there has been data to show the effectiveness of the vaccines and we're talking in this case about pfizer and moderna waiving over time. the incidents, the production against mild to moderate disease is really beginning to wane among those older populations. what is so significant is that those elderly populations, they would have been the very first to receive those doses when they began really going online eight months ago. and that is significant because

the recommendation that they're making is that individuals begin getting that booster shot starting on the eight months from their most recent. the second dose of the vaccine. for those that got the johnson and johnson vaccine, there are questions about what that means for them. because it went online several months later, they're still in the process of recommending a second johnson and johnson shot. there is a third booster shot and when and when the data shows the second johnson and johnson shot the same for that down the road. there is another important step that must happen here. the fda must go through a review to look at the data and ensure the effectiveness of the data before this. a quick note about the significance of this. president biden is 78 years old. he received his second dose of the vaccine on january 11th.

he is coming up, himself, on what would be eight months from that second dose. the white house said they would follow the science for when the president might get a booster. >> dr. carr, i'm sure a lot of people are doing what i did this morning when i heard this is doing the counting. i know when my eight months is up. a lot of people anxious about the rising numbers of coronavirus cases. a million in eight days. so first, what is the significant of eight months. so now we're coming up on the eight-month mark as we said. this is not an on and off switch. that should be very reassuring. we're seeing a slow progression.

it is a waning immunity. it should not be concerning, it just mean that we may need to boost certain populations. the elderly, the immunocompromised, and front-line physicians that got their vaccines very early in the course of the pandemic. >> you know the beginning, doctor, of this conversation about boosters, there was folks including medical professionals that said a better use of the vaccine. they say it will continue to be a serious threat. is this, the boosters, the best use of the vaccine, and what about the logistics of it? >> that is a raging debate right now and i have to agree in the medical profession that giving

boosters in the u.s. is not the best use of vaccines. the lowest income countries will not see vaccines until 2023. the delta variant will be raging throughout the world. it's not the best way to give boosters and the surplus should go to other countries in an effort of vaccine diplomacy. >> would you say that by making this decision we might be less safe or less protected in the long run? >> not necessarily. when but think about vaccines and global public health, we need to think about the entire world. so that is not the case that we're protecting ourselves less. it's that by protecting everyone equally, we have the surest best of ending this pandemic. >> so logistics.

there was a time when not so long ago you could walk down the street in new york and there was vans, people were getting vaccinated. a lot of testing centers are gone. you understand how all of this happened. can we get up and run fast enough to do this? >> yes, right now we're focusing on people who are immunocompromised. so we're not talking about mass vaccination sites right now because we don't think that we need to vaccinate and give a booster to every eligible american over the age of 12. you know we're really just focussing on those immunocompromised and at greatest risk. that is the key. >> i want to go back into what we're seeing now out there, particularly with schools.

heidi the new urgency is coming as we see kids infected all across the country. it is already seen a surge in new cases after just nine days of classes. tell us a little more about what is happening where you are. >> yeah, chris, we're hearing a lot of fear but also resignation. just within one week of opening the doors this county saw about 100% spike in positivity rates in in-school transmission. that is having a dire impact on the community here. we have 600 kids that were sick enough for ventilators. there is a staffing shortage. people don't want to drive busses with dits not masked. but the most difficult part was talking to the parents

including. >> i'm going to bankrupt you there. let's take a listen. >> this remains a pandemic of the unvaccinated. we know getting more people vaccinated is the best way to end this pandemic. thanks to our efforts to get more shots in arms we're making progress. in the last two weeks alone nearly seven million americans rolled up their sleeves and got their first shot. that is the highest two-week total since the beginning of june. over the past month we also have seen a 75% increase in the average daily number of 12 to 15-year-olds getting vaccinated. particularly important is adolescents going back to

school. and once the numbers from food are reported, we will have reached 200 million americans with at least their first shot. 200 million americans with at least one shot. that's a major milestone. americans across the country have continued to step up, do their part, and get vaccinated. we're using every lever at our disposal to fight the virus including ensuring state and local laid leaders have the tools and resources they need to respond to outbreaks caused by delta. our covid-19 surge response teams are a whole effort. these surge response teams are

now working with 16 states to their needs, to standing up free testing sites, to surging ventilators and ambulances to strained health systems. gets shots in arms, sending and supporting the use of life saving treatments. and we will continue to work with states to do all that we can to match resources to their needs. just yesterday president biden elected fema to continue to reimburse states, tribes, and territories for all emergency response calls through the end of the calendar year. a three-month extension of the order he signed on his first

