 So good afternoon, everyone. Sorry for the delay, but we decided to postpone the media briefing by one hour so that we could get you the most up-to-date and factual information possible. And I wanted to include Dr. Levine and Secretary Smith in my call with the White House as well so that they could get the latest facts, too. So as we normally do on Tuesdays, we just got off the phone with my fellow governors, as well as Dr. Fauci, CDC Director, Dr. Walensky, and White House officials following a recommendation. And I want to stress recommendation, not a mandate, from CDC and FDA this morning to pause Johnson-Johnson vaccinations. This came as a bit of a surprise to us, as you might know, but we'll get into more details. Dr. Levine and Secretary Smith will provide those details. But I just wanted to note that this recommendation from the CDC and FDA was made out of an abundance of caution due to extremely rare blood clots found in six cases out of the 6.8 million people who have been vaccinated with Johnson and Johnson. The Johnson and Johnson vaccine, for the most part, has shown to be safe and effective. And I, myself, was happy to get it last week. Here's what we heard on the call. Again, to reiterate, this pause was done, as they say, out of an abundance of caution. The FDA and CDC will be further convening tomorrow to discuss so they can make recommendations to providers. And I think that's key as well. How are they going to treat these symptoms? They emphasized these incidents are extremely rare. And this pause is likely to be a matter of days, not weeks. So with that, on supply, they said Vermont will see about the same allocation as last week. This is because, although we're not getting any J&J this week, there'll be zero ship to us, we'll see a slight increase in Pfizer and Moderna for both the state program and the federal pharmacies. So with that, I know there will be a number of questions, but I'll turn it over to Secretary Smith to go into further details in terms of the vaccination sites. Thank you very much, Governor. As the governor said, we've heard this on multiple calls this morning out of an abundance of caution after, as the governor mentioned, six people out of more than 6.8 million developed blood clots, federal authorities have paused the administration of Johnson & Johnson vaccine. And the federal government, over the next few days, will be reviewing data over the, like I said, the next few days, and will make future recommendations. Again, as I've heard many times on the calls this morning, this is out of an abundance of caution. To support this effort and provide the federal government time to conduct its thorough review of these six cases, we have in this state in Vermont paused Johnson & Johnson clinics for the remainder of the week until Friday. This gives the federal government time to carry out the review of these six cases and make recommendations. Here in Vermont, this delay, this delay is approximately 2,000 appointments today and approximately 2,000 more through the end of the week. There are 1,800 appointments that have been scheduled out further than this week. We will determine what to do with those as we get more information. But for this week, Vermonters who are scheduled for appointments will be offered to reschedule for the two dose vaccine with Johnson & Johnson at a later date if and when the, or they can keep with Johnson & Johnson at a later date if and when the precautions is lifted. Right now, it is too early to assess what, if any impact this will have on our longer term vaccination strategy, we will be looking forward to the federal government's recommendation and will modify our strategy as time, as the timeline, modify our strategy and timeline if it is necessary. And it is important for Vermonters to know that this action, again, is taken as the experts say out of an abundance of caution and so the experts can review the six cases in more detail. We are all hopeful the administration of the J&J doses can resume in the days ahead. And I just wanted to mention that if you are one of the people that were scheduled for today and this week, we will have people reaching out to you and rescheduling with, if you want with Moderna or Pfizer vaccine, we are adding more clinics and more space available to accommodate as necessary. In other news, I'm happy to report that almost 50% of Vermonters have received at least one dose of the COVID-19 vaccine and moving on to those aged 30 and older. We opened up registration yesterday and as of this morning, more than 15,000 Vermonters in that age group have made appointments. Turning to BIPOC Vermonters and household members, over 6,000 individuals have made appointments. We have made progress to close the gap in the last two weeks. If you have not done so already, I encourage BIPOC Vermonters and household members to make an appointment on the state website at healthvermont.gov slash my vaccine. If you are unable to sign up online, you can call 855-722-7878. Press 1 if you need an interpreter for services. Just a brief update on the Department of Corrections. Testing results came back over the weekend and reported that the Northern State Correctional Facility in Newport has no inmate cases of COVID-19. With those that have been medically cleared and this new round of testing results, that means that this correctional facility is now clear of the virus among inmates there. The system as a whole had no inmate cases of COVID-19 at the end of last week, but a new intake at the Springfield Facility just tested positive and is in the Medical Isolation Unit and has been since that intake came into the facility. So has been medically isolated from the rest of the facility. In terms of vaccination, here's an update on the progress in corrections. 589 doses have been administered, 313 inmates have refused. We will begin vaccination those age 30 and older starting this week. On the overall progress as of this morning, 264,300 people have been vaccinated against COVID-19. 90,100 have received their first dose of vaccine and 174,200 have received their first and last doses. We will keep you updated as things unfold with the federal government. At this time, I'll turn it over to Dr. Levine for his weekly update. Thank you, Secretary Smith. Briefly, the number of people with COVID-19 reported daily continues to range in a fairly broad range from well below 100 to the low 200s. But our seven day average is gradually diminishing as you'll see when Commissioner Pichek provides his slides. Our positivity rate is also a bit lower at 1.8% and hospitalizations remain steady but higher than we'd like at 30 with five people in the ICU. We've had only a few deaths thus far in April, but unfortunately we are now at 233 deaths. As the governor and secretary noted, obviously the big news today is the CDCs and the state's actions regarding the Johnson and Johnson vaccine. I know this is unsettling news to some coming as things were moving ahead fairly well. Until we know more, for monitors who were scheduled for appointments will be handled as was described by the secretary. And if you are calling our call center this morning, you may experience some longer wait times and we appreciate your patience and understanding that there are others that have perhaps the same concerns you have. Regarding what is actually going on with the vaccine, there's a curious clinical syndrome that is now being reported of blood clotting but it's blood clotting in more unusual or atypical places at a time when people's platelet counts, platelets being that part of your blood that actually is involved in blood clotting, go to very abnormally low levels. This is considered rare and just the fact that six cases in over six million doses surrounding out one in a million have been reported at this point in time. Just think about that in comparison to the unfortunately tragic calculations we have in this country of your risk of being a death statistic from COVID which is about one in 500 plus. The individuals who have had this, the six cases are being analyzed very closely and that's one of the reasons for the pause but they range in age from 16 to 48 are all women and their symptoms and disease began six to 13 days after their vaccination dose. The CDC is calling this a pause. They're using it as a safety signal, putting safety of the American people first and foremost. The reason for the pause is to allow the advisory committee on immunization practices to give the FDA to allow that group to meet but also to give the FDA, the CDC and the states the time to give the healthcare community the information they need about this unusual blood clotting syndrome. As I mentioned, the blood clots are on unusual places. They're not as traditionally in the legs or traveling to the lungs which would of course cause shortness of breath or chest pain. They may involve the brain in a very unusual syndrome called central venous sinus thrombosis which would provide for a severe headache or they may involve the gut which could involve abdominal pain as a symptom. They also want the clinical community to be aware of when this may begin after vaccination and that the treatment for these blood clots, this being an atypical syndrome, is not the traditional heparin but involves other treatment modalities. I wanna emphasize that to date though we have received only a few reports of adverse symptoms regarding the Johnson and Johnson in the symptom reporting online tool, all of those go in the category of benign and non-serious symptoms. We have not seen any of this cases of blood clot in Vermont and anyone who's been vaccinated with the J&J. Now for Vermonters who are concerned, there's really three time frames you need to think about after getting a vaccine. One is the immediate timeframe or as we've talked about previously, it's common to get mild headache, mild fever or chills, some achiness, some fatigue, usually goes away within a couple days at the most. This syndrome does not present that way and if you've had those symptoms after the Johnson and Johnson or any vaccine, except the fact that that was part of just the kind of non-serious symptoms we see after getting a vaccine dose. Then there's the period of time where you may have gotten the Johnson and Johnson more than one month ago. You are probably at minimal if any risk from getting this syndrome at that time point as well. It's really