 Welcome back to Senate Education on February 16th. We're now shifting our conversation to vaccinations in schools. Dr. Levine, Secretary of French, great to have both of you with us. As the committee on education, we thought it a priority to have a conversation around vaccinations. What does it look like going back to school after the summer? What should we be thinking about now? I'm thinking two things, certainly around. And we also have the chair of health and welfare and usually a majority of that committee here as well, which is great and a huge help to this conversation. So let me frame it up with two things. Number one, the COVID piece, COVID vaccination mandates, whether or not we should do that. I do that. I'm also wondering if you might in your comments mention if other states, I did a quick Google search look like maybe California and Louisiana were doing it, but I could be wrong. The other piece is actually a bill in center Alliance committee that I have and I'm just, and we don't need to really jump into this but just know because it's actually it's really in center Alliance jurisdiction, not this committees, but at some point even later I'd love to just talk about the assumption but today let's talk just about COVID. So with that, for is yours. Easy topics, easy topics. Yeah, good afternoon Dan for Secretary of Education, maybe, since I started with a health prompt this would be more appropriate for Dr Levine to begin this time. Hi, Mark Levine, Commissioner of Health. I'm trying to respond to what you just put into a big package. Yeah. This isn't my day by the way Dr Levine I'm really not knocking it out of the park so you'll have to have to just bear with me. I'm sorry. This could be my last day here. The first day I come back to the state house could be my last. But I think you know what I'm getting at. Thank you. So, let me start with a little history. Because obviously we do have some vaccines that are required for the K through 12 levels. Okay, and normally we're quite cautious about that we are in our normal course of business we usually await expert guideline setting and don't just go out there on our own so to speak. So whether we're talking FDA advisory committee on immunization practice ASAP or CDC. But our history with the current required vaccines is we're pretty consistently around the 95% range. So very successful with students and all those grades. And there's a report coming out in four to six weeks that will be the most recent years experience which should again be at the same high level. Normally, just to give you an idea of process, we would have a tremendous amount of stakeholder engagement. We at the Department of Health would look at all of the science. We would come to our own conclusion. We would get the input from our pediatric colleagues at a AP and the pediatric infectious disease community input as well. And then we would have a commission advisory council you've heard about and talked about previously within Vermont. And we would want them to deliberate as well because their charge is to make formal recommendations to me as the commissioner of health. We would then have to engage in a rule change process and obviously that would involve some public inquiry input as well. That becomes part of that process. I certainly have to justify, if you will, if I could use that term, why Vermont should jump out ahead of any of these other national expert guideline setting bodies or panels or ASAP. Did you want me to address some specific items about COVID that explain why this didn't happen yesterday. Sure. Okay. So, obviously, we know that there's a paucity of severe outcomes in our children. That's been very consistent. And even though the news headlines when people over dramatize things during Omicron has been more pediatric hospitalizations than ever. It's probably true because there were more cases of Omicron than ever everywhere around the country. But that doesn't mean kids were having worse outcomes. It just means a very low rate of severe outcome was magnified by the large number of people afflicted by getting the virus. As you know, the vaccine has been available to our adolescents for some time this year, but the five to 11 has been the most recent, and they are very recent. And the zero to four of course, is still pending and not on the agenda for the FDA's advisory panel yet because the data is really not ready. And our own experience in Vermont is quite good right now. We are up to a 65% rate in our five to 11 age group. We're well in the 70s and the adolescents. And in that 65%, 54% of what we would term fully vaccinated, meaning both doses, and 6% have received one dose. Uptake has been steadily increasing. And we don't actually know the final landing point yet, because it continues to be a moving target. So all of that is advisory to us right now, if you will, and we are watching the data closely. We're aware that we have abundant testing capabilities in schools. Nurses can do symptomatic testing of children who become symptomatic at school. And so we have a lot of windows into understanding the impact of both vaccination and the disease on our pediatric population. And so that's sort of way of the land as it is right now. I'm trying to remember all the things you mentioned in your preamble. If I've covered them all I didn't cover the other states, but I'll let Secretary. So are you recommending as the state's chief medical officer that as we move back are you thinking about getting to the point where next fall as we're starting to talk to constituents and others that the state of Vermont would mandate COVID vaccines for students. So are we thinking about it we think about a lot of things all of the time. Yes, so so this is in the, this is