Once again good morning everyone. Thank you so much for coming this morning. I think it might be appropriate for us to pause for a moment. I lost a good friend last night. Dianne feinstein was a friend of more than 30 years just an incredibly effective and extraordinary member of the senate and leader and we mourn her loss in more ways than i can articulate this morning. I thought we take a moment of silence in memory of dianne and ali for contributions to our country might be appropriate. [silence] for the past three years have been privileged to serve as the chair of the coalition. We are multisector Advocacy Coalition dedicated to ending deaths from seasonal and pandemic influenza. An ambitious goal and when we believe is achievable. Now maybe more than ever. Coalition members are a unified voice for the influence of the ecosystem including organizations dedicated to Public Health, patient advocacy, academic, Scientific Research in addition to health care professionals. The coalition includes Biotech CompaniesHealth Care Distributors vaccine and antiviral and diagnostic manufacturing. As im sure many in this room remember at this time last year we had an unprecedented what we call the tripledemic rsv, flu and covid simultaneously circulating. The impact on American Families was staggering. The surge hit Young Children especially hard. Childrens hospitals across the country struggled to keep up with the growing caseloads of kids waiting days for a hospital bed and makeshift Holding Areas like always and playrooms. We could have and should have done better. This year that the cdcs new center for forecasting and analytics is expecting perhaps a more typical respiratory disease season however this by no means is a good thing. Many of you have heard the phrase i know, as we have, its justus the flu. What we forget as a nation to flu kills up to 50,000 americans every year including many children. What makes this all the moremo tragic is not many if not most of these deaths are preventable. If that isnt enough flu results in up to 700,000 hospitalizations and many millions of illnesses this year costing over 10 million annually in excess and largely preventable in medical costs. This is to say nothing of the economic burden to absent students absent employees. This makes him fun to perhaps her countrys most predictable unpreventable most preventable Public Health crisis. For many years our country has seemingly viewed this annual tragedy as inevitable. Now i share the sentiment of all of you that more can and must be done. Unfortunately this lack of National Urgency extends to another great threat to our country for pandemic influenza. Or global for global epidemics have been reported in the pastoral years as most of us recall including one in 1918 which killed nearly one third of the world affected one third of the world and kill the least 50 Million People. Imagine how much more deadly and influenza pandemic could be in todays globalized world. Unfortunately we know that pandemics dont wait in line. We are currently in the midst of the worlds largestur avian flu outbreak which has resulted in deadly outbreaks in mammals in addition to the deaths of tens of millions of and while the current risk to humans is the myth that may not always be the case. We know its a matter of when and not if. The next influenza pandemic emerges. For all these reasons we are delighted to have the opportunity to host a briefing here today on the 2324 flu season and the federal governments role and influence of preparedness and response. The coalition is releasing today and afteractionre report highlighting Lessons Learned for the next season. For those of you in the room i encourage you to pick up a copy if you havent already. As her speakers will highlight a number of federal agencies play outside roles in the fight against the flu including the cdc, bardette and the nih so we are looking forward today to learning more about how the federal government and its partners throughout the ecosystem are working to respond to this flu season can prepare for another pandemic. With that i want to turn it over to my friend congressman rick larsen of washington state. Rick has been an incredible partner in champions on influence and is the sponsor now of protecting america from seasonal and pandemic influenza actor whatha we call the influea act. Its groundbreaking legislation that will make them meaningful and badly needed improvement for federal flu preparedness and response. The coalition is delighted that the bill has been introduced and we are incrediblysm grateful for the congressmans leadership and his presence here today. With that let me introduce congressman rick larsen. [applause] thanks tom. Appreciate the introduction and i want to thank you in the coalition and folks at the centers for Disease Control and others are joining again this year and i want to thank the panelists as well for joining us. When i join you last decembers seasonal flu with ravaging across the country and sadly during the 20222023 flu season it was the deadliest y season ad five years and claimed the lives of children. T the cdc estimates as tom mentioned as many as 50,000 americans have died last year from the flu. That is more than the number of americans who died in Motor Vehicle accidents. Additionally as many as 640,000 americans were hospitalized with the flu as well. I never lose an opportunity to talk about how im on the committee but its especially relevant because as the lead democrat on the committee and supported t implementations we have made historic investments to improve vehicle and Highway Safety and response to rising traffic fatalities but theres an analogyth here. Investing in the infrastructure to prevent fatalities is important and similarly as we enter another flu season we need to make a strong investment in infrastructure to decrease the likelihood of seasonal and pandemic flu as well and therefore decrease and eventually eliminate these clearly highlyre preventable deaths just like we do onth the roads and we can do with the flu and we did and we need to make that same commitment. The covid 19 pandemic demonstrates