the people who have had symptoms begin in the couple of weeks after their dose. As I noted, it was six to 13 days for these six cases. That would be obviously a more delayed headache and much more severe headache where you'd get symptoms related to the clot in the brain. So just to give you some perspective on that, this advisory committee on immunization practices will be meeting tomorrow afternoon. They're a group of public health and medical experts and they will review all of the available data and make recommendations. I wanna emphasize that we, the CDC, the FDA are all committed to vaccine safety and transparency every step of the way and that is why these actions have been taken and acted on so rapidly. We'll continue to work with our federal and state partners to understand what this means for Vermonters and we'll keep everyone informed as we have throughout the pandemic about all the many ups and downs that might occur. You can stay up to date by following our at Health Vermont social media feeds on Facebook and Twitter. Now especially now as we work through what the J&J situation means for our vaccination efforts, I wanna speak to the other important efforts to keep the virus at bay. Some of the data is starting to look more promising but we will still need more of it before any true trends emerge. Because the fact is the more transmissible variants of the virus aren't just going to suddenly disappear, they'll keep looking for a chance to spread to the next person leaving those who are not yet vaccinated potentially susceptible. Right now we know those people are the younger Vermonters who have not yet been eligible for vaccination and these younger Vermonters are like all of us sick of the pandemic, missing their social lives, maybe willing to take more risks. You may have seen some images in the media of North Beach and Burlington this weekend where it appeared that beachgoers were largely unmasked without much physical distancing between them. This scene is likely not unique to Burlington. It's probably just one example of many going on around the state, certainly around the country as warmer weather arrives. I want Vermonters to enjoy the outdoors. We know it's safer than being outside, inside. And I know how important it is for everyone's mental health to socialize. So on the one hand, I really do get it, and I empathize. But I was really disappointed to see such a blatant disregard for the rules. This kind of behavior is just not okay right now. Not by young people, not by middle-aged or older adults, not by anyone. We've told you there's going to be a time to return to large gatherings, just not in April of 2021. Everyone who enjoys our beaches, parks, and any other public place needs to remember we are all part of a larger community and need to protect one another as we wait for more Vermonters to get vaccinated. We've tried to keep it simple, masks on faces, six-foot spaces, and uncrowded places. We all need to adhere to that while we're in this race against a mutating virus. Because we're now closer than ever to Vermonters becoming eligible to make their appointments, including these younger groups, we've had to carefully balance supply and demand for many months, and I want to thank all of you for your understanding throughout the process that has brought us to this moment. It's felt so long to many of us, but I'm still in awe that a little over a year after this pandemic, we have safe and effective vaccines, and we are close to 50% of Vermonters, 16 and older, having gotten their first dose. Last week, I shared my top 10 reasons these vaccines are so good. Today, I have another version, a top 10 list I hope younger people, especially, will hear of why to get vaccinated. One, just because you're young and otherwise healthy does not mean you can't get very sick from COVID-19, including even though it's less common for this age group needing hospitalization. Two, there's still much we don't know about long COVID, when COVID symptoms persist for months in some people, such as fatigue, joint pain, chest pain, brain fog. Three, if enough people don't get vaccinated, we run the risk of more person-to-person transmission, which means more opportunities for mutation to occur, leading to variants that might evade the vaccines we have. Four, we're all ready for a time with less anxiety and uncertainty in our lives. Knowing we are protected can help us do the things we want to do, without that feeling, we've all experienced this past year. Five, seeing friends and family, I don't think this one needs any further explanation. Six, whether you love your work or if it just pays the bills, getting vaccinated means staying healthy, which means less missed work and less financial stress. Seven, we've learned from this pandemic how critical being in school and college are to our learning, social lives, relationships, and mental health. Getting vaccinated means we won't have to miss out on that. Eight, whether for work or for fun, getting vaccinated means you can protect yourself when you travel, especially when infection rates vary in different places. Nine, incentives. There might be a creamy coupon awaiting you at the vaccine site as things go along in the near future. And finally, the future, kind of a big one I know, but making this one decision for yourself now to get vaccinated really will make a healthier future for all of us. And if you have someone in your life who may still need a reason to get vaccinated, younger old, talk to them, help them find their own reason. A personal reason will always be the most compelling. And once they have a reason, think of ways that you can help to make it easier for them to actually get vaccinated, whether it's helping making an appointment, arranging transportation, childcare. These small things can make a big difference because every person who chooses to get vaccinated brings us all a step closer to moving past the COVID-19 pandemic. And when you do get vaccinated, please remember, your first shot is just the beginning. You're not fully protected until your body has time to mount its full immune response two weeks after your final dose. As excited as you may be to get that first dose, remember, you are still at some risk. So first thing after you get that shot, set a calendar reminder for two weeks out. Be patient, keep up all the prevention and count down the days for when you can get out there and safely enjoy everything you've been missing. Knowing you will all have our appreciation. Thank you and I'll turn it over to Commissioner Pichett. Thank you very much, Dr. Levine and good afternoon everyone. As Dr. Levine alluded to this past week, we've seen some welcomed improvements in our COVID-19 data. First over the past week, our seven day case rate fell 23%, reversing three weeks of elevated case growth. Our weekly cases reported this week, total 1049, a decrease of 183 compared to last week. Also, generally cases are down in almost every age category, but we've seen the greatest decrease among those 20 to 29 years old who have previously been driving our case growth in Vermont with their rates falling 11% over this past week. This is of course a very good sign. However, as Dr. Levine alluded to, note that this age group continues to have disproportionately high case counts relative to its population. We also have confidence that the decrease in case rates this week is real based on the significant and continued testing that Vermont is doing on a weekly basis. In fact, over the past 30 days, Vermont leads the country in terms of per capita testing occurring. And you'll see also that the Northeast ranks very high on this metric as well. Indicating that here in Vermont and across the Northeast, we are identifying many of the cases that are in our communities. Testing continues to be critical as we work to control the virus until everyone has had the opportunity to be vaccinated. So certainly a big thank you to every Vermonter who is routinely and regularly getting tested. And we certainly encourage everyone to consider doing the same. Now, taking a look at the forecast that we presented in late March, you can again see how we tracked very close to the forecast for about the first seven to 10 days. But then, very fortunately, our trajectory changed about a week or so ago, and that changed significantly for the better. Now, the new Oliver Wyman forecast indicates that cases will stay relatively flat in the short term, but again, decrease as we move into the later part of the month and into May. While the CDC ensemble forecast indicates a flatter trajectory over the next four weeks. However, in either case, a forecast that is either flat or decreasing is certainly welcomed news as it gives us more time to reach those in Vermont who are not yet vaccinated and which will end up decreasing the chance and the likelihood that our cases will rise again before we've been able to reach everyone who wants to be vaccinated. We continue to see encouraging signs in terms of the uptake of the vaccine among our population. Per the CDC, Vermont continues to be one of the highest, one of the states with the highest percentages of its 65 and older population that has started or completed vaccination standing at 91.6% today. We also continue to rank fourth in terms of overall doses administered and seventh for the percent of our population that is fully vaccinated. And as we can see, the vaccine is continuing to make an impact on those age groups with greater vaccine coverage with cases continuing to be flat or decreasing in the 60 and older population. And again, this just shows us how clear it is that the path out of the pandemic is for all of us to get vaccinated when it's our turn. And we can also see that the pace of vaccination continues to be strong in Vermont. This week, we again set a new vaccine record, vaccinating over 11,000 people in a single day. And our seven day average has increased 16% over the past week. The strong continued uptake across Vermont means that we continue to be on pace to meet the upcoming May 1st vaccination ranges laid out under the Vermont Forward Plan as well. Further, we continue to have confidence that we will meet these marks set out both in May and June and beyond as the new Census Bureau survey data indicates that nearly 85% of Vermonters will definitely or probably get the vaccine. And that's among people who are not yet vaccinated. So