full day in office. importantly this maintains 100% federal reimbursement for state deployments of national guard personnel. president biden committed to the american people that he would do everything in his power to end this pandemic. from his first day in office, the president has marshalled a war time effort to do exactly that. we have been preparing for every scenario including the potential need for vaccine booster shots. our approach for booster shots is simple and it is consistent with the approach on every other front. guided by the science, and always stay one step ahead of the virus. now let me turn to dr. murphy to discuss our booster plans and

then our doctors to discuss the science of the plan. over to you, dr. murphy. >> thank you, it is good to be with all of you again today. our top priority is always protecting people and their families with from covid-19. we have been fortunate to have safe and effective vaccines that offer outstanding protection against the worst of the virus. the covid-19 vaccines that are authorized in the united states have been remarkably effective even against the widespread delta variant. we know even highly effective vaccines become less effective overtime. so we can make a plan to take proactive steps to extend and enhance the protection of the

vaccines. having reviewed the most current data it is now our clinical judgment that the time to lay out a plan is now. recent data makes clear that production against mild and moderate decide decreased overtime. this is likely due to waning immunity and the spread of the delta variant. even though this new data affirms that the protection remains high, we're concerned that this pattern of decline we're seeing will continue in the months ahead. e with are announcing our plan to stay ahead of the virus by offering booster shots to fully vaccinated adults 18 years and

older. they're eligible for their booster eight months after receiving their second dose of the pfizer or moderna programs. we plan to start the program the week of september 20th, 2021. i want to be very clear. this plan is pending the fda conducting an independent evaluation. and, the cdc advisory committee on immunization practices. based on a thorough review of the evidence. thises our most vel neshl populations. health care providers, nursing home residents, and other senior providers. we will also deliver them

directly. the people that receive the johnson and johnson vaccine we anticipate vaccine boosters will like i will be needed. we expect more data on j&j in the coming weeks. we will keep the public informed of the timely plan for the j&j vaccine. the department of health and human services. it was informed by the data, thoughtful analysis, and by collecting years of experience as always we will continue to follow the science of a daily basis and take whatever steps are necessary to protect the nation from covid-19. the plan to administer booster doses does not change our

commitment to vaccinating those not yet vaccinated here in the u.s. and around the world. the over whelming majority of hospitalizations and death continue to occur among the unvaccinated. we will continue to ramp up efforts and increase vaccinations here at home and to ensure people accurate information about vaccines and access to vaccinations. we will also continue to expand our efforts to increase the supply for other countries building on over 600 million doest that we committed to donate globally. we understand that global pandemics require global response and we will not stop until america and the world are vaccinated against covid-19. i'm speaking to you as your surgeon general but more importantly as an american who felt the pain of losing family

members to this disease, and hears each day the stories of live that's have been upended and altered by covid-19. the brave doctors and nurses in our hospitals. the teachers working to get our kids back in school, and the front line workers making sure we can get groceries and supplies. our quickest path to getting covid-19 under control once and for all is getting vaccines to those that need them as quickly as possible. so here is what you need to know. if you're fully vaccinated, you still have a high degree of protection from the worst outcomes of covid-19. severe disease, hospitalization, so we are not recommending that you go out and get a booster today. instead, starting the weekend of september 20th, full lid fully vaccinated adults can get their

booster eight months after their second shot of an mrna vaccine. we must do everything that we can to protect our communities from covid-19. that is our path to ending this pandemic. i will now turn it over to dr. wolenski that helped us information the decision that we are making now. >> good morning, doctor. good morning, everyone. i want to provide a update on vaccine effectiveness. we're releasing three articles with data that i will now describe that are helping to inform our booster plans. recognizing that there is a reduction in protection overtime we have been analyzing a number of cohorts to understand how long production from the initial covid-19 serums will last.

examining numerous cohorts through the end of july and early august, three points are now very clear. first vaccine induced protection against infection will begin to decrease overtime. they will remain relatively high. and third, vaccine effectiveness is generally decreased against the delta variant. so let's jump into the data. you will see two studies. one from new york and one is an analysis of data from the mayo clinic. may 3rd through july 25th, new york examined covid-19 tests and linked them to vaccination status. this allowed new york to study vaccine effectiveness against infection overtime for more than 10 million new yorkers of all ages. vaccine effectiveness in may during the vaccine rollout in

the state was 92%. in the later months, further from vaccination, it declined to 80%. this data will be published in the mmwr today. the clinic analysis looked at vaccine analysis for the pfizer and moderna vaccines. it is with data through july 16th. like we saw in the new york data, vaccine effectiveness against infection declined overtime. in this case from 76% to 42% for those that received the pfizer vaccine, and 86% to 76% for those that received the moderna vaccine. these are currently available on a server. today the cdc will also publish data from our national health care safety network. a nursing home cohort.