the u. S. Is not adequately compared prepared for the outbreak of Infectious Diseases. Congress made progress last or what we are able to get a National Awareness plan first you future emergencies in the event of pandemics pandemics. Fidel introduced the protecting america from seasonal and pandemic influenza act to bolster thise conference the federal responseem to seasonal d pandemic flus. Specifically the bill increases access to vaccines and therapeutics strengthens Vaccine Development manufacturing supply chains promotes research and development of new technologies to detect and prevent and respond to the flu. This will Congress Needs to continue to fully fund these initiatives that save lives and research to prevent economic harm at the same magnitude we saw during covid. If congress does not act the next pandemic could be a flu pandemic. Dont take my word for it we have experts here today. Experts will explain and demonstrate how important is that we respond and that we prepare and that we provide prevention to billions of folks in the united states. And as well listen to the incredible women and men who are working every day to keep people healthy and safe. Talked your Health Care Provider and get your flu shot. I got mine yesterday. I had scheduled for later in the month but i thought it better show up to this with a flu shot so encouraged folks to ask your Health Care Provider about that so thank you all for being with us here today. For what youve done what you will continue to interpersonal stores inefficacy that make all the difference. Thank you again for inviting me to joinhehe you today and as yon imagine i wont be sticking around. Their few things going on in capitol hill and theyll give it back to senator daschle. Thanks. [applause] thank you rick for your leadership and for your presentation. We wish you well as you confront the many challenges congress is facing today in particular. Our next speaker is dr. Subten who servesnf as the director of the Influenza Division at Cdcs National Center for immunization and respiratory disease. She provides programmatic leadership and overall scientific and administrative management of the influence of divisions activities and functions. The doctor dugan earned a masters of science in that very pairs in college and a ph. D. In Infectious Diseases from the college of veterinary medicine from the university of georgia appeared shes been an outstanding leader and we have so enjoyed the opportunity to work with her. We have many supporters in this whole effort we have a huge champions. Rick larson and dr. Dugan or two of our finest champions. Please welcome with me dr. Sub dr. Vivien dugan. [applause] thank you so much senator daschle and representative larsen for those kind of important remarks. I want to for all of our members here today who are attending this briefing at a crucial time during respiratory season which is starting to happen. Not only myself but all of us at cdc especially at our center in her division at the cdc are grateful for the coalitions strong commitment for raising this awareness and of the importance of influence of viruses and preventing detecting treating influenza. Of our Panel Members here today have made a strong commitment to work hard to combat the Health Social and Economic Impacts that influenza has on not only the public. Local space that i want to start with a brief overview of last season, 222023 influenza season. It was a very good example of how unpredictable the flu can be. It also demonstrates why we work so prior to sleep to keep up with our systems and infrastructure so we can determine whats happening with influence and where its happening in a timely manner. Typically the flu peaks in february and the less thats what we saw last year was an early season. Activity started in september and we started ramping upto in october and it peaked in december which was much earlier than what weve seen in the past. This was the least three weeks before the earliest peak in 25 years and very unpredictable. Our metrics that we use at cdc to assess the severity of the influenza season indicated again it was a moderately severe flu season and we estimate, these are the numbers we had out recently come to last the season in 20222023 season that these 31 Million People were sick with the flu and 360,000 people were hospitalized with the flu and approximately 21,000te people dd from influenza or flurelated complications. For some populations we have seen indications that was more than moderately severe season. Children and seniors as a representative larsen mention. Adult 65 or over were hospitalized at the highest ratesig last season that was followed by children who are younger than five years y old. Again oneot of the other numbers we track was an unfortunate and sad number. We had 176 pediatric deaths last season alone andd this number s above the seasonal average in the thirdhighest number of pediatric deaths during the seasonal flu epidemic in this reporting started in early 2004. These numbers really serve as an unfortunate reminder again of the immense Health Social and Economic Impacts of the flu and the importance of vaccination. A little bit about vaccine effectiveness from last year. Our data on vaccine effectivenesses last season from the cbc shows the vaccine provided substantial protection against flu illness and flurelated complications. In a report that we published yesterday we estimated the flu vaccination prevented more than 66,000 flu hospitalizations last season in the u. S. So getting a flu vaccine is good at reducing that risk of flurelated hospitalizations and children may reduce the risk of children beingdr hospitalized threequarters or 75 and for adults and so that reduces the risk that he will going to the hospital. We are looking strongly to modernize the influenza vaccine especially for age three and two influenza virus is one of several here and those can cause more severe complications in children. Again the estimates we are looking at in retrospect shows that flu vaccines are saving lives so they are an important tool that we have that we need to do more with. The flu u Vaccination Coverage n the u. S. Was lower than what we would like. We can always do better with flu Vaccination Coverage. 