a possibility. Oh, absolutely it's in the realm of possibility but it's not something we are thinking about today as something that my gosh, we need to make a quick decision on this. You're starting to sound like a politician, you're really. But you know, I do believe that the data is supporting a more. What's the word. I don't want to say we're sitting on our heels but a more to live a more deliberate stance. Okay, because it is a moving target and we are having great success and knock on wood. The experience and kids in our state has been wonderful. We have not had the level of serious outcome sometimes it only takes one or two bad outcomes to generate, you know, sufficient energy enthusiasm, alarm in the public and even in state health officials to want to do something. It would have to take a lot of really bad outcomes now because things have been really going very well with regard to our children and with regard to our ability to keep our schools open and keep in person education going. And that's getting better all the time. So we need to keep thinking about this unquestionably, but we don't need to think about it in an urgent manner at this time. So what would the process be to get to that point. I know that there's a there's a council so what sorts of. If I were talking to a constituent the deliberations. This is, I know you, you're not, you don't make decisions on your, you know, you have a team of folks, and tell us a little bit about that council and how it needs and they give recommendations to you, etc. Absolutely. So the council just had its first meeting. Okay, for the last somewhere under two years, it's supposed to meet annually, but with the pandemic it didn't have its meeting a year ago. The meeting was mostly operational I would label it. But understanding what the future agenda could hold. The council's charge is essentially to make recommendations to the commissioner of health regarding vaccination schedules for students K through 12. And it is advisory in that regard it makes a recommendation. Obviously would get some of the same input I get from my own department, because we would have members of our immunization program on the council and available to the council, so that all of the important data regarding other vaccines and their performance in a required versus non required stance would come to light. And their understanding of the up to date data on this vaccine would come to light as well so that they could use that in their deliberations. We would also seek as much input as we could from those federal and national bodies, whether they be in the government, meaning FDA CDC ASAP, or whether they be in the more professional organization like infectious disease Society of America, a AP for the pediatricians academic home, etc. So, a lot of pieces going into the hopper to enable us to come to a reasoned conclusion, regarding what we wanted to do. I hope that answers that. So, so when I think the other question I would have is how, how often does the group meet. And I'm not and the only reason I'm asking is I'm trying to get a sense of would. It doesn't sound as though you would anticipate it being February that a mandate for vaccinations would would for COVID vaccinations would happen before the end of the school year it would be perhaps it's more to the fall. And that's what I would think. Okay, certainly we want the council to meet again, just to do its usual work, which would be to know this report that's coming out in four to six weeks to be able to review that understand where we are with the traditional vaccine schedule, and how Vermont schools are doing with it and how Vermonters are doing with it. So we want that input for sure. One would think it beyond belief if COVID wasn't at least on the agenda, as an item for them to begin to have a discourse on, even if it wasn't as formal as having 1000 pieces of input and testimony. Yeah. I apologize if you've already said this what percentage of our students, you know, K through 12 are vaccinated that are at, please on on COVID, COVID, COVID. So for K through 12, I mean it gave you a 65% for five to 11 age. You're now asking five to 17 which I do have somewhere give me a second. It doesn't have to happen right now. I gave a 70% for the adolescents. So, well in the 70s, yeah. So about roughly 65% of the kids that are in schools right now, something like that are vaccinated. Yeah, let me get you a precise. Absolutely. Yeah, no. So, as the discussion is going on and you're very definitely going to be listening to CDC as well, I would think. And kids are kids are different from what we've seen happen in adults. But I can't help but ask my health and welfare question which is around the next booster shot, and what you're learning about that because that will, that'll affect adults and it'll affect children, ultimately, but I'm just, is there any. I think that I, when I read it just all over Robin Hood's barn but what, what, what are you getting out of the information about the next shot for people. So you're referring in a sense to the fourth shot, as opposed to. Yeah. Okay. So just so everybody's clear. Center for the mRNA vaccine. The words fully vaccinated now include the two shot series. We look at fully protected and up to date as it being a three shot series that third shot sometimes called a booster but I believe that's actually not what it is it's just part of your initial series to get your immunity up to par. The general lines is now referring to yet a fourth shot and at one interval that would occur. So the CDC just came out in the last week or so with more formal recommendations again because they changed the interval dosing for immunocompromised people, which gave them another opportunity to review it