weekly covid-19 case counts were used to evaluate vaccine effectiveness overtime. these data demonstrate that vaccine effectiveness declined overtime from 75% in march to 53% as recently as august 1st, 2021. this is a substantial decline in vaccine effectiveness against infection among those most vulnerable including during months where delta was the predominant circulating variant. taken together, you can see that while the exact percentage of vaccine effectiveness overtime differs on the cohort and the study, data consistently demonstrate a reduction of vaccine effectiveness against infection overtime. importantly though, data analyzed through july continue to demonstrate stable and highly

effective protections against severe illness and hospitalizations for people who are vaccinated. including in the same reports described before, data from new york state and mayo clinic also shows that it remains relatively high both overtime and during periods when the variant was surging. the cdc will also publish data from the ivy network which examines data over 3,000 adults to 21 hospitals across 18 states between march and mid july. this report compares effectiveness early after vaccination and later after vaccination between 13 and 24 weeks. and found that vaccine effectiveness against hospitalization remained high. however in this study only about 7% of samples sequenced were the delta variant. taken together, they confirm

that while protection against infection may decrease overtime, protection against hospitalization is currently holding up pretty well. as we make decisions about boosters we have to look at effectiveness in the specific context of the delta variant. preliminary data from august 6th from two of our cohort studies that include more than 4,000 health care personnel, first responders, and other front line workers show waning effectiveness in the context of the delta variant. from 92% prior to delta, to 64% with delta. noticeably it did not show effectiveness overtime. they suggest full vaccination in the context of a delta variant that may be correlated with less

production against sars-cov-2. we want to prevent severe infections. the data that we will publish today and next week demonstrate the vaccine effectiveness and shows that infection is wayning. even though infections are currently working well to prevent hospitalizations we're seeing concerning evidence of waning effectiveness overtime and against the delta variant. additionally reports from our international leagues shows increased risk of those vaccinated early. especially among those who are at higher risk or who were vaccinated earlier during the phases of our vaccination

rollout. in the context of these concerns we're planning for americans to receive booster shots. starting next month, to maximize vaccine induced protections. our plan is to protect the american people and to stay ahead of the virus. before i turn things over to dr. fauci. our vaccines continue to offer the best protection against severe covid illness. while we're still learning how they perform overtime and how long they will last, one thing is very clear. getting vaccinated can keep you out of the hospital. in areas are low vaccination coverage we continue to hear far too many heartbreaking stories of those that didn't get vaccinated and then got severe

covid-19. the more people in the hospital and tragically more people are dieing of covid-19. we are averaging over 500 deaths per day and these are largely preventable. now i will turn things over to dr. fauci. >> thank you, i would like to provide you with the immune logical basis that would support a third booster mrna immunization. ly show you four points and representative data from these. higher levels of antibody are associates with higher levels of

efficacy of the vaccine. third, higher levels of antibody that may be required to protect against the problematic delta variant. finally, a booster that increases antibodies by tenfold and likely much more. next slide. let's take the first concept. that levels decline overtime and that is regardless of the variant. if you look at the horizontal access. day 29 is when you get your second shot. you see the level of antibodies go up at 43 days but look at what happens at 119 and 209 days. regardless of the variant involved, the levels against those variants decline overtime. next slide. next concept.

that higher levels of anti-body are associated with higher levels after vaccine efficacy. this is referred to as an immune correlate. this is a paper recently published. it shows a model of vaccine efficacy based on the phase three trial showed that four weeks after the second dose that what you have is a neutralization of one to 100 that goes up from the vertical red line. that gives you an efficacy of 91%. if you look at the dark black line going from left to right, as you go further up you get a higher degree of efficacy. so the higher the neutralization, the higher degree of efficacy of the vaccine in this model.

