White House Vaccinations Chief Dr. Bechara Choucair on the road to vaccinating America

Dr. Bechara Choucair - 20210405ChoucairXM

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Marianne O’Hare: Welcome to Conversations on Health Care with Mark Masselli and
Margaret Flinter a show where we speak to the top thought leaders in
health innovation , health policy , care delivery and the great minds
who are shaping the health car e of the future. This week Mark and
Margaret welcome Dr. Bechara Choucair, Coordinator of Vaccinations
at the White House. Dr. Choucair is overseeing the most massive
vaccine effort in history, lea d ing President Biden's promise to put 200
million doses of COVID - 19 in the first 100 days into America ns

Lori Robertson also checks in , the Managing Editor of FactCheck.org
she look s at misstatements spoken about health policy in the public
domain , separating the fake from the facts, and we end with a bright
idea that’s improving health and well - being in everyday lives. If you
have comments please e - mail us at [email protected] or find us
on Facebook , Twitter , or wherever you listen to Podcast and you can
also hear us by asking Alexa to play the program. Now stay tuned for
our interview with Dr. Bechara Choucair here on Conversations on
Health Care.

Mark Masselli: We're speaking today with Dr. Bechara Choucair a Vaccination
Coordinator at the White House under President Biden. He recently
served as Senior VP for Community Health and Chief Health Officer at
Kaiser Permanente.

Margaret Flinter: Dr. Choucair also has served as the Commissioner of the Chicago
Department of Public Health, where he initiated data driven
innova tions to address the social determinants of health. Dr.
Choucair , we welcome you today to Conversations on Health Care.

Dr. Bechara Choucair: Well, thank you so much for having me here. It's -- I'm really thrilled.

Mark Masselli: Well, that's great. You kn ow, we're witnessing the most massiv e
vaccination effort in history. I think when President Biden first came
to office, he said he was going to have vaccines to over a 100 million
vaccines. And along that journey, he doubled the amount in his first
100 day s. And he just announced that all Americans would be vaccine
eligible by April 19 th . Moving that date up from May 1 st . I wonder if
you could just take our listeners behind the scenes and help us
understand how the President's whole government strategy has been
deployed to meet this quest to vaccinate everyone in the country ?

Dr. Bechara Choucair: Of course, well, let me first off start by sharing some top line
numbers. 11 weeks ago, the U.S. was averaging less than 1 million
vaccinations per day, our curren t seven - day average is over 3 million
vaccinations per day. And this weekend, we've reported for the very

Dr. Bechara Choucair - 20210405ChoucairXM

first time ever, 4 million shots reported administered in one day. And
as of today, we've administered over 168 million doses as a country.
And for pe ople 65 and older, where we know 80% of the deaths from
COVID is happening , m ore than 75% of people 65 and older, have had
at least one shot of the vaccine that's up from 8% 11 weeks ago.

So when you look at the number, this is really impressive. And I
co ntinue to be in awe on how this country is coming together to get
us all vaccinated and getting us past this pandemic. I'm so grateful for
the millions of people who are w al king in every day , and were
involved in this effort. And when you look at what the vaccination
strategy is about, it's really about increasing supply. It's about making
sure we have more vaccinators across the country, and creating more
places for people to get vaccinated. And that's really what we've been
focusing on. And when you look at the supply, we've delivered about
90 million doses in the last three weeks when you , when you look at
it, and we continue to work with states , with tribes , with territories,
with pharmacies, with community health centers , and others to
create more and m ore places for people to get vaccinated. And all
along , equity is at the center of all this work.

Margaret Flinter: Well, we have certainly taken note that the Biden administration has
been very clear about being focused on making sure the nation's most
vu lnerable populations, those hit hardest by COVID - 19 are in line to
get the resources that they need and to vaccinate the country's most
vulnerable populations. And we understand now that vaccines will be
made available to all community health centers , who have a particular
focus on that I know you have a history with community health
centers, and that they will be part of that solution. Maybe you could
talk a little bit about this new development and the role that
community health centers are playing today in addressing health
disparities which have certainly been amplified by the pandemic?

Dr. Bechara Choucair: Absolutely. And back in February, we launched the program with
federally qualified health centers to allocate vaccines directly to them
through the federal government. And this is an integral part of our
equity efforts that's focused on those who are not underserved , those
who are hardest hit. And this effort around equity includes many
more aspects to it as well, like our community vaccination center s,
mobile clinics, building vaccine confidence. And I know both of you
are national leaders in the community health center movement . You
know, I'm a family physician, I had the opportunity to train in a
Community Health Center, I was a Medical Director of a Community
Health Center, I was an Executive Director. So I know how relevant
this work is and how much of an added value Community Health
Centers offer across the country, particularly when it comes to the
equity issues.