again for the gender. I don't know how these things happen right now. Right now the general public third dose is listed as five months, whereas previously it was at six months. So that's changed. So foreshadowing of yet another dose. And I think part of that is because of the fact that Omicron is now so much on the retreat throughout the country at different way different places different rates that it's no longer as serious a consideration for giving people yet another shot. So what's going to happen is people are going to do studies and continue to follow immunity levels, mainly by neutralizing antibody levels of vex in their bloodstream to see how much waning occurs in individual people over time. The second thing that will occur is there will be more whole genome sequencing than ever before, so that if another variant comes along will help hopefully have the lead time to do the laboratory experiments to know if current vaccines will still be effective or if they'll be what's a new invasion on the part of the next variant form to the vaccines that exist, but there's been no talk about a fourth dose yet and everyone from Dr Fauci to the CDC director everyone down has been very cautious about saying we don't believe the data shows this is needed at this time. And we're just going to have to wait and be patient, but to make sure everybody on the call understands if you are at all immunocompromised. All of those individuals should have a fourth shot. And that's very clear in the newest iteration of the guidelines and the interval for that happening has moved even closer to after basically a month or more after the third dose of your vaccine you're eligible already for a booster. So that's a different population makes up a few percent of the total population. So what as kids are the kids who are vaccinated. What are you hearing about the their transmission of the virus even though they may be vaccinated. I mean our kids are kids the little carriers that people had been talking about early on. I think with Omicron that's proving to be more true that it was earlier on, to be honest. But the reality is, yes, I mean they every human being has been more susceptible to nasal infection with Omicron is the portal of entry, and potentially being able to transmit to others. And I don't believe prior to Omicron it was as dramatic as that. Thank you. So you're personally. Thank you. I don't want to go into too many questions if we were also going to hear some kind of presentation from Secretary French, or are we just all questions today. Well, this is a, this is a good conversation do you want to just go ahead and ask it in. Yeah. I know it's just about this definition of vaccine and unvaxxed or vaccinated and vaccinated because I just want to make sure I have that clear like when I look at the Department of Health website when it says, you know you have a lot of nice graphs about you know, vaccinated and vaccinated. That's the two shots because what you when I heard I think I heard you say just want to make sure I get this right that vaccinated is two shots even though fully protected is two shots in the booster. Right. We show it both ways now. Okay. So, and that just went live actually so you can go on the vaccine dashboard, and it will show who's gotten boosted, as well as who's just gotten the full series. So but fully vaccinated is two shots. Are you saying it's the three. No, we haven't verged from the national definition. We've just brought in the amount of data we're providing. And then, yeah, that's that's helpful. I think I did see a graph on VT digger that did break it out like that which was helpful and then. So, somebody that has just one shot. Do they fall on the unvaccinated or the vaccinated pot. They fall in the categories have received at least one dose. Okay, that's another category between you and me. It was worthless for them to get vaccinated. Well, the two of you and everybody listening throughout the United States. But it is true one dose one doses and not going to really help anybody in this age of Omicron and beyond. So I don't want to appear non compassionate because there may be people who said, my adverse reaction was so severe that I cannot get another dose of this, and I have to respect that and then. And also trying to tie your comments and in a purchase with Senate Alliance just keep in mind that the five to 11 year age range only gets two doses at this point. That's all that's been authorized under the way. But if I if I see a graph that says, these are the unvaccinated that that that's pop that is including the single. No unvaccinated means nothing. Okay. Hopefully, as we get more data and we can break it out like you said you just, you just done that. Okay, I have other questions but we can go on. Okay. So just for clarification. So when Senator per six was talking so am I I have as an adult, I have my booster. Is that considered fully vaccinated or is just the two shots considered fully vaccinated. Okay, that's the national definition for the national definition. Okay, thank you. Thank you. Until it changes until it changes. Okay. Yeah, thank you. Anything else for Dr Levine at this point, he's going to be with us for a little bit, because we have questions please center personally. I have another question is probably more productive being and that is on the vaccine schedule. Is there a time, have we ever taken off a vaccine off the schedule like, I don't know, polio or something probably at one point was required and isn't. The advisory council, he said that's their normal work they looked at the schedule. And then there's a third time where, you know, if the disease isn't around or if, like, we're at 99% vaccine does it come off that requirement. So, so I don't