60 of all adults in the u. S. Got a flu vaccine last year. We are working hard toad address those concerning drops in vaccinations that have been happening. Pregnant people as well as children we have seen large decreases in the number of children and pregnant people getting vaccines especially for the flu and racial and ethnic disparities. I want to share that a little bit and to senator daschle mentioned that tripledemic that happened last year for rsv and influenza. We are probably wondering if and i think its a very good question and we dont know whats going tot happen. The course we have other viruses now front and center circulating and we expect that we are going to see influenza activity this year along with cocirculation of interstitial virus as well as rsv. So what may happen this year in the narrative hemisphere is what happened in the southernhe hemisphere, its always flu season summer and looking at that activity we look for clues as to what might happen here in the u. S. So we are looking at what is circulating in the Southern Hemisphere and its primarily each influenza virus is different from what we had last year. The hemispheres in a distinctive flu season only one country had cocirculating viruses. We released a study of vaccine effectiveness looking at 5000 americanso countries last year n 2023 and they found people who got a flu vaccine were half as likely to be hospitalized with the flu as compared to those who did not get the vaccine so again underscoring these vaccines to work and they do prevent hospitalizations. Again its not a perfect predictor for what may happen here. We fully expect that the flu will show up here in the next coming monthsex and it is to spread in theas season so its important to think about getting vaccinated. As we approach the flu season this year in the u. S. Its important member september and october, now, is the best time to get vaccinated. Many of us are getting vaccinated now for influences is a great time if you havent gotten a flu vaccine to go out and get 11 for influenza. We recommend from the cdc that everyone six months or older get a flu vaccine and to encourage americans to get a flu vaccine be punched a new campaign called and maybe saw the flyers and postcards we have a friend that are circulating and we have an annual no time for Flu Vaccine Campaign as a collaboration with the ag council and the american medical association. A Digital Campaign from last month has cute and wild animals at the idea is that a flu vaccine can tame the illness that can decrease the chance that youll have some kind of competition or hospitalization from influenza. We developed the educational tool through partnerships and focus groups and engagement with consumers. Hopefully we can share some of the Digital Assets that we have on social media and other feeds to get that message out. Their postcards available with links to social media and well put that slide back up at the end today. Before i close i do want to go to influence a viruses without pandemic potential because as you know theres a counterpart on the pandemic side. While most of the discussion today is all about seasonal influence and seasonal flu viruses are readiness billy never changes. We are always in a posture of being ready for any pandemic viruses that may evolve our move from animal populations into human. Im grateful for those on the panel here today keeping influenza pandemics front and center in everybodys mind lest we forget whats happening in the background. And senator daschle mentioned influence has been for the past couple of years impacting poultry at unprecedented rates. So this is really where again these viruses are very unpredictable and constantly changing. Nd so they continue to enhance our preparedness to be ready for whatever may happen in whatever may evolve to become a threat to people. Is there a domestic hospitalizations and surveillance and their global work that we build partnerships and have that readiness for seasonal that serves for her pandemic readiness as well. So we will monitor and analyze all the changes in the viruses that happened to push hard in sequencing which has been a sound technology and tools to help us with the viruses and also how we can track and again get near realtime information to make vaccines available. We are partnering with the american Public Health to expand our sequencing capacity as well is not just the cdc put across a Public Health labs so we have the capacity to know whats going on and whats happening in the flu ecosystem. So in closing the unpredictable nature of the flu and that looming threat of a severe flu season keeps us on her toes as well is that persistent risk of pandemic influenza fortifies cdcs p commitment to fighting e flu wherever and whenever its happening. We are extremely grateful for the partnership inn these effors shown here today and i want to remind everyone that knows a great time to get vaccinated to protect yourself from the flu and to protect those who are around you. With that, thank you very much. [applause] thank you dr. Dugan a device well articulated and i hope everyone can take all of those words seriously and act upon them. Im pleased to introduce our other esteemed speakers who will join us for a panel discussion. Rounding out the panel we have Joe Lastinger a founding board member and treasurer of families fighting flu. Joes family story is driven much of his work. Providing his perspective on what different lines of Public Health look like. Dr. Gregory branch the Health Officer and director of the Baltimore County department of health and family we have doctors l. J. Tan the chief policy and Partnership Officer at the immunize. Org and cochair of the National Adult influenza immunization summit. I welcome each of our panelists this morning and in some cases they have traveled some distance even as early as this morning to be a part of this and we are delighted they could be with us today. Given their background and a commitment toen this challenge especially. Joe im going