third issue. higher levels may be required to protect you against delta. i'm showing data from the left and a paper in the new england journal has very similar data from pfizer. if you look at the left panel, what you're measuring is neutralization. it is the same as the people in the pink circles and you're looking at the fact that the neutralization tighter required to neutralize the standard prototype, which was the original variant, is clearly that it is lower as you see it all goes down in pink when you're dealing with delta. the next concept gets today

booster. it increases by at least tenfold. these are data from moderna but pfizer announced very similar data. the bottom line is if you look first at the left panel, the antibody titers just before the third dose and 15 days after the third dose is shown right next to it that says d-15. as you see a remarkable increase in titers against the 614-g. the b-1351, and the pfizer data that you expect to be very similar to the moderna. it is also against the delta variant. so you get a dramatic increase in antibody titers when you do a

third immunization dose. last slide. and so in summary, the current data that indicate that antibody levels decline over time, higher levels are associated with a higher level of efficacy. higher levels of antibody may be required to protect against delta. and a booster mrna immunization increases antibody titers by multiple fold. all of this supports the use of a third booster mrna immunization to increase the overall level of protection. back to you now, jeff. >> thank you. i want to be clear the whole effort is ready to get every american that needs one a booster shot.

pending fda approvals, booster wills be available starting the week of september 20th. the plan is for the rule to be simple. get your booster eight months after you got your second shot. if you got your second shot on february 1st. thanks to the aggressive actions that we have taken to establish our vaccination program it will be just as easy and convenient to get a booster shot as it is to get a first shot today. we have enough vaccine supply for every american. and you will be able to get a booster at roughly 80,000 places across the country including over 40,000 local pharmacies.

in fact 90% of americans have a vaccine site within five miles of where they live. and importantly booster wills be free no id or insurance is required. so the bottom line is that we are prepared for boosters. and we will let the ground running. with will cannot to work with states, welcome providers, and ensure that americans know that you should get a booster shot eight months after their second shot. and we will be laser focused on getting boosters to long-term care facilities to make sure that residents and staff get their shots and are safe and protected.

>> importantly we will maintain our focus abroad because we know the virus knows know borders. we have shipped more than 115 million vaccine doses to 80 different countries. more vaccine doses donated than all other countries in the world combined. and this week we started shipping half a billion pfizer doses that the u.s. pledged to purchase and donate to 100 low and lower middle income countries in need. in the coming weeks and months, we will do even more to lead the global vaccination efforts. accelerating our work here in the u.s. and in other countries.

our war-time effort will continue to do everything that we can to get more people vaccinated here at home and around the world. we can and must do both at the same time. because this is what it will take to end this pandemic. and we will not stop until we get the job done. with that, let's open it up for questions. >> thanks, jeff, as a reminder please keep your question to one question, there are many today. first let's go to staten news. >> hi, folks. this is a mike ryan quote from a w.h.o. briefing earlier today, about booster shots. if we think of the analogy, it's handing out extra life jackets to people that already have life jackets. i'm curious, i know you

emphasize thad this is a false choice, vaccinating americans versus the rest of the world, but can you explain throw is not finite vaccine capacity and this it does not come at the expense of first vaccine or second vaccine doses for folks elsewhere in the world? >> so, let me go first, and then dr. murphy if you want to add anything. to end this pandemic we have to protect the american people and we have to don't do more and more to vaccinate the world. both are critical. and we're proving that we can protect our own people here at home as we help others. just to give you some data here. in the months of june and july, the u.s. administered 50 million shots here in the united states. and we shipped more than 100 million to other countries. as i said, the 115 million doses

that we already donated is more than all of the other countries combined. and during the coming months when we talk about booster shots, we expect to give about 100 million boosters in the united states and we will donate more than that. so we are continuing to serve as the president said as an arsenal for vaccines for the world and you will see us do more and more. it builds on the trips waiver. the commitment to co-vax. and we're on track to produce a billion doses of covid vaccine

in india, and our work to support vaccine manufacturing, to produce more than 500 million doses. and we're just going to keep going and going and going. so this is a situation where we're going to do both. we're going to both protect the american people, and we're going to do more and more to help vaccinate the world. >> thank you, i do not accept the idea that we have to choose between america and the world. we clearly see our responsibility to both. and we like to do everything that we can to protect people here at home while recognizing the pandemic across the world and it being key. we know that and we see that

clearly. and we believe we have to work on both fronts. but when we see data giving us indications that protection is starting to plinish, and we recognize if this trajectory continues, the people well protected today may see more vulnerability in the future. we have to act. and that was a collective decision from the top medical experts in this administration. so we will do everything possible to protect people in our country in is why we're announcing this booster plan, but we will also continue to accelerate our efforts to vaccinate the rest of the world and we take that responsibility very seriously. >> next question, please. >> hi, thank you for taking my question. how realistic is that september 20th launch date given that we

have not seen an official u.n. request yet. >> that is the date that we're working forward and as we said that is pending both the fda's approval and the asips recommendation. that's the date that we're prepared for beginning the week of september 20th. >> i there. first of all why did you decide not to limit this and say that all people will need a booster shot, and secondly you say in the statement that the protection against severe decide could diminish. how certain are you about that? are you saying that you do not believe the vaccines will continue to be highly effective?