know if it has anything to do with the advisory council but certainly smallpox would fall in that category that because that's now considered a pretty much eradicated disease. It's a pretty rare phenomenon. And we certainly would never go with just the Vermont immunization advisory council recommendation on that we would hope they were bringing it to our attention, because we hadn't gotten there yet. And everybody in the healthcare world was saying, we don't need this vaccine anymore. Dr. Levine, Secretary French. Thanks for being with us. Any comments related to responses to some of the questions you've heard or anything additional thoughts that Dr. Levine left out or anything at all. Certainly, as Secretary of Education I am a member of the advisory council so I think you know you've heard from Dr. Levine that the function of the advisory council is just that to advise the Department of Health and it has a statutory purpose that predates coven. We certainly have this on our radar to address the coven issue. We did have a meeting recently it was largely an organizational meeting we still have pediatric member that needs to be appointed by the governor previous member had retired fairly recently. And Dr. Levine has the authority to appoint several members as he mentioned, largely, most likely from his staff and immunization expertise from the health department so that council, you know will be constituted, and we'll begin working on this issue in the coming weeks and months. And other than that your comment about what's going around nationally, you know I too am an observer of some of that so it is what I'm seeing right now is largely just political activity, certainly at the state level. You mentioned Louisiana I think you know Louisiana is a good example where they had a legislative committee recommend not to mandate the vaccine I believe the governor vetoed that and then put put coven on the mandatory list under his own authority or whatever they've delegated the governor. Then we see a lot of districts also that's another level of activity so it's not just state level activity so there's activity around school districts themselves particularly some of the larger urban school districts are taking that up I think that's really how the ball got rolling in California and LA and Oakland were in San Diego we're thinking about that. So we've seen that level of activity and then there's what I observe another layer of activity that's focused on athletics specifically so we've seen school districts around the country mandate vaccination for athletes for as a condition of participation and winter sports and so forth so again largely my from an anthropological perspective I would suggest it's largely political activity at this point. But we are, we are connected through our national organizations and I think that's one of the things we've leveraged and you know Dr Levine and I've been a lot of the meetings together and work closely on various issues related to schools. So we do leverage our national organizations and so we're tied into those conversations as they emerge. But, you know, we're very pleased at this point with the level of uptake and vaccination at our schools as you know we're we're endeavoring to do some reporting on that information. It's, you know, it's again always challenging when we're doing these data tasks that rely on joint agency cooperation and coordination because we, we have pretty substantial data protections and privacy protections and acted in our various agencies so when we work with those boundaries that can be challenging but I think in a good way. So, we are working on that I think it is, as we come through the amicron surge we're very interested in focusing on those ecosystems those school districts that haven't achieved higher vaccination rates I think it's a good proxy for operational stability going forward and we'll likely see other variants will will continue to have cases in schools and that'll come and go on a cyclical basis. And we think often about those lower vaccination rates and some districts and ecosystems contributing to more instability so we want to think about what we can do to support them, certainly to improve their vaccination but just to ensure that we can keep those schools open for those kids center lines, you have your hand up. I mean as you're going through the discussion with the advisory group. And from your, your perspective in AOE. One of the things of course that we've always been concerned about is ensuring that there's plenty of time for notice. Regardless of what's going on out here in the real world terms of the, the virus or not the virus I mean it makes it so difficult I appreciate that but have you set kind of a time in your own mind. After what, where the decision has to be made about whatever conditions should be in place. When kids and teachers go back to school in the fall night now I also know there's summer school after school stuff going on, you know, so it's continuous but I think parents are looking for the day the door reopens in the fall so do you have kind of a timeline that you're putting in place you're thinking about, and you're muted. Really, I just. I haven't thought actually directly about the specific issue because so much of it is dependent on the science, you know as Dr Levine described there's multiple layers of, and I think again appropriately multiple layers of scientific review that need to occur. I can just fall back on my experience leading school districts that you know in August August is always a busy month for schools that's where a lot of we see a lot of enrollments up until the last week or so before school starts. So I would think you know certainly the best case scenario would be if there