Dr. Bechara Choucair - 20210405ChoucairXM

You know, there are about 1400 o r so federally qualified health
centers across the country, they serve almost 30 million people, two -
thirds of whom are living at or below the federal poverty level . 60% of
whom are racial and ethnic minority. So when we started this
program, we were reall y focusing on this population to make sure
they have access to the vaccine. And we started with about 250 or so
of these federally qualified health centers. In the second phase, we've
added 700 more federally qualified health centers who got invited to
par ticipate, and we're sending the invitation to the remaining
federally qualified health centers and look alike community health
centers to participate in this program.

And I have to tell you both , I had the opportunity to go last Friday and
spend time at on e of these pop - up clinics that were done by La
Clinica, which is a federally qualified health center in the East Bay
here in California. And to get to see the passion, that commitment,
this effort that's bringing so many people together to make an impact
i n people's lives is truly heartwarming. And on top of that, as we all
know, a couple of weeks ago, we announced a $6 billion investments
in Community Health Centers across the country as part of our
American rescue plan to support testing , t o support treat ment , to
support vaccinations, as well as expanding the health center ’ s
operational capacity during this pandemic and beyond. So I continue
to be a big fan of the Community Health Centers across the country
and grateful for the tens of thousands of people who run and
participate in supporting people in these Community Health Centers,
particularly with that equity focus.

Mark Masselli: And that's such an important investment by the Biden administration
and well appreciated. You know, I really liked your thre e pillars you
want to increase supply, increase vaccinators , and more places for
folks to get vaccines. But I do want to sort of talk about the issues
around vaccine production . 62 million Johnson & Johnson vaccines
are being examined with for possible con taminants that emerg ed in
the same plant w h ere 15 million vaccines were scrapped last week for
contamination with components of the AstraZeneca vaccine and the
CDC has halted AstraZeneca ’s vaccine production at the same facility
due to ongoing concerns . Ob viously, big implications for the
President's target , if supply chains get disrupted. I'm wondering if you
could address s ome of these ongoing challenges?

Dr. Bechara Choucair: Well let me just start by emphasizing that no vaccine that was
manufactured at the Baltimore facility has been used in any U.S.
vaccination efforts so far, because that facility hasn't been authorized
by the FDA. So all the vaccines that the J&J vaccines that's out that's in
the public that's been administered did not come out of tha t facility.
And now as you all know, J& J now is installing a new senior

Dr. Bechara Choucair - 20210405ChoucairXM

leadership team to oversee all aspects of production and
manufacturing at the emergent facility, and will have full
responsibility for the operations, production , and manufacturing of
the facility. And as a company that will continue to work with the FDA
on addressing any type of manufacturing issues. And no product will
come out of the Baltimore facility without full authorization by the
FDA. And this is a critical part of ensuring qu ality and safety of vaccine
product. And we also heard from J&J that they do not expect that this
to impact their overall commitment to provide nearly a 100 million
doses of vaccines by the end of May. So we are still on track to have
enough vaccine supply for all adults by the end of May.

Margaret Flinter: Well, Dr. Choucair that is great news , a nd the focus on vaccines is
obviously so vital to success and kind of all consuming, but we want to
remember we still need COVID testing, right, and that is still
inconsistent in many parts of the country . Some places probably quite
easy to access and some not so easy. And it seems like almost from
the beginning, we thought we would soon have a rapid test ,
affordable, easy to use rapid test, even use at home tests . We still
don't have it. We're watching infection rates climb again, in many
parts of the country, in part driven by the varian ts . What's your sense
of the timeline? Are we going to see some significant progress in this
over the coming weeks and months? An d as we think about issues of
children and the varian ts, t his just seems like a pressing issue. We're
just not sure where things stand now. So , shine some light on that fo r
us ?

Dr. Bechara Choucair: Well, let me just start by saying that testing continues to be a very
important part of helping us fight this pandemic. Carol Johnson, my
colleague on the White House COVID response team, she's our testing
coordinator. She continues to make sure that we continue to focus on
testing, and there's been significant investments in testing with the
$10 billion commitment that was announced a few weeks ago as part
of that American rescue plan. There are efforts to increase serial
testing, the FDA has been doing a lot more work on testing. And we'd
want to continue to en courage people across the country to focus on
testing as a key strategy to help us beat the pandemic. And
vaccinations is extremely important. We're really proud of the
progress. Meanwhile, we need to continue to focus on testing as well.