the remaining number of Vermonters that are surveyed, 85% indicate they will definitely or probably get vaccinated now ranking the highest in the country on that survey. So again, please encourage your friends and family to get vaccinated as of course it will be critical to making our community safer, continuing to reopen our economy and putting an end to the pandemic. Another really positive sign this week is the fact that we only have one long-term care outbreak that is active. This is down from the four active outbreaks we reported last week. And also the fact that very, very few long-term care facility residents have been infected over the past month. We continue to see certain parts of Vermont with higher caseloads than others, in particular this week in the Northeast Kingdom. But there are also some signs of improvement. Again, in particular, Rutland County and Chittenden County have seen their cases come down this week. So again, important for everyone in Vermont to be careful, but if you're living in those communities with higher rates of virus, please take extra precaution. Turning to hospitalizations, you can see the rates continue to be rather stable with the overall hospitalization rate increasing about 6.4% this week. Again, we anticipate the hospitalization numbers to go down once we've had greater vaccination coverage in those 50 to 64, which are still the age groups that are primarily ending up in the hospital when they contract the virus. And we're also thankfully continuing to see the impact of the vaccine on our fatality rates. Now, we stand halfway through April about, and the number of fatalities is down considerably compared to March. And again, we continue to anticipate this lower fatality rate through the month of April and into May and the summer. Last, looking at the region and the nation, there are similarly some signs of optimism around the Northeast with the cases appearing to stabilize a bit with the overall number of cases reported this week compared to last down about 1%. With New York, Massachusetts and Connecticut seeing their cases improve while New Hampshire and Maine have seen their cases continue to rise. And finally, turning to the national heat map, you can see some of that improvement in New England on the map, certainly. But you can see some parts of the country that continue to be of concern, particularly Michigan, but also Minnesota, Florida, and you can see still the New York metro area has a pretty significant amount of cases. So something for us to keep a close eye on in the weeks ahead. And with that, I'd like to turn it back over to the governor. Thank you, Commissioner Pichek. With that, we'll open it up to questions. All right, so we'll begin the question queue starting with Christina from WCAX. Good morning, governor. So now are you worried at all about skepticism and losing faith in vaccines, all three among Vermonters? Are you worried that maybe people will take pause and wonder, maybe I should have a reason to be concerned since these were developed so quickly just because of this one obstacle? Well, my confidence, my comfort level has increased after meeting online remotely with the Dr. Fauci, CDC director, Dr. Walensky, other governors as well, and hearing the data specifically, six cases out of 6.8 million. They're doing this out of an abundance of caution and public safety is obviously paramount. They want to be sure of what they're seeing and then be able to treat it correctly. So after hearing some of the CDC press conference as well as our conversation with the White House, I have complete confidence in what we're doing and I believe that they will have recommendations in the next couple of days so that providers can treat if they find this. And I think that that's key here because I would have to believe that the normal treatment of blood clots isn't recommended for this scenario. So I think that's what they're doing. I'll let Dr. Levine comment further, but I myself have complete confidence and I believe that we'll get through this and then people will remain confident. We've seen nothing with the Pfizer-Moderna in terms of any reactions and we haven't seen anything with Johnson and Johnson in this state either that we know of. So it's all good news and we'll get back on track fairly, I think, very soon. Dr. Levine. And the only thing I would really add to that is the caution is certainly something that we should respect because safety should always be first, but again, it shouldn't necessarily alarm us in terms of the statistics that've been presented and in terms of the fact that when you look at total doses of vaccine, not just Johnson and Johnson, but all three together and the rarity of any serious adverse events, it's quite remarkable, actually, when looked at in that perspective. This caution is really addressed to a large degree to the clinical community in terms of making sure that all can identify the syndrome when it occurs, that constellation of atypical presentation of blood clot, atypical symptoms, low platelet counts, but clotting occurring, so that reporting can be enhanced so that everyone will make sure that if they've seen anything even remotely close to something resembling these six cases, that they begin reporting and providing that information so we can get a better handle on it if it is any more extensive than what we think. And then lastly, as the governor said, the unique nature of the treatment for it compared to, if I could call it, more traditional blood clots. You, as we know right now, it's about one in a million chance to have this risk. Do you feel then that this pause by the federal government is an overreaction or this recommendation of a pause? I don't really think so and something that's such a novel syndrome we're talking about, it's related to an older syndrome. Called HIT, Heparin-induced thrombocytopenia. This is now being labeled vaccine-induced, thrombotic thrombocytopenia. And the bottom line is, when it's something that unique, I think if they wanna take a pause and be cautionary, that's completely reasonable and we should respect that. Not be fearful, just respect that and understand that they're going through a process that needs to happen. I think it's going to be a relatively brief pause, to be honest, and that will be fine. It will have been disruptive and that is very unfortunate, especially for people who are planning on getting their vaccines today or in the course of this week. But as you've heard from the Secretary, we're gonna take care of all of those people. So I think things are probably as they should be. I'd rather be cautionary upfront and not have to be a critic later on, saying, well, why didn't you stop and reevaluate this? It's being done real time and I respect that. So then what would you say to the women who kind of see themselves in these six women who experienced this serious condition, who are now taking pause, they're hesitant about and worried that they might contract the same? Sure, I think again, putting it in perspective. If it's a few more women, perhaps, but let's say it's only six women out of almost seven million doses, we need to learn if there's something unique about these women, something that they may have in common, something we can all learn from in terms of directing who should and shouldn't get the vaccine later on, if that could be possible, based on the analysis that they're going to do. But again, I was very careful to outline the three different time frames and the majority of women who either got the vaccine well over a month ago or just got the mild symptoms one gets at the time of the vaccination itself are not at risk. It's women who are somewhere between a week and a couple of weeks out who may have symptoms that, frankly, would be quite serious and alarming to them whether they were related to the vaccine or not. And I don't think there are going to be many of those. Thank you. Yep. This is probably for the doctor too, but Governor, we're getting closer to the 16 to above 16 group, if you will, received a couple of questions from school nurses and others who are working with youth about A, whether they need parental permission and B, how does that all work? Can that 16 or 17 or however year old get some help and get their appointment made and then get their parents permission or how do you guys see that working out? How you're gonna check that out? Yeah, that may be more Secretary Smith, but you will need approval from your parents in order to do that. But I'll let Secretary Smith answer the rest of it. Sure, that's a great question, Steve. And one of the things that 16 and 17 year olds, obviously their only option is the Pfizer dose. And so they will have to sign up for the Pfizer dose. When they sign up, they will need a parental or guardian consent in order to do that on site. So there'll be a box there that a guardian has to check to make sure that they have approved this 16 or 17 year old. We're gonna just have to see how, the next couple of days sugar off here just to see how we put the program together in order to make sure that those 16 and 17 year olds, again, two thirds of the vaccine they're not eligible for. So to make sure that they have access to that vaccine. And I suspect in the next few days we'll have something to talk about. So how does the parent check that box off and we know it's a parent? Yeah, I mean, there's been a lot that we've been doing here through the pandemic that you can game the system. But I would just urge parents to be mindful of when a child is signing up to be with that child as we're going, you could possibly game the system. But at the same time, I would just urge, like I said, I would urge parents to pay attention. Probably for you doctor, but this blood clot situation and everything has probably gotten, especially women of childbearing years, a little nervous. I know blood clots are also something that can be a problem for folks who are on birth control and such. How does, are you worried that that's gonna kind of cause people to back off a little bit? So those are the kinds of relationships that are being worked on right now with this ACIP group to make sure that they understand best. Cause you're correct. If you're in the pregnant time period or the postpartum time period, without anything else going on, you are at somewhat increased risk. So that's well known. We also know that there's an