>> well, thanks jeremy for that question. look, first of all i would say that when we look at the data we see a reduction in protection. that is an important part of why we made this recommendation. we want to protect all adults in our country from the worst effects of covid-19. if you look at how we started to vaccinate people, at the beginning of the vaccination effort, we prioritize health care workers, long-term care facility residents and the elderly. it's the same populations that we will be starting with. we prioritize the most vulnerable and we think it will be null in our goal to protect the country.

>>. >> yes, i just wanted to ask again if you can provide details for the plan on administering the booster shots. you have to reach the same number of people as the current campaign and many of the federal mask vaccination sites have closed. will we see them shift to doctor's offices? smaller clinics, and will they continue to be an intermediary? and secondly can you tell us, are you focused a lot on the data looking at antibody responses to vaccines, can you tell us what we learned about the t cell response, and the recommendation of boosters next year or the years to come? >> yeah, first there are 80,000 sites across the country.

90% of americans live win five miles of a site. the booster will be administered at the 8 month mark. we're going to be working very closely as we have throughout with governors and state officials for them to get vaccinated in a new way. fema stands ready to help in any way. reimbursement has been extended. 100% reimbursement. so we will make sure it is convenient and easy for all americans to get their free vaccine, their booster shot, at or around their eight month mark, over to you dr. fauci. >> thank you for that question, alice. no doubt they will play a role in not preventing infection but

in the progression of disease and the situation that t cells usually do in eliminating or blocking against infected cells. they are not easy to measure, and we will continue to study the t cell response, but the important slide that i showed was the correlate of protection slide that you showed that no doubt was an increase in production of the antibody. that is likely the most appropriate measurement of a correlate of immunity. that is one of the issues that swayed us towards the relationship between antibody and linking that to the next to last slide where i showed you

could dramatically increase the antibody by a boost at the third boost months later. and if you looked at that the increase was really rather substantial. but again not to downplay the ultimate potential importance of t-cells. but if you look at the relationship between antibody titer and vaccine it looks pretty good. >> next question, please? >> thank you for taking my question. it sounds like effectiveness starts wane sooner than eight months. if fly is not an issue, can you walk us through the science of how you landed on eight months? >> why don't we start with you, dr. murphy, and then if anyone

else has anything to add. >> thank you for that question, so let me talk you through how we're looking at this. we did see that around the six month mark you see the mild to moderate infection. but we know the purpose is to keep us out of the hospital and save life. fortunately we are seeing that still holding at a high level. and our anticipate is that if the trajectory that we're seeing continues, that we will likely see in the future a increase in breakthrough hospitalizations and breakthrough deaths and that's why we used our judgment to see when, to make a determination, of when that might be. that's when we came to the eight-month mark. there is nothing magical about this number. it could have been a week

earlier or later, we spent a lot of time and thought into this, and then ultimately to come to that determination, and lastly, we said in the last several months that we're looking at the data closely and when we see a signal that we will let et public know and tell them the plan. we looked at the best data that we have and we saw a ciggal and we're sharing a plan. and we want to assure people that the vaccine they have today will continue in the future. >> may i had another piece of data we have is our international colleagues ahead of us in the delta surge and are

a few weeks ahead of us in terms of other populations. data we have seen from our international colleagues, specifically and especially israel, demonstrated a worsening of infections against vaccinated people time, and so we remain concerned about that as we see in the context of delta variant some breakthroughs that are occurring and decreased vaccine effectiveness that's occurring in the context of infection. we are watching other countries -- and the experience of other countries carefully which is worsening infections over time. >> jeff, one another thing. it has been such almost reproduceable phenomenon with covid-19. if you wait for something bad to happen before you respond to it, you find yourselves, you're considerably behind your real, full capability of being response. so as vivek said in the