Mark Masselli: We 're speaking today with Dr. Bechara Choucair , Vaccination
Coordinator at the White House under President Biden, you know,
congratulations, the U.S. vaccination program is really quite
remarkable, especially when it's compared to many parts of the
world , wh ere it's been erratic or non existent. And as long as the
world remains unvaccinated, I thin k it's fair to say it's a petri dish for
variants to grow in and something of a concern. And obviously, we've

Dr. Bechara Choucair - 20210405ChoucairXM

seen that the pandemics out of control in Brazil, in E urope in Italy, the
surge cases are really being driven by , at least in the Europe side on
the B - 1 17 variant, I believe the CDC just announced it's the most
prevalent variant here in the United States. I'm wondering, could you
address some of these challen ges of how the U.S. is going to help deal
with the global supplies that are needed to really to make sure that all
of us are safe, because we can't be isolated from the rest of the
world?

Dr. Bechara Choucair: Well, let me just start by saying that my role is focused exclusively on
o ur efforts in the United States. We are a country that has suffered
over half a million deaths more than any country in the world. In the
meantime, we have taken significant steps and under the President's
direction, the United States has re engaged with the World Health
Organizations on day one. We have committed to providing the most
funding to Covax of any other country in the world , with $4 billion.
And this gives money to developing countries to purchase vaccine. We
also ann ounced with our quad partners that we are working to
achieve expanded manufacturing of safe and effective COVID - 19
vaccines, at facilities in India and thu s boost production globally. So a
lot of work has happened, and more will happen along the line.

Marg aret Flinter: Well, that's so important. And while we're looking at all the
accomplishments and the things we can look forward to in the future,
we know that the American Rescue Act also is making big investments
in public health and supporting public heal th and addressing issues
that drive health inequity , even without the issue of the pandemic.
We'd love for you to highlight some of the transformation initiatives
in the Rescue Act that that you think as a public health person holds
some promise for really improving public health and helping to reduce
health equity in our country, even beyond the pandemic, which some
day will be over.

Dr. Bechara Choucair: Well, thank you, Margaret, for bringing that up. And on the American
rescue plan l et me highlight mayb e three of the many ways that the
American rescue plan is, is supporting public health. First, as I
previously mentioned, there are literally billions of dollars in fundi ng
for Community Health Centers. We've already announced $6 billion in
investments, bu t there's a total of $7.6 billion and in that p ot that's
dedicated to Community Health Centers that we know are a
cornerstone of reaching underserved populations in this country. So
we know these dollars will go to expand access for vaccine , expand
access for testing, treatment, preventive and primary health care
services to people at high risk of COVID - 19 as well a s expanding the
Health Center's operational capacity during the pandemic and as
you've said in your questions even beyond that, beyond the
pande mic.

Dr. Bechara Choucair - 20210405ChoucairXM

The other example I want to lift up is the $7.6 billion that are available
to expand the public health workforce. I think all of us agree that the
public health workforce has been severely underfunded for decades.
And we really need to expand capacity to prepare for and prevent
future pandemics. And to do so in a way that brings in people from
the communities that have been hit hardest by this pandemic. And
then the last example I'll highlight is the $3 billion in CDC funds, t o
states and large citi es that were announced recently. This funding will
be a way to bring community based organizations and faith based
organizations into the work of public health when it comes to
responding to this pandemic. But it also helped build relationship that
will endur e beyond this pandemic and can help address some of the
chronic conditions that many people in this country are facing, who
don't have adequate care or adequate access to health care services.
So it's a lot there that I'm really excited about. I do want to point out
the one key aspect of the work that's really about building vaccine
confidence that we're seeing, and we know that doctors and nurses
play a huge role. And they're the most trusted when it comes to
messaging around vaccine confidence. And we'd w ant to make sure
that we're leveraging that voice. We're bringing more people into
what we've announced last week around the COVID community core,
which is a set of trusted messengers across the country that are
stepping up and helping us deliver the messa ges about the safety of
the vaccine and the importance of vaccination. So I'm hoping that
many of the listeners would be interested in stepping up and be part
of this COVID Community Corps and help us deliver the right
messages to their friends, family and community contacts as well.

Margaret Flinter: Wonderful.

Mark Masselli: That's a great clarion call. And the American Rescue Act is
breathtaking in its scope and its vision, we would want to focus a little
bit now on this race that we're having between th e vaccine and the
variants. And I talked earlier about the B - 117 being now the dominant
strain in the United States, and it seems to be more contagious, more
lethal, highly transmissible, also really impacting younger populations.
Well, I'm wondering what your sens e of the likelihood of the vaccine
efficacy persisting against these rising strains , in a sense – and it
sounds like you're building an infrastructure that will address the
boosters if they're going to be required and what are the plans for
scalin g up o r any additional scaling up might be needed if a booster i s
required?