increased risk by being on birth control pills, although again, the relative risk and the absolute risk are two different things. So it turns out to not be a very common event, even though there's an increase in risk. Most women are not gonna have that problem. The other two vaccines that are available have not had any such association. So if, in answer to your question, if a woman was concerned just in general about getting vaccinated and having a risk of blood clotting, they have two options that there's been no such association made for and would still be considered to be quite safe and effective for them. And as time has gone on in these last number of months, the obstetric gynecology community has had the opportunity to be really watching exactly how women are doing with the vaccines because they've been encouraging pregnant women to get vaccinated with pregnancy being considered a high risk condition regarding COVID and wanting to reduce any bad outcomes in either the mother or the developing fetus. So they're still standing by that quite clearly. And as long as the blood clot risk is not significant with these other two vaccines, I would still tell women that they have other options that they can utilize and not put themselves at any risk that we could discern. All right, we move to the phones with Stuart, NBC 5. Yeah, good morning. The former president who has a fairly large following I should just statement a little while ago calling this JNJ pause a disservice. He said the people who've already taken that vaccine are gonna be up in arms and maybe all of this was done for politics or perhaps it's the FDA's love for Pfizer. Should we simply disregard all of that or what is your reaction to that? Yeah, from my standpoint, yes, you should disregard that. I think the whole point of this pause was to give the FDA and CDC an opportunity to reflect on this and to provide guidance to providers so that in the case of the previous question, those women who might be pregnant should have a conversation with their healthcare provider to determine if this is the right path forward for them to provide healthcare providers with an opportunity to treat whatever may happen as a result, just to be safe. Public safety is important and this type of dialogue just undermines all we're trying to accomplish. And I think what the CDC and FDA did, first of all, this was advisory, this was a recommendation, this wasn't a mandate. And we followed their recommendation because we want everybody to have confidence in this. And I think there's two schools of thought. The way they're handling it, I think the FDA, Dr. Fauci, Dr. Walensky, CDC are handling this is to provide that confidence so that we don't hear this in the future so that they are able to provide enough information to healthcare providers and to everyday citizens about what this means so they can make decisions on their own. So I think it's unfortunate that this has to take a political turn because I don't think anyone wants this. We want people, I think everyone, whether it's whichever side of the aisle you're on, wants this pandemic to be over. So in order to do that, we need to get more vaccines out, more vaccinations in arms in order to get back to normalcy. So again, I think it's unfortunate to turn this into a political battle. All right, we talked about how this is a recommendation not a mandate, but is your intention to follow the recommendation in all cases for this day? Yeah, I mean, look at what we've done here in Vermont over the last 12 months. We followed the guidance, we followed the experts, we followed the science, the data and so forth. This is more science driven. This is the expert saying, we should take a pause here, let's get it right. Let's not make a mistake, let's get this right, take a short pause and then we'll get back on track. And I would imagine by this weekend, we'll be back on track. So let's make sure we provide, just make sure that we didn't miss anything. I think that's what they're saying. And so I have complete confidence that they will do that. And again, we'll get back to vaccinating folks with the J&J, I think, in the not too distant future. Thank you. Wilson, the AP. Hi, everybody. I'm curious how far behind the delay and the J&J vaccines will push the state. I don't know how many individual cases would be affected and then how long you think it would take to make that up? And are you still confident the state can meet its reopening guidelines and that July 4th date we're all waiting for? Yeah, again, Wilson, I was comforted by the fact that there's an increase in the number of doses for Pfizer and Moderna for this week. So even though we're not receiving any Johnson & Johnson next week, we're receiving a couple million more doses of across the country of allocation. So we're on par with where we were last week. We feel as though we'll be okay at this point in time and they'll make a decision soon. And like I said, it's not as though they're not making the Johnson & Johnson at this point in time either. Keep that in mind. So this inventory will be built up and I would assume that they'll be allocating this next week and we'll get a larger supply and we'll just add appointments. We'll just add more vaccination sites. We'll do whatever we can to distribute the allocation we receive. So I'll let Secretary Smith, anything you wanna add to that? The governor said it all. I mean, the only thing I will add is that at this point, we don't really know what the impact will be and but we'll make it up like the governor said. We will, as I said in my remarks, we'll evaluate this for the next few days. If it's the next few days, I think we're okay. If it extends beyond, then we'll reevaluate. But if we get more dosage, we will make sure that it gets in people's arms. Okay, great, thank you very much. Thank you. Howard, BPR? Question. For Dr. Levine, do you have any recommendations to folks who may have gotten the Johnson & Johnson shot over the past few weeks if your family maybe has a history with blood clots? You mentioned headaches and the pains in the gut. If you're feeling any of that, are you encouraging those folks to reach out to their doctors and or the doctors maybe to contact those patients they know that have blood clot in their medical history? And again, I know Dr. Levine will answer this, but remember they're saying what they've seen thus far is within that six to 13 day period. Right, so what about for the folks who just got it and have that medical history? Right, so good concerns. Again, we want to balance being alarmist with being rational and making sure that the expectation is that you will do fine as opposed to the expectation is you will have a serious blood clotting process going on. We don't even know if having a personal or family history of blood clotting is a risk factor for this syndrome at this point and that's why again, the pause is a good idea to get this kind of information under our belts as best it can happen, but I would reiterate again it's those time frames that are most important. So if you've just gotten vaccinated and you're having a mild headache and you have other symptoms of a vaccine reaction, they will disappear quickly and you have nothing to worry about and it most likely won't be the worst headache of your life. If you're in this window of time, which appears to be within a week or two weeks after the vaccine has been administered, you might have a serious symptom if you got this syndrome which could be a more traditional swelling or pain in your leg from the traditional kind of blood clot if it traveled to your lung, shortness of breath or chest pain, but for these more atypical blood clots that are being reported in these women, the one to the brain is going to be accompanied by some kind of neurologic symptom, often a headache if there was something in your gastrointestinal symptom, it might be abdominal pain. So while I would want people to be aware of those, again, I would not want them to get carried away thinking that because this pause was put on, there really are 6,000 women out there as opposed to six out there that had this adverse outcome. So keep it in perspective, is my plea. Right, and I understand that and I understand the media's responsibility as well to be responsible here with this information but what I think I'm hearing you saying with this information that came out today, there are not any precautions or indications that patients should be thinking about or looking at knowing what we heard this morning? That's true, I can't say if you're worried about it developing and you just got the vaccine, take a dose of this or that or do something in your lifestyle this direction or that direction because we really don't know enough about it to say that, those things. And this kind of immune clotting problem probably doesn't have such an easy fix, it develops kind of spontaneously and unexpectedly. So we can't really comment on anything a person can do other than be vigilant and if they have severe symptoms, make sure they're attended to. All right, thank you. I have a follow up on Wilson's question a little bit. If it turns out that the FTC and the CDC put a stop to the use of the J&J vaccine for any significant length of time, that's gonna have an impact on the state's vaccine supply. And as far as I know, herd immunity is one of the things that we are sort of holding out as a goal in order to reopen the state. So I just wanted to ask, I didn't really get a clear answer on what circumstances could affect the reopening and the July 4th date that we're all thinking about, especially in terms of business guidelines. Yeah, well, again, from the start, from when we laid out the plan, we said it was all based on vaccinations. Having said that, again, we're about four or five hours into this. We don't believe this is going to have a long-term impact. We'll know more in the next day or two. So I don't believe that there's anything to worry about at this point in time. We feel as though we're on solid ground and we'll move forward with the plan that we've laid out. All right, thanks so much. Cameron, St. Alton's messenger. Hi, yeah, I just wanted to ask at this point, I believe I heard that there were 2,000 appointments affected. What is going to happen to those doses? Are they just being held at the moment or do they get disposed of? Well, again, from the Johnson and Johnson, one