introduction you want to stay ahead of the virus, and if you look at the indications that we've had including with what dr. walensky just mentioned you don't want to find yourself behind playing catch up. better stay ahead of it than chasing after it. >> next question, please. >> and so the biden administration and you see it on your screen, recommending starting september 20th that folks who have been vaccinated twice with the moderna or pfizer vaccines should get a booster shot eight months after that second vaccine. i want to go back to mark themly and harvard medical school physician dr. didi meracar. doctor, let me start with you. there was technical stuff in there, a lot of slides. bottom line, they were trying to make the case that this makes sense, it makes sense from the medical aspect of it. the risk appears to be going up, and the efficacy going down

thanks in large part to the delta variant and also that we can walk and chew gum at the same time. we can serve the american people and we can get vaccines out to the rest of the world. your reaction and the highlights from what you heard? >> chris, i'm learning about this in real time like you, and i am frankly very surprised. i'm not surprised for the need for a booster nor am i surprised by the science. i have great respect for dr. fauci, dr. walensky and dr. murthy and i have been friends since college. what i was surprised with the speed of the rollout, and first prioritizing immunocompromised people, elderly people and co-morbid conditions and age 18 upwards can have a booster is surprising to me given that we know that vaccines still offer a fair degree of protection against hospitalization and severe illness. >> given the fact that those folks who got those vaccines

first were in those immunocompromised front line health care workers and some people would argue, that there's the fact that there are 80,000 locations and 40,000 in pharmacies. jeff made it sound like they're ready to go. it's all going to be very smooth. do you see any problems? >> i frankly, think it will be a logistical nightmare. i understand that they are ramping up capacity, but we've had such a difficult time vaccinating americans with the first and second dose. we also have to think about messaging when sudden guidelines like this are presented to the millions of american, there isn't that nuanced messaging. waning immunity is not zero immunity. so i think we should have done a better job in terms of messaging and a stepwise approach would have offered that nuanced perspective. >> there's also the argument, mike, it's been hard enough to get half of america vaccinated

at all. how is the white house persuading to balance people who aren't vaccinated and getting those who are vaccinated with the second dose to get a booster, and put that all if you can in the next minute in the perspective of the stakes which are so high for this country, for the health of both the american people and the economy. >> i think the last thing we heard there from dr. fauci which was also the point that jeff zients began with at the start of the briefing and this is one step of staying ahead of the virus and encouraging those who were probably the first in line to get the vaccine by need and by desire to explain what was so important about this step that the white house is outlining today. it was significant to me, as well to see them run through the data that shows that decreasing efficacy over time from infection and they also emphasize there is still protection against the most severe illnesses as a result of being vaccinated. but in terms of the logistical

challenge. this is a president who came into office with the wartime response to the virus and standing up and the mass vaccination of the american people and the white house is confident that because the challenge at some point became a lack of demand rather than a lack of supply that so many pharmacies so close to americans would have a supply, but there is an additional layer to this. we are also waiting for the administration and the fda, the cdc to approve additional vaccination for younger americans and they hope that eventually they will authorize the doses for the most young americans. and so that adds to the logistical challenge that this white house would have to face and it's one they're beginning to address right now. >> with millions going back to school and mike, thank you very much for reporting from the white house. dr. naracar, thank you, as well. that will do it for me this hour. i'll be here the rest of the week and on friday we'll take

questions on how to stay safe when heading back to the office. send them to us on twitter with the #msnbcanswers and email us at talk@msnbc.com. we have experts to answer them live friday right here, msnbc, 11:00 a.m. eastern. "andrea mitchell reports" is next with my colleague garrett haake. next with my colleague garrett haake. you'll jump for joy. ♪ here, better protection costs a whole lot less. you're in good hands with allstate. click or call for a lower auto rate today. was that your great-grandmother, keeping the family together? was that your grandfather, paving the way for change. did they brave mother nature... and walk away stronger? did they face the unknown, with resolve...and triumph. ♪♪ there's strength in every family story.

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good day. this is "andrea mitchell reports." i'm garrett haake in washington where president biden is feeling intense political pressure two critical fronts. first, on afghanistan the president getting a briefing from defense secretary lloyd austin and joint chiefs chairman mark milley this morning as the mass exodus of americans, foreign nationals and afghan citizens with visas continues. with some people arriving at dulles airport in northern virginia. and new from the u.s. embassy in afghanistan, a message from kabul that they cannot ensure safe passage to karzai international airport for flights departing the country. there are serious concerns over whether taliban forces will allow thousands of u.s. citizens and afghans outside of the country before the august 31st withdrawal deadline. on the coronavirus we will hear from the president this afternoon as the delta variant is fueling the largest seven-day average in cases in six months, spurring the nation's top health