Dr. Bechara Choucair: Well, thank you for the question, Mark. And let me just start by
saying that we are very much in a race against the varian ts that we're
seeing across the cou ntry. And what we know is that the same set of
mitigation efforts that work ed for the wild type of the virus work ed

Dr. Bechara Choucair - 20210405ChoucairXM

for the variants. So first off, now is not the time to loosen restrictions
on mitigation measures like masking and social distancing, and ot hers .
We have made as a country, we have made so much progress over
the last few weeks. And we have to keep making gains and pushing
the numbers of new cases down, you know, a base of 60,000 cases
per day is still way too high for us to let our guards dow n. And that's
why the President has been very clear by calling on governors, mayors
to make sure that we're doubling down on those mitigation efforts.
We keep our masking mandates, we reinstate them, if we drop them
now , i t’ s absolutely not the right time to put our guard down.

At the same time, we have to continue to push our vaccination efforts
forward. We've making tons of progress. I've mentioned this a little
earlier. Now we're doing on average 3 million shots per day. And we
have to continue to do tha t. So we have to win this race. And I'm
grateful for everybody that's being part of this effort across the
country. Meanwhile, the government has a role at all different levels
a nd individually, we have a role , to make sure that we continue to
mask out , ma ke sure we continue to keep social distancing , wash our
hands, avoid travels , and be able to stay safe in the next few weeks as
we build up immunity across the country.

Mark Masselli: Just on the side , vaccine passports. I know the White House came out
the other day and not something they're going down , any sense of
certainly in the private sector we're seeing in Israel that they have
adopted that. Does it make sense for businesses and others who want
to do that i f it's done outside of the government here?

Dr. Bechara Choucair: Well, I mean, let me be clear the government is not now nor will be
supportive of a system that requires people to carry a credential,
there will be no federal vaccinations databases and no federal
mandate requiring folks to obtain a single vaccination credential. But
we know that these tools are being considered by the private not for
profit sectors. And we want to make sure that our voice i s there, our
interest is fairly simple. We'd want to make sure that we're protecting
the privac y and rights of people living in this country. So these
systems are not used against people un fairly . That is really our
position on vaccine credentialing at this point.

Mark Masselli: And I think that's a great message for the American public to hear .

Mar garet Flinter: Absolutely.

Mark Masselli: So, thank you so much.

Margaret Flinter: We've been speaking today with Dr. Bechara Choucair a COVID - 19
Vaccination Coordinator at the White House under President Biden.
Learn more about his vitally important work by going to

Dr. Bechara Choucair - 20210405ChoucairXM

buildbackbetter.gov or follow him on twitter @choucair . Dr.
Choucair , we want to thank you for all that you've done in your work
to - date, to contribute to healthcare to public health and for really
making this huge, huge step forward in helpin g us defeat the COVID
pandemic and for instilling confidence in public health in the United
States. Thank you for joining us on Conversations on Health Care.

Dr. Bechara Choucair: Thank you so much for hosting me.

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Mark Masselli: At Conversations on Health Care, we want our audience to be truly in
the know when it comes to the facts about health care reform and
policy. Lori Robertson is an award winning journalist and Managing
Editor of FactCheck.org, a nonpartisan, nonprofit consumer advocate
for vo ters that aim to reduce the level of deception in U.S. politics.
Lori, what have you got for us this week?

Lori Robertson : A Food and Drug Administration presentation on monitoring the
safety of COVID - 19 vaccines listed possible adverse events the agency
m ight track, but an Instagram post misrepresents the document .
Falsely claiming it shows the vaccines are known to cause harmful
side effects including death. It's just one example of misinformation
about the COVID - 19 vaccines that is circulating on social media. The
popular Instagram post cites a government document to falsely claim
that federal officials know that the COVID - 19 vaccines cause death
and other dangerous side effects. But the post is wrong. The FDA
presentation at its sites which is publicly a vailable doesn't say that
and there is no evidence that the COVID - 19 vaccines have caused any
deaths. The FDA presentation was given at an October 30 th meeting
of a CDC Advisory Committee. The presentation outlined a variety of
ways that FDA ’s Center for B iologics Evaluation and Research would
monitor vaccine safety once COVID - 19 vaccines were available. One
slide in the presentation showed a “ working list of possible adverse
event outcomes. ” These are outcomes the FDA could possibly monitor
once a vaccine was authorized. Daniel Salmon , Director of the
Institute for Vaccine Safety at Johns Hopkins University, told us
officials develop a list of adverse events to monitor in order to
proactively ensure the vaccine rollout is safe. And there's a difference
betw een a report of an adverse event following immunization and an
adverse event caused by the vaccine , h e said . Anyone can submit a
report of an adverse event that occurred after immunization through
the vaccine adverse event reporting system, with more than 109
million doses of COVID - 19 vaccines administered in the US as of
March 15, the CDC received 1913 reports of deaths that took place
after someone received the vaccine . Then on March 15 , t he CDC said
that none were linked to the vaccination. “ A review of available