of the highlights of the Johnson and Johnson vaccine is that it can be stored at higher temperatures, room temperature, I believe, but higher temperatures nonetheless. So there's no danger of losing those at this point in time. So we feel good about that. And again, we'll see what happens over the next couple of days, but we are not disposing of anything at this point in time. All right, thank you. For my business magazine. Hi, Governor Leonard, Dr. Levine can speak about another flying ointment, which is the news out of Israel about the South African variant being able to dodge to some extent or a little bit anyway, they don't know exactly the Pfizer vaccine. And that's just another element in this. Dr. Levine. Yeah, thanks. You were talking about the South African variant. Is that what I heard you say? Yeah. Yeah, the 351. So it's kind of really not a huge news breaker or a huge surprise. We've been talking all along about the fact that some of the variants are worse than others. And the two that are the ones that we most concerned about are the South African and the Brazilian when it comes to being able to at least partially, because not totally, but partially evade the vaccines that are out there now. And Israel, of course, having a lot of experience with the Pfizer one. One of the advantages of Johnson and Johnson as we've reported previously was that it was studied at a later time in the pandemic. So it had a little more activity to be evaluated against some of the newer variants, just because they were happening at the same time. Whereas with the Pfizer vaccine, that those trials preceded a lot of these variants. I would only look at this information in one way. And that is that the faster we get the population vaccinated, the better, because there'll be less opportunity for such variants to continue to develop, because there'll be less and less transmission of virus from one person to another and less mutation occurring. I wouldn't say the sky has fallen because the vaccine isn't 100% effective against the variant. It's still gonna be effective in a large number of times, just not as much as in the general population will say. So again, we have to look at this with some concern, but it certainly doesn't mean that we can't suppress virus down to very low levels, even when there is a variant strain that may partially evade the current vaccines. Okay, great, thanks. Good afternoon, Governor. Can you hear me? We can now, yes. Okay, sorry. Good afternoon, Governor. I've heard from several moderates who were concerned that the legislature approved a measure that would expense for $10,200 in unemployment benefits in 2020. Well, the rest of the working public would have to continue to pay and wouldn't have the same tax rate. As you're aware, many of these are moderates collecting replacement income from Department of Labor. They collected more income than they would have if they continued to work during this period of time, at least a dozen states have chosen not to accept these payments as taxable income. I'm curious if you support this decision by the legislature and in your view, if you do, why it's good policy from the state of Vermont to give tax breaks to individuals that weren't working or were unable to work and would not, those who continue to work don't get that same break. You know, it's in my nature, Greg, to be in favor of tax breaks. So this follows suit. I think the federal government decided to do this. The first $10,200 would be exempt and we just followed suit here in Vermont. I think it's appropriate. And especially with the pandemic and those who are not working. But I would also offer that we should be trying to reduce the tax burden on the majority of Vermont or something that I've been doing or trying to do over the last three or four years. So we'll continue down this path. And if we can give some relief to those who have not been employed, I think it's a good thing to do. And we'll just keep moving forward and try and make Vermont more affordable for everyone. It sounds like this is going to leave about $12 million hole in the income of the state. Obviously, that's going to be replaced by the people that are paying those taxes, but that doesn't seem unfair, right? We are receiving about $2.7 billion in this new package. I'm sure we can find a way to make that up. And it's all the way you count it. You know, if they aren't working, I'm not convinced that it's that high, first of all. But we may not have ever received it had they not been given this relief and so forth. So they'll spend it as well. They can put it towards their expenses, paying their mortgage, putting food on the table and so forth. So it's going to be spent. And again, that drives economic opportunity as well. So I think we did the right thing. I'm in favor of giving this tax exemption. And any further tax exemptions the legislature is looking at, I would probably look favorably upon them. OK, and lastly, do you have a time frame yet for when Department of Labor will re-institute a job search requirement? Again, as I've said in previous press conferences, as soon as we have an opportunity for kids to be back in school and things are back to normal and child care doesn't become an issue, then we will re-institute the work search requirements. But I would say it's going to be fairly soon. As we know, we've been able to vaccinate the majority of the school staff. We announced the summer programs coming up, summer camps, and so forth. So this goes hand in hand with our path forward. And I would say you should expect some time between now and the 4th of July, maybe sooner than that, we will re-institute the work search requirements. All right. Thank you, Governor. Appreciate your time. And I will actually get on Friday. Thank you. Avery, WCAX. Several schools will be going on break next week and some families may be considering travel. What do you all recommend? And is there a worry since many children are not vaccinated yet? Well, again, we want them to follow the guidance, the travel guidance we have in place. If anyone who is vaccinated does not have to be tested when they come back. But anyone who has not been vaccinated, if they travel, need to be tested when they return back to Vermont within three days of when they return. So if they do that and follow the other guidance as well, make sure you wear a mask, keep distance, physically distance, we will work our way through this. I mean, obviously, it's a concern anytime that people travel, and we're not recommending that. But if they do, just follow the guidelines we have in place. Anything, Dr. Levine, you want to add to that? Yeah, within three days, have a test when they return. And just another quick question, how can someone say they travel? Maybe that's a question for Dr. Levine. Again, I think just follow the guidance that we've laid out here in Vermont, and they should be fine. Dr. Levine? That's exactly correct, Governor. Just follow all of the same guidance. Be vigilant. Make sure just like you would avoid large gatherings here, you avoid large gatherings when you're away as well. This really boils down to just that. And Dr. Levine, unrelated to travel, have we seen an uptick in cases associated with Easter services or gatherings? You know, it turns out it doesn't appear that we are, because at the same time we're doing the post-Easter kind of tracking, we're finding that our cases are downed, and the trend line is going in the downward direction. I can't say that there were no services associated with Easter cases. I'd have to really look in much more detail there. But my sense is the goal was to have churches continue to be in operation, but abide by all of the guidance we provide, and when just not seeing outbreaks that are associated with churches like we did earlier in the pandemic. Thank you. 22, local 44. Yeah, I had a question for Dr. Levine. I had seen some people concerned that the FDA and CDC recommending causing Johnson and Johnson is going to create more vaccine hesitancy. I wonder what your response is to that, and maybe if you could just kind of go through the rigorous process that these vaccines go through even on this accelerated timeline to get that emergency use authorization and how people can still have confidence given that rigorous process and whether or not they should be concerned right now. Yeah, again, I'll let Dr. Levine answer for himself. But just to put this in perspective, once again, six cases across the country out of 6.8 million who have been vaccinated. We're seeing we've had 560,000 deaths in this country, about 750 deaths per day. So the chances of becoming ill with this virus are far greater than the disadvantages of the Johnson and Johnson. So I think, again, them taking this time to get this right and to make sure that they get all the information to the providers so that they can treat if this circumstance comes up, they can treat those patients properly. I think that's the key here. And that will instill the confidence, I think, by taking this and saying, we've got this right. Just do this if X happens. And this will reinstall the confidence. Dr. Levine? The goal would be that this be a confidence building change as opposed to a confidence eroding change where people will have more respect even for the process that's being gone through. Now, we need to see how this plays out over the next few days, but that's what I would hope it would be. With regard to what these vaccines have already been through, so a typical trial for a vaccine right now is in the 40,000 people range. And so many things are going to be picked up in those 40,000 people in terms of how effective the vaccine is, and in terms of safety, what common side effects might or might not occur. But something that's occurred at less than a 1 in a million ratio is never going to be seen in one of these trials. Or if it's seen, there's not going to be enough of it seen that you could statistically, in a significant way, show that there's an actual harm to you to be done by that particular outcome. So anything that we do in health care, whether it's a vaccine, whether it's a medication, whether it's a type of treatment, whether it be surgical or lifestyle, over time, events end up accruing, and we start to learn something we didn't learn in the original study about what can and can't go right or wrong regarding use of those treatments. Same thing pertains