was some requirement like this coming down in August if not early August would be useful to allow people to make those decisions but again. I just intersected that sort of let's say my experience reference with the practical aspects of how long it's to take to stand up vaccination clinics and how long it's take to get people fully vaccinated you know what would that look like. So I haven't done any of that calculus yet. I guess I'm thinking, in particular about notifying parents, you know what, how much time does it take to get the notice out to folks so we don't run into some of the issues that we've seen, you know, with the reopening of school. Not all those questions. Well it is, you know, back to sort of the observations and the lessons learned nationally I think that's precisely, you know, part some of the problems we've seen, you know where I think California announced a certain date and they found out that would exclude a large number of students from Los Angeles from being able to attend school so you know those things have to the operational aspects have to be factored into that decision making. So I would, you know, if we think about sort of the ideal of doting parents, letting parents know in the summer in advance of the fall that would be sort of a best case scenario but what's proposed, you know, propelling people forward in the case of California for example I'm sure as a sense of urgency over the public health requirements so conceivably these kinds of decisions can be made mid year. And then it's then it really does become a function of logistics and ensuring people have access and are motivated and have the right communications and so forth so again hard to predict how this would play out. But we do, you know, I would just reflect and say we have the appropriate structures in place as a state to make sense of these decisions that we've been fortunate to have so many different experts weighing in. We have been very generous with our time throughout our management of the pandemic whether it be the infectious disease docs at UVM or the pediatric experts that we have. Everyone's really, you know, chipped in to contribute to the safety of our school so I think we're poised to, to make sense of this and to be proactive as we have throughout the pandemic. But it's not clear to me yet what shape that decision making will take or what trajectory it would have. Thank you. I'll try to slip in two questions. One is about the, I heard from the governor's press conference on Tuesday about the masks and how that relates to vaccine so I haven't read the article so maybe you can just update me because I think I saw 80% vaccine and, and that's related to the mask so maybe just update us on that thinking and policy and if that's settled or still something to think about and the other just question I have that you too probably can or anybody maybe here can remind me we don't have it mandates anywhere else like this state employees are, are encouraged to get vaccinated but if you don't get vaccinated you can test and still go to work if I'm correct. Am I correct that there is no absolute mandate for vaccine anywhere that the state has done I know the feds have their mandate for like certain fed workers but my correct that we don't have any mandates in the state for vaccines. Well start off with just an update from the press conference so to speak and we had a policy mechanism of call it this 80% threshold that we had written into our guidance back in a August. We did go live in September, a totally different moment in time sort of pre Delta, you know, and we were intending, and I think appropriately seeking to leverage our, what has emerged as a national leader in terms of school level vaccination. And also wanted to, you know, encouraged to provide incentive to that so the challenge was lauding our accomplishment because we still have a lot of work to do and we really those last mile issues so to speak in terms of vaccination are some of the harder ones. And we did create that mechanism and then put it on delay I think at least three times because you know that we started getting into the Delta context we weren't weren't satisfied that that was an appropriate decision and it was in January. We were dealing with Omicron that we delayed it again and said it would go live February 28. Then we certainly suspected, I think you know that Omicron would have that steep sort of Omicron curve and the steep decline. And that's more or less played out as we predicted in that regard but 28th was essentially picked out, you know, it's the other side of student vacation February vacation so it's let's go with that is sort of the next milestone and if we need to will delay it again. So what we announced on Tuesday was that we're not going to delay it again so it goes operational, but I think more to the point. You know that the idea of the threshold was something we had inherited I was inherited we created back in August in a different moment of time so we felt it's a useful tool. We've talked about it enough we've delayed enough let's start. But what we've been thinking more about is just the general trends that we're on it's not so much a specific threshold. You know as I said at the press conference we see Connecticut Massachusetts Rhode Island, not, not surprisingly states that entered the Omicron surge earlier than Vermont and exited earlier than Vermont, making decisions to remove mass now. Rhode Island's a little later in March 4. So we were signaling that we're on this, we're on this sort of glide slope if you will towards we'll call it more endemic management and I think the real my takeaway on that is that schools will no longer need separate mitigation requirements than the broader mitigation