Dr. Bechara Choucair - 20210405ChoucairXM

clinical information including death certificates, autopsy and medical
records revealed no evidence that vaccination contributed to patient
deaths. And that’s my fact check for this week. I'm Lori Robertson,
Managing Editor of FactCheck.org.

Marg aret Flinter: F act C heck.org is committed to factual accuracy from the country's
major political players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact that you'd
like checked, e - mail us at www.chcradio.com . We'll have
FactCheck.org’s Lori Robertson check it out for you here on
Conversations on Health Care.

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Mark Masselli: Each week , Conversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. Students of
public health are often tasked with devising interventions for
addressing some of health's biggest challenges. And for Harvard T.H.
Chan School of Public Health students, Dan Wexler and Priya Patel.
Their idea netted an award and launched a business idea at the same
time. The students were tasked with addressing food insecurity in
underserved parts of the world, including in neighborhoods in their
own backyard families living in high poverty, low reso urce area in
finding fresh, affordable, healthy food in neighborhoods with no
grocery stores or food markets. They thought of the current trend of
healthy meal or meal services like Blue Apron and wondered what if
we modified that business model to serve t he needs of those living in
food deserts. Wexler and his partner sourced food delivery companies
that could provide pre packaged meal kits, with all ingredients
included, even spices, dressings and recipes. And instead of home
delivery approach, they desig ned refrigerated kiosks that could easily
be placed in local neighborhoods. Wexler says they wanted to make
the idea of healthy eating and meal preparation as simple as possible.

Dan Wexler: I think the biggest change is that there is no delivery system do or to
door per se. And that by going and setting up these kiosks in the
community, you can have a very lean design you can have , you don't
need a storefront, you don't need to pay for shipping. You don't need
to have inbox refrigeration. And you are very m uch addressing the
needs of access by physically saying, hey, here is healthy food. It's
convenient, because everything you need is in the box. The directions
are simple, very picture bas ed, there’s a lot of literacy issues. And so
just really thinking abo ut how can we take all those lean design
principles to facilitate access? That really, I think , mak e i t a solution
that has the poten tial for impact.

Mark Masselli: And they also conducted research with local ethnic groups to create
recipes that would reso nate with their families.

Dr. Bechara Choucair - 20210405ChoucairXM

Dan Wexler: Then we just went down to community and did taste testing at the
Farmers Market and talked to people and said, you know, do you like
this? What do you want to be able to eat for dinner? How do you
want to cook? So basi cally, we have some dishes that is similar, similar
textures, similar spices. One thing that we found is , there's a little bit
of contention between parents who want to eat more traditional
foods and kids who want to eat more American foods. And we tried t o
alleviate that and bridge those gaps , so one of our recipes, for
instance, is a chicken pot pie pasta. So it's kind of American, it's fun
sounding. But also we use a lot of tr aditional seasonings and spices.

Mark Masselli: Customers can simply walk to th e kiosk and purchase their meal kits
with the snap cards or cash, and the added benefits , t he Kiosk will be
run by the residents of the neighborhood, giving them an opportunity
to purchase the kiosk and run them like a franchise offering an
economic benefi t to the community as well. Their idea earned them
the Rabobank - MIT Food and Agrib usiness Innovation prize , and
$15,000 in startup money to launch their enterprise. A low cost
portable, healthy meal service placed in portable kiosk in food desert
neighborh oods, offering families a simple solution to address the
problem of poor nutrition p roviding an economic opportunity at the
same time. Now that's a bright idea.

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Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli .

Margaret Flinter: And I'm Margaret Flinter.

Mark Masselli: Peace and Health.

Margaret Flinter: Conversations on Health Care is recorded at WESU at Wesleyan
University, streaming live at www.chcradio.com , iTunes, o r wherever
you listen to Podcasts. If you have comments, please e - mail us at
[email protected] , or find us on Facebook or Twitter. We love
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Health Cente r.

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