to vaccines. And so this is now being picked up, if you will, in the post-study phase of our analysis. But that's why everybody is being followed chronically. That's why the people who are in the studies are still being followed as potential cases of whatever just to make sure things don't develop over time. That's why we have this vaccine adverse event reporting system so that we can get the highest level of confidence that everything that could be reported is being reported. And that's why, frankly, this pause, partially at least, is occurring so that clinicians can actually start to think about the patients they've seen and say, I wonder if Mrs. So-and-So was actually a case of this new syndrome. Let me go back and look at her chart. Let me forward it to the CDC and the FDA and see if there's some learning that we can do from that case or if it's totally unrelated. So all of this is really what's coming to bear right now. And it's a healthy process. But again, it shouldn't be one that makes people less or more hesitant to get the vaccine. Because again, look at the number of doses of this vaccine, then look at the number of doses of the mRNA vaccines that have been given over even longer periods of time and how well the majority of the population has really done. In comparison to the statistics about one in five or 600 people might die of COVID. The number of states that have cases that are in the double digit percents of the population have gotten COVID. Who might get long haul COVID? Could it be 1% or 10% of those who've had COVID? Those are all statistics that are much more alarming than a one in a million occurrence that we've learned about today. And just a quick follow up for you, Dr. Levine, a bit of a housekeeping item. You had said the Department of Health had only received a few complaints when it comes to the Johnson and Johnson vaccine, all of them going in the category of benign or non-serious symptoms. Were these some of the complaints that we have just seen across the vaccine spectrum and was it just kind of proportional to what you've seen in the complaints with the other vaccines? Nothing here that was specific to Johnson and Johnson? Yeah, so these were local reactions or what we call systemic reactions, which are fatigue, fever, achiness in the body, headache, things of that sort that are short lived after you've received your dose of vaccine. And they go across all three vaccine platforms. I don't believe one stands out more than the other. They're kind of in the class of what I would label expected responses to the vaccine. And often the kind of response we frankly tell people is a good thing to see because it means their body's immune machinery is working and they're going to get a good immune response to the vaccine. Great, thank you both. Good morning. Maybe a point clarification. I've heard it said a few times in this press conference there's only like six cases with blood clots nationwide. Kind of downplaying the number, but isn't it really that there's six reported cases that nobody knows for sure how many people may have had blood clots and especially people may not have insurance or don't want to go to a doctor or may not even realize that they have blood clots. So I mean, could the number be higher than six? Yeah, yeah, that's correct, Mike. And then another reason why the CDC and FDA decided to take this pause, they just want to make sure that that was accurate and that there weren't more cases out there. So that's something they're going to be looking into as well. Okay, I just was trying to make sure I understood it correctly. So my question today, maybe for Secretary Smith, does the state have the number of people that in fact refuse Johnson and Johnson shot based on another moral, ethical, religious, or other reasons, including J&J being laid out of the gate trying to catch up to the other two drug companies, what the actual number of people that either refused to show up for their appointments or when they got there, turned them down when they found out they were getting J&J. Yeah, we're not forcing anyone to have either Moderna, Pfizer, or Johnson and Johnson. So it may be tough to come up with that number because they're given a choice. So they may come back and they may not want a vaccination at all, thus they wouldn't sign up. But so I'm not aware. Dr. Levine. Yeah, just to build on that, you are given a choice. You know what you're going to get when you go get the vaccine, but we also don't have anything built in that says, why did you want this vaccine than not that vaccine? So if there was a person who had a strong reason for wanting one versus the other, it's actually not part of the registration process. The goal is that they get what they want. And that's the way we've kind of designed the system at this point in time. With regard to your other question, Mike, these kind of blood clots, this is very serious illness. So I would suspect these people would have presented to healthcare because of the severity of their symptoms and the impact that had on them so that we would probably know about them. It wouldn't be like people who have a more innocuous symptom and can choose to go to the doctor and not choose to go to the doctor. These would be very serious episodes. And if God forbid there was someone who died of this, we're in the era of doing a lot of work with medical examiners because we're in a pandemic. So medical examiner would usually treat a sudden unexpected death in a younger person in the COVID era as I bet a look for everything and make sure that there was no obvious reason that this person died, check for COVID, but also they would take note of the vaccine status and integrate that in. So my hope is that the six, even though it may not accurately represent the whole universe, is pretty close to representing the whole universe just because of the significance of the illness that would have occurred. Okay. And lastly, I think it was Liz Murray from the pre-crest last time asked about a breakdown by locations for the shots. We've heard various numbers that has been problems like at UVM Medical Center and some of the hospitals that have had significant numbers of wasted or spoiled or I don't know, they arrived as damaged goods or whatever, what is the update on that request he made? Yeah. I honestly don't remember a request being made for that information. I'm sure we can work on getting that. I don't know if there was a public records request placed for that or not, but let me make a note to look into that because I'm just not sure how that turned out unless Secretary Smith has an update. Yeah, Mike, there may be some confusion here. I thought she wanted to know sort of the percentage and Dr. Levine came in and talked about the percentage, but we certainly can give any sort of information that she needs. Yeah, she's received the report. Okay, I guess I'll ask for that one too at some point. Okay. Okay, thank you. Okay. Joe, the Barton Chronicle. Hello. I have one question that's a bit of a clarification for an earlier question. If parents take a child to young to be vaccinated out of state and they return and the child as is required gets tested within three days and that test comes back. Negative, is the child clear to go back to school right away? I believe that is the case and we are not asking anyone to quarantine during those three days just to get a test within three days of return. Okay, thank you very much. My second question probably will end up with Dr. Levine. The AstraZeneca vaccine which has not been approved for emergency use in the United States has been administered about 200 million times elsewhere in the world. And at least from a Lehmann's perspective, there appear to have been some level of reactions that look similar to the ones reported in the Johnson and Johnson vaccine. Number one is my understanding of that correct. And number two, if it is, is there a chance that the wider use of the vaccine and therefore the larger pool of potential people with reactions will help the CDC and the FDA in their look at the Johnson and Johnson vaccine and perhaps speed their reaction? Yeah, so if I could reframe what you just asked, you've actually postulated one of the theories which is that there's a relationship in the type of vaccine platform, AstraZeneca and Johnson and Johnson compared with the other platform, which is the mRNA. So both the AstraZeneca and the Johnson and Johnson have a vector called the arborovirus, which is harmless, it's a common cold virus that is harmless and rendered harmless to humans, but it actually is the vector that brings in the information that we're trying to make antibodies against once it's injected into us. The AstraZeneca was from a chimpanzee arborovirus, the Johnson and Johnson is a human arborovirus, so is there something about that vector that causes in rare circumstances antibodies to be made which end up working against platelets and causing this blood clotting tendency? So that's a theory that people are working with. Keep in mind that even the AstraZeneca with that huge number of worldwide doses hasn't had a similar, huge number of cases reported. It's still in about a one per million ratio, I think if you do the math. And it's been a little better worked out with some recent literature in the New England Journal of Medicine, which I'm sure when the ACIP looks at all of this, they will be cognizant of and be contemplating about the Johnson and Johnson. But right now we don't know too much more than that. And all we know is that in the other platform that's been authorized, the mRNA platform, this does not seem to be true. So more learning to come, but clearly it's going to be instructive for the ACIP, but they have other work to do with regards to the cases that we know about here. Thank you very much. Andrew, do Caledonia record? Yes, thank you. Good afternoon. For Secretary Smith, a couple of follow-ups on the prison update that he gave Northern State. As the full lockdown been lifted earlier in the outbreak it was mentioned there was one in May that was hospitalized just looking for a update on his status and if any staff from the outside of the outbreak were main infected. Yeah, in Springfield I said there was an intake that went into, nobody's been hospitalized. So I said in Springfield there was a intake that came into the facility that was in medical isolation and that's normal on