requirements and there's no special reason that schools need protection and we had to have those special reasons before because we had a large number of the population namely students that weren't eligible for vaccination so we erected a multi layer response to keep them safe and also education as a policy priority. As we, as we're contemplating the sort of the post Omicron environment and I think you know Dr Levine would agree that it's accelerated our thinking, you know, about endemic and where we're heading and certainly there will be variance they will come and go will continue to have cases in schools and so forth. But my observation, largely with vaccination is that we've, in spite of these fluctuations we've since the beginning of the year we've, and since last spring, we've been on this trajectory of continually driving down the risks from the virus you know it's vaccine has been a significant contributing factor in that trajectory, but we have the new treatments coming online and so forth so that you know, as in spite of the cyclical experience the schools have experienced directly on a daily basis. In the background spin this this movement of vaccination that's really driving down the risk so we're at that point where we can contemplate, removing some of those measures and this is where we start to. And this is where everyone is intersecting the risk from mass relative to an educational perspective versus the health perspective and we have growing understanding that that mass are causing some anxiety if you will there's certainly they interfere with some of the instructional opportunities inside of schools we have, we have schools in the state that still haven't enabled music this winter because they've been fearful of that and mass. Masking with musical instruments we spent a lot of time on that last winter is really kind of tricky. But any rate, we don't feel it's necessary now but we still have schools doing those things so we have to kind of move down this trajectory of weaning people off those types of mitigation self homegrown mitigation and so what we announced on Tuesday is like we're going to we're going to do the 80% we've talked about enough we just think it's a good way to get people moving in that direction. We're behind the other new England states a little bit but at some point and not too distant future it's likely we're going to recommend a removal of mass altogether. It still would be a local option so school districts would have the option to keep the mass in place and I think we'll see a lot of individual decision making which I think is great and Dr Levine I think would agree. That's that's kind of where this is heading is like each of us has to do that risk assessment and we also have to think about the people next to us and a respectful and kind way you know that someone sitting next to you doesn't have a mask on it doesn't mean bad things you know they're they're doing that own risk, their own risk assessment, but you know increasingly we just have to acknowledge in Vermont our schools are incredibly safe and I made the point on Tuesday, I don't know, you know which schools in the world are safer than Vermont and we do our higher vaccination rates and so forth and our strict adherence to our mitigation measures. So we need to have the courage to make that next step but it's it is a we prefer to take a phased approach to the 80% sort of like a toe in the water. But that that decisions coming soon and we want to give folks enough notice to start thinking about those things and starting to work towards a personal and organizational level of acceptance that it's okay. You can do it so. Did I hear that we have a list of where everybody is like we know there are some schools that are over 80%. Yeah, that's what we're working on now is alluding to we have we took. We're working on some joint agreements between our agencies to take the immunization registry information and intersect that with the enrollment data so when when students children were getting vaccinated they, they were not required to disclose the data that they attended so we had no way to sort of do that match our first attempt to this started before the holiday we were asking nurses to identify the percentage of students that are vaccinated in their school by going into the registry. And that we only got about a 50% response rate to that because the nurses were just, you know, buried with contact tracing and everything else and so we had to think about another way to do it. I mean, the school year we thought of doing it this way to but we didn't have accurate enrollment information the enrollment information doesn't. The reporting deadline isn't October 1 and then we go through a big cleanup process so it's only recently that we have stable enrollment information from October one, which is, you know, outdated but at least it's stable. We're trying to do that match right now I think you know again our interest was to prepare for the sort of next level policy iteration where we want to focus in on specific districts and schools to find out what supports would be useful to them. If they had lower vaccination rates it wasn't so much to think about the what can we do to raise those vaccination rates so certainly we are interested in that, but it's also to acknowledge you know again this idea of organ or operational stability that those districts that have lower vaccination rates, we should prepare for them having difficulty staying open during times of surge so we want to figure out what supports are necessary to enable them to keep schools open for kids. There are questions for Dr. Levine, Secretary French. I could answer the second question that Senator Perk attack. We don't have an absolute mandate for