to start with you. One of the things we always here and i know youou hear this probably even more than the rest of us that is just the flu and in so expressing that its just the flu a lot of us minimize its impact. How do you respond when you hear that expression . Primarily with regret. My wife and i come up thats how we did it to, to be honest with you. Its just the flu and it wasnt something to worry about. When our daughter emily became sick and was diagnosed with the flu a think we were more worried at the time about school and the hassle and it was an inconvenient time. But what we learned from a mild illness diagnosis, our daughter died in five days. A healthy child, five days later she died. We found her nonresponsive and gave her cpr and she did not make it. Since that time we have done as much as we can to help educate other parents that its not just the flu, that the flu is something they can be very deadly and dangerous and is deserving of a little bit of time to get vaccinated and prevent. We are so deeply saddened by storiess like that and we are al the more grateful that families like yours and you in particular are willing to share these tragic stories so that we can recognize just how much more serious the threat is. Its not just thes flu. As you have so well articulated. Im going to put our audience on notice. Im going to be turning to you after ai little while for questions if you have any soapy thinking of questions if you have some for the microphone to come around. Mr. Tan can you talk about the role that the government plays in preparedness and response and how it goes outside of government to amplify its reach . Thank you for much of the want to thank the coalition for inviting me to be here. Aa quick comments on that. I do credit a large in Public Partnership that works together to fight influenza but also other diseases as well but one of i the things the summit has been grateful for an appreciative of has been to collaborate with scene at the centers of Disease Control and the department of health and Human Services working with privatesector partners and nonprofit partners to not only get the word out about its not justst the flu but to provide te data that partners need in order to make targeted messaging in order to speak with a unified voice as to what the science shows about the impact of influenza. I think some the things we have learned working in publicprivate partnerships at the cdc and hhs is the flu isnt just the flu in terms of disease. Because of the complications from the flu because of the frailty and the impact of the flu and frailty we have implications for many that we dont traditionally think of that represent advocates who represent longterm care advocates who represent a Healthy Aging population and the number of times has spoken to someone who was seven years old and they have said lji dont need a vaccine because im running a marathon tomorrow. Wi said yeah but the flu is god to take you out. Thats one thing and collaboration we have with the public in the privatesector and the other thing i want to emphasize that the Current System and what we have been talking about today is ive always said this the readiness that we have talked about seasonal readiness is pandemic preparedness. The federall government provides the empress truck sure that will allow its private partner sectors to respond when the next flu pandemic arrives and its imperative for us to maintain that readiness every year. If we can vaccinate as per the recommendation everybody six months of age and older in this country dont you think will be able to deliver pandemic vaccines to that same coalition when we need to . I think thats a collaboration between the public in the privatesector and thats so important in supporting that language is really important. I want to thank you for that. So well said. I wasnt planning to do this. Let me follow up with the question and i might ask each of our panelists if they have a thought on this. Im increasingly concerned about Vaccine Hesitancy in its ability to undermine our capacity to deal with seasonal pandemic flu. If theres one thing we could do to address Vaccine Hesitancy more effectively what would it be and i will start with you. Say thank you senator daschle. Thats something that exploded command of the coca pandemic the hesitancy with vaccines but one of the important things to recognize is the majority of Americans Still understand the social norm is to get vaccinated. Thats why many adults and children continue to stay but theres a local and active antivaccination movement they would need to be aware than most important thing in addressing that stickelback to the most trusted person that the average american interacts with which is your Health Care Provider. Stedrepare health h care providers and give them the information and the knowledge they need to talk to their patients with the science and the evidence and addressing the direct concerns of those patients so they will accept a vaccination and it gets a strong recommendation. I want to say working with Health Care Providers and im sure this wonderful panel has many other ideas. Dr. Branch . Thank you for the coalition and thank you for having me here but one of things that has happened is we have done some wonderful things. We have eradicatedwe many diseas andse because of that has the generations go on i truly believe because of that they feel like i really dont need that. So we dont have this many people dying of smallpox. We have gotten over chickenpox and other diseases that we have been able to push to the side. Unfortunately the education is extraordinarily important to remind everyone how successful we have been with vaccines and it is not something that they can forget. We have issues on social media and i think because we have been so successful with vaccinations that people forget. A place of real experience. Thank you for that good answer. Joe . Im probably going to get a little bit of a different answed here. Im kind of with you that im a little discouraged right now, not defeated a little bit discouragede and the reason for that is that when we lost our daughter