any intake. In terms of, go ahead, I'm sorry. I'm sorry to interrupt. Yeah, during the course of the Newport prison outbreak it was announced that one inmate had been hospitalized at North Country as a precaution with favorable vital signs. I'm just curious what the status of that particular inmate was. Has his infection cleared and he's been returned? Yes, he's been returned. That's been quite a while ago and I apologize for not announcing that but he's been returned quite a while ago and he's been medically cleared. You may very well have announced it and I messed it up. And the prison itself in lockdown or is it now been returned to its more... I'm gonna have to get back to you on the lockdown status of it but right now it is clean in terms of the virus and I'll figure out where that status is for you in the next few hours. And then finally, with the cases, the inmate's all being cleared and this drifting into your rear view mirror, have any lessons been learned and any operational changes implement for this result of this particular outbreak? You know, one of the things that I gotta give corrections credit for is they've learned a lot through this pandemic and the aspect of moving people to cohort people that either are infected or have been exposed with those that haven't proved that as wide of an outbreak it was in that facility, it did stop the facility from even spreading even further and the quick action. The other thing they did which was very good and very knowledgeable in terms of getting information was the ability to test on almost a every other day basis in terms of what was going on in that facility and having good sort of information on who was positive, who was not positive and being able to react on that. I think the other thing is even refining our cohort measures in terms of making sure that bathrooms and shared facilities are not shared during this procedure. So in every sort of situation, in every case we learn something and I think those are the things that we learned. It reinforced what we were doing but it also gave us a little bit of a nugget to help us in the future as well. Okay, thank you very much. Kat, WCAX. Hi, I had a woman who reached out to me saying that she signed up for a Pfizer shot with the state's Berlin JC penny site. However, when she got there on Sunday, she was given a Johnson and Johnson shot instead. The person at the site apparently told her that they never know which ones they're gonna have day to day. How often does that happen where someone's shot is changed and they don't find out until they arrive at the site? I honestly have never heard that happen but maybe Secretary Smith has. Kat, let me track that down. I haven't heard of that situation happening but let me track that situation down. You said it was at the Berlin site. Is that correct? Yes, on Sunday. Okay, let me figure out what. So it was at the Berlin site. Yeah, usually what happens if we have a, if we have, you know, on the website, if we have it as Pfizer or Moderna or Johnson and Johnson, we have that at the registration page as you sign up. Frankly, you can sign up now you can go back into your registration and seeing it. You remember we had it one dose or two dose. We've changed that now. We've actually named the dosage that's there. So if there was a switch, I've gotta figure out what went on there and I will get back to you on that. Cool, actually reading back through the email she sent me, she said it was a two-dose shot that she didn't specifically say Pfizer but she did say it was definitely a two-dose shot that she signed up for. Okay, she signed up on April 5th before the changes were made where she could see exactly which dose it was. Yeah, it used to be one shot or two shots and now it's, it actually names the type of vaccine there is. But let me find out what went on in Berlin. Okay, second question I've got. Obviously, I tweeted out today, I've got a horse in this race because I'm among the group who was scheduled to get a Johnson and Johnson shot later this week. So if you were in my shoes and the fed said in a couple of days, hey, we're resuming use of that vaccine. Would you get that shot if you were me? I'm gonna let the medical expert answer that question. And I'll let Dr. Vingo. I'm not gonna play your doctor cat but I'm gonna answer more generally. There's two pathways that could occur. Pathway one is going to be, this is a rare event. We've learned what we can from it and we think you should take the shot without a lot of concern. Pathway two is we still think this is a safe and effective vaccine. It does have this very rare and unusual potential outcome that could be very, very serious. So because of that, we're going to say that certain people shouldn't have this vaccine at all. I don't know what certain people will be. Perhaps certain people would be women of your age or women of childbearing age or women who are on birth control pills or it may say none of that. But that's what I would listen to very carefully because it will clearly give you the answer you're looking for much more than I can at this point in time give you a final answer but it will be something that I think is very clear and if there's a risk to a certain part of the audience of people who might get one of these vaccines or another, it'll become part of the protocol of who can and can't get it. So stay tuned I'm asking you to do. Yeah, so I know the state doesn't run the federal pharmacy program but for people in my position who registered with a federal pharmacy, I know I haven't heard anything about what to do now neither of the several people I know who did register through providers like Walgreens or CVS. Did you get any sense from the White House call today about what the steps are forward for people who are kind of left in this limbo? Should we be canceling appointments? Should we be staying put? Yeah, I don't believe the White House call addressed that at all. We've canceled pharmacies. Yeah, we have canceled pharmacies but the White House call didn't really address this next step into the future that you're looking for pending the information that is gonna come out from the ACIP. So we're doing everything precautionary at this point in time but they didn't give us any other information because I do think they wanna have this process for the next several days where the committee analyzes everything and comes up with some conclusions. All right, so basically don't go cancel all your appointments just yet. Well, your appointment should have been canceled already and your next question is how do I regain my appointment if it's okay to do it? And we'll be giving you information on that as well when it's available. The pharmacy might do as well. And the pharmacy will be pivoting off of what the federal and state government says. All right, thank you. For Daily Express. The question I have today is if the pandemic started, the governor is taking that kind of a macro look meaning in the entire state shutting down businesses, closing schools, et cetera. As we're now reopening the economy, there are certain areas of the state that have higher focus rates as here in Orleans County. We just went over a thousand positives. Would it make sense at this point to look at the state regionally, look where the hotspot are and make those areas more restrictive so you don't disrupt the economy from toss across the entire state but try to contain the spread of the virus here? Well, again, we've taken a different approach throughout the entire pandemic. And I don't believe we'll change course at this point in time. I would advocate for those communities to take a look at what's happening in their communities and trying to educate more because it is preventable. Wearing a mask prevents a good majority of the transmission of this virus just keeping some of those gatherings to a minimum. That reduces as well. So if everyone follows the guidance, I believe that we can reduce the amount of transmission. And I think, again, that communities can play a part in this and trying to advocate for those in those communities do the right thing. Okay, it just seems stranger for having increased 23% the last two weeks that we're opening up bars and social clubs. It just seems kind of productive to what we're trying to achieve by July 4th. Well, again, we have given communities the opportunity to take stricter action if any of your communities up in the Northeast Kingdom want to close down some of these of the bars, restaurants and so forth, bars and clubs in particular. I think that's what we had opened up recently. They can do so. We just said that we're going to open it up broadly throughout and there's a lot of restrictions, by the way, within the bars and restaurants. For those, I mean, I read numerous times where people would say, we've just opened it up with no restrictions. And that couldn't be further from the truth because at that time, there was 50% occupancy. It was closing down at 10 o'clock. You had to maintain distance. There was a lot of restrictions still in place. So there are still restrictions in place right now. And if you follow the guidance, follow the guidelines, we feel you can safely reopen. But if a community decides they don't want to do that, they can take action to make it even stricter. Thank you very much, Governor. Lisa Loomis, the Valley Airport. Thanks, Jason. This question is probably for Commissioner Pucek or perhaps Dr. Levine. What can you tell us about demographics of those who have been in the hospital and in the ICU in March and so far in April, as cases ticked up and are now trending down? Thank you very much for the question. So we mentioned at the beginning that when we get broader vaccination coverage for those 50 and their 50s and their 60s that we expect to see the cases go down. And that's because those are the age groups that are making up the majority of those that are hospitalized in March and in previous months as well. They've been a pretty consistent age demographic. In March, we also did see a slight increase in those that are under 50 also end up in the hospital relative to February, because cases in those age groups were higher. The hospitalizations in March for those under 50 year olds were pretty similar to January. So it was sort of a similar burden on the hospital system. But that's sort of generally the makeup, is that those that are over 70 are trending down over time, those that are in their 50s and 60s still make up a majority. And we saw a small uptick in those under 50 in the month of March. Thank you very much. Ben, BT Digger. Of the official comments on kind of how this was uncovered exactly, and were you expecting to see complications displayed into the vaccine process? I mean, millions of people have been vaccinated and nothing had been uncovered before recently. So were you surprised at all to see this kind of change in the event? Yeah, personally, I didn't see this one coming. But again, there's checks and balances within the system. CDC and the FDA have an obligation to safety. And they decided to take a route that's more of our precaution and just a pause. And so I think we've come to expect the unexpected throughout this pandemic. Nothing is ordinary. And this isn't ordinary either. So we just have to roll with it and we'll make the best of this situation. And hopefully in a couple of days, they'll provide the guidance needed for the providers to treat anyone who might fall under these circumstances. Dr. Levine, anything you want to add? The only thing I want to add is this is how things happen in the medical world. Everybody knew that AstraZeneca was having an issue with blood clots, unclear how much of an issue. So when one or two reports would come in in this country, that would pique people's curiosity and really make them wonder, are we seeing something similar? Early in the pandemic, you heard about MISC, that sort of multi-organ inflammatory syndrome that is seen after the infection in kids. That's something nobody would have ever really anticipated or expected or could characterize. And when kids started to get reported on from different places in the country at different times, those individual reports eventually accumulate to the point where people take notice and start to characterize a new syndrome that we wouldn't have expected and didn't know anything about beforehand. So this is kind of how it works, I hate to say it, especially with things that are so rare that you couldn't pick them up in a study and you couldn't anticipate them because they're such an unusual outcome or manifestation. Tom Davis, come to Sir Matt. Thank you, Jason. Thank you, Governor. Just following up on your conversation with the White House, one of the things you said during this press conference is the pause is the reason to give the TEC and other administration a chance to study this event and come up with a sense of how, you know, where it came from and how best to treat it. Given that they said that the typical way of treating blood clot may not be effective here, did they give any advice on course of action for treatment in the rare, rare case that you see this in Vermont? They did not from what I understood and that's just from a layman's position. Maybe Dr. Levine caught something, but I think the point was not to treat it the way you normally would treat a blood clot. And I think that that's why the team decided to put a pause on this and they are going to get together tomorrow to determine what you should be doing. And so I think that that's why they put this pause into place so they could make sure that they weren't doing more harm than good if someone did was impacted by a blood clot. All set, Tom? One follow up of that, thank you, Governor. Obviously again, there's such a rare chance that there's some likelihood that people who have had the J&J vaccine in six days have gone by or more, they get a severe headache or some other symptoms that may be totally unrelated to having the vaccination. Are you suggesting those people still reach out to their healthcare providers or is everyone like to say an abundance caution? Yeah, I think what they, what I heard on the call was not just a normal headache but a severe, severe headache, severe pain. And I know that's tough to describe but it's the severity of the abdominal pain or any other pain headache and so forth. That's when they suggest that you contact your provider. But again, I don't want to give advice on when you should always consult your provider if you feel uneasy about this and have any questions. Thank you. Quick final follow up. Dr. Levine, in this case, will you be giving any guidance out to the healthcare community? But or given the fact that they haven't gotten any, I can just have them follow their best practice. No, we are actually going to, probably this evening, have completed a health alert notification to the entire clinical community. So they'll have the most up to date information we have about this, which is not gonna be a lot obviously but it's gonna be more than they've had to work with to date. So that will be going out later this afternoon of this evening. And just with regard to your other questions, as the governor said, everyone looks at their own symptoms and gauges them in one way or another. But this syndrome would produce pretty severe symptoms. So it would be an outlier for a person who gets headaches a couple times a week. They would know that this was probably a very different kind of a headache. And there is a treatment for this. So the pause was not to actually allow people to know what the treatment was. It was much more like the governor said to allow them to know what the treatment shouldn't be in terms of traditional treatment because there are other treatments that we would use. This would be a syndrome that clearly would end up being seen in a hospital that had an ICU that probably had access to blood specialists, hematologists who would characteristically be consulted on a case like this because these are in the very unusual realm. So the patient might even be transferred to an academic medical center. So it's that kind of a scenario. Okay, thank you both very much. Guy Page, Chronicle of Vermont State House. Mr. Levine mentioned a meeting soon of an advisory commission on vaccination practices to discuss this blood clot scenario. I have readers who want to be apply in the virtual wall of that meeting. Will it be open to the public and if so, how can we find it? Yeah, I believe it is, Guy. Dr. Levine? Yeah, it's the ACIP, which is the Advisory Committee on Immunization Practices, which is advisory to the CDC. It's 1.30 to 4.30 tomorrow afternoon. I suspect there will be some kind of publicity about how to access what comes from that meeting. Generally, I think they are public meetings, but I don't want to speak for them specifically in this instance, but that's my belief. What is the name of that body again? ACIP. IC, okay, thank you. Also, Governor, the Civil War started 160 years ago yesterday as this war comes to an end, as our wartime governor, what do you see as the greatest challenge Vermont will have during the reconstruction period all of? Probably some of the same challenges we had pre-pandemic, our demographics, making Vermont more affordable, growing the economy. All of those things, all the challenges we had pre-pandemic are still with us today, but we have opportunities, especially with all the federal money we're receiving to make really, really huge investments in our infrastructure and all the things that necessary that we haven't been able to do because of a lack of resources. And if we do this right, if we invest in the right areas, we'll come out of this stronger than we went in, but I would say again, directly some of the challenges we had before the pandemic are still going to be with us. Hello, Vermont Digger. Hi, I have a question for the governor about the American Recipe Plan. You released your spending plan related to HARPA after the legislature had already decided how to spend a sizable piece of the money. We're wondering, given the timing, are you concerned that your proposal might be brushed aside in the final week for the legislative session? Yeah, I just want to put this in perspective. The American Rescue Plan was passed and signed just a few weeks ago, less, you know, like five weeks ago. The legislature decided to start spending some of that money when we haven't, first of all, we haven't received any money yet, first of all. Secondly, we haven't received guidance on how we can spend it. So I'm concerned about that. I know one bill right now, H315, has some spending in there that I'm concerned about. We'll go through that bill. I have other concerns with the bill as well, so once I receive it, I'll go through it and we'll decide what we do from here. But again, this is a once in a lifetime opportunity with the money we're receiving. It's a lot of money, but we have to invest it wisely. And I believe it's in those buckets that I talked about, the infrastructure buckets, whether it's broadband, housing, climate change, and the economy. So if we do this right, we'll come out of this stronger than we went in. But I am, yes, I'm concerned that they are spending this before we know what the rules are and we may have to pay it back and we're not leveraging it in the right way. But we'll work with them. I've already spoken to leadership about this we're presenting. And again, they were under different constraints as well. When they were putting their, the house was putting their budget bill forward. They didn't have all the information either. So we've all been struggling with this. When I put our initial budget together in January, we didn't have any indication of how much we were going to receive and what it was going to be for. So again, we're all going to have to be flexible, willing to listen to one another. And if we do and make the right investments, we'll be better off for it in the end. Thank you. Okay. That's it. Thank you very much. And if I could just leave you with a couple of thoughts here. I know this is a bump in the road in terms of the Johnson & Johnson pause. And I will, you know, this is a recommendation. It's just a pause, but we're still, even without the Johnson & Johnson vaccine, we're still going to vaccinate more than 20,000 people this next week. So think about that, how far we've come over the last three to four months. Three to four months ago, we didn't have a vaccine in place. And today we have almost half of those 16 and over getting their first vaccinations. So we should be proud of what we're doing. We're going to continue. We still have two very viable vaccines in place. And I believe Johnson & Johnson will be back online sooner rather than later. So again, thank you very much for listening in today.