state employees but we have a requirement that state employees be vaccinated but it has an off ramp. So if they so choose to remain unvaccinated they don't lose their job. They are. They must attest to their status and to the fact that they will have testing performed on a regular basis, which is usually occurring at their side of work for most people. So they don't have to travel a lot to get that done. So what percentage of state workers have been vaccinated? Yes, today I heard the number was 94%. Thanks. Senator Campion. Yeah. Could I share my screen for a second to answer the question I could answer previously. Absolutely. Daphne will grant permission. There you go. Hopefully people can see something. Yeah. Okay, so these are publicly available slides that are on the DFR website. And this is the most recent week. We don't show all of these at every press conference because the press conference would be even longer than they currently are. But this shows the remarkable performance of our youth and really reflective of their parents of course as well with regard to vaccine in the age groups you requested. So this is five to 17 so K through 12 essentially. And you can see the robust rate that we are way ahead of the majority of the nation at 676.3% starting vaccination. And then we move to fully vaccinated, meaning they've gotten two doses. Almost. Well it is two thirds essentially. Again, way ahead. And then for those eligible for a booster, which means age 12 to 1734.5%. And then finally, we get where we are with our vaccination progress. If you look at the juniors and seniors in high school, if I could characterize this bar graph, a bit more broadly than perhaps I should, we're up at around 80%. Everybody in the middle and early high school years, 75%. And of course our newest population, lower than those two. But this is really, you know, substantial progress. Dr. Lee, would you go just back to that the slide that mentioned the 34%. I missed. Is that 34% have gotten the second shot. No, no, I'm sorry. Third, third shot. Yes. Okay. Right. Okay. Well, these numbers are, yeah, this is really, really good news. You don't, you know, I think of a like a lot of 18 year olds as being seniors, while you cut it off at 17. It has to do with the EUA that came out and what age range. Okay. Everything before was 18 and older. I was going to add some commentary from, that's okay, Senator Purchick's question, you know, about state. And I would just say, I think that, you know, we have as Dr. Levine described that state requirement, and that's, I think useful to think about in terms of not so much as a state requirement, but an employer employee sort of association. We have that playing out in school districts as well. There have been several school districts have explored that by leveraging their employer employee relationship to require a vaccination. But I, you know, I just make the observation on our student vaccination data. We, and draw the distinction between staff vaccination versus student vaccination because we have a high degree of staff vaccination in the state well over 90% we suspect. And we think that's very consistent, you know, regardless of if you're in Canaan, or, you know, and will stand at the rate is very high. The vaccination rate, on the other hand, varies considerably. We know that already, just in the patterns of the county basis and so forth and we suspect that will play out the school level. But it's interesting to note, if you think about Vermont's population and where the density of our population exists, it exists in Chittenden County, which tends to be a more progressive, I'll say political area I'm providing political commentary. That's great. You think about Chittenden County being more progressive and perhaps more interested in mitigation measures. And that's precisely where a lot of our population is concentrated so it shouldn't surprise folks that we have a state level rate that's considerably higher and if you compare perhaps to a southern New England state. A lot of their densely populated urban centers are are really tough nuts to crack relative to vaccination right so they have distrust people of color distrust of government and so forth. There are some advantages in our regard but we we have this other Vermont as well as you get out in the rural landscape. And that's where you know we I call it the last mile to borrow the metaphor from broadband. We have to get down to those small very small economies of scale to push a needle on vaccination. That's a good one to push the needle on vaccination. We have a lot of work to do in the landscape and it doesn't really result, you know, and, you know, take a batch of vaccine up to Canaan, it isn't necessarily an efficient way you know there isn't a large number of people there to do that. But those are the kinds of issues we have to address and sort of the next level that's why it's important that we maintain the momentum, because we, it is pretty amazing how high rate we've been able to achieve but we still have a lot of, a lot of work to do in the landscape and to keep that momentum moving is important. Great. And I completely support and agree with everything Secretary French just said, and we have maintained school based clinics and community clinics throughout the state. So these opportunities have been ongoing. Based on whatever data we now have to analyze about the student vaccination rates in some of these settings we may need to adapt strategies again to, to meet the need. And just in sort of tying in the slides we just viewed. We are doing remarkably in Vermont. I think if there's anything I showed you it's the fact that most of the country is not doing remarkably yet with the uptake in our youth. And we are doing remarkably. So I fully support and will continue having the kinds of conversations we're having today. But you can see that we are still so far out in front that we don't want to prematurely make any decisions that with time, the state may arrive at the destination. Anyways, without enforcement, if you will, of a mandate kind of level, because we're just seeing the growth in this continue to occur. So just to be cognizant of that. Dr. Levine or Secretary French, do either of you know, have a sense out there about the third shot to sort of drop off. And I wonder if it also if you see an adult sometimes that people go for the two and then, you know, the third it's just not happening is, is there some some sort of anecdotal info or scientific info on that. Yeah, our data on the adults is, I believe, you know, 66%. Why I guess I'm wondering, and that's the million dollar question it's it's hard to understand. Now data that I just presented to the state this week shows that at least in a CDC study that was just performed. The likelihood of a serious not a serious but a systemic adverse reaction from the third shot is less than that from the second shot. So that should be reassuring to people who are worried that oh I didn't do so well with the first and the second. I don't even want to try the third, because it turned out the data would argue against that. So that was very pleasing to see at any rate and hopefully people will take notice of that. There seem to be the sense of urgency that people had when they first got vaccinated. And as part of pandemic fatigue it's part of learning to live with the virus and understanding what we've all been through. But it's still a little bothersome to me that, even with all the time that people have had. I'm not exactly rushing to get that booster shot, at least that final third of the group that needs to. And you know, this is really what's required when people talk about herd or community levels of immunity. They really want to be immune that level with the current virus and its current iteration. And it's unfortunate that we just can't have that same sense of urgency applied now but that's my interpretation. Secretary French, I think was going to say something as well. Yeah, I was just going to just a anecdotal observation of the sort of intensity or the need for communication around that particularly with school employees wasn't there for boosters like we saw with the initial shots, for whatever reason. But we know school staff have participated in that we did have. And if you remember when we first launched vaccination for school staff, there was a large number of school staff in Vermont that received the J&J vaccine. So we did see a lot of interest when that information was coming out around the booster. What do you do if you've had J&J. We did see a lot of interest on the part of teachers and staff around that question. But my general impression is a lot less interest in the booster. I don't see the level of activity that we saw with the initial vaccine series. Thank you. Any final. Yes. Thank you. I hear from constituents about adverse effects from the vaccines and reference to some database of adverse effects for vaccines. I'm assuming you get this question every once in a while. Dr. Levine so I just wonder what what you, you know, what's the what's the response to that what do you recommend we say to our constituents that are worried about about that. Yeah, if by once in a while you mean every week. Yes. The database is called VAERS, which is vaccine adverse event reporting system. It goes to the CDC. It's a publicly available database. I think more practitioners put the data in then the public but the public still can. Anything that you could remotely construe as an adverse reaction to the vaccine, no matter when it occurred in terms of time after the vaccine can be put in that system. So it is a broad net that's being cast by having that system. It does get analyzed by CDC, and that's where we learned a lot about myocarditis, which is one of the more serious, obviously adverse effects, even though it's quite rare. But that's where the data, one of the places the data came from to help support an understanding and a warning about myocarditis, but generally, most of the people who raise the questions regarding that system want to undermine it. In a way, because they basically want to say believe everything in the system. And if you do, it means at least 15 people in Vermont have died because they got the vaccine, which of course is not true, or we would be really on top of that. But this stuff does go through vetting by the CDC and further follow up an analysis so that we can actually know rates of bad, really bad outcomes. And the system shouldn't be viewed as this is the truth just because it went into the system. It's what really the analysis of what went into the system is that counts. So, and again, not to discount that people have adverse reactions, but the majority of the adverse reactions are either local reactions to the shot, or they're what we call systemic reactions that any shot might give you like fatigue or chills or fever, or what So, really hard to understand that not every reaction is one that we should take note of and warn people to never get the vaccine. Thank you both very much. It's very helpful appreciate the full hour that you were able to give us. It means a lot. And we also appreciate everything the two of you continue to do. Okay, I think we'll leave it there. Thank you. Thank you appreciate the support. Committee we have right. Yeah, thank you doctor rights and democracy. Today is their advocacy day. We'll take a little break just quick stretch come back at four o'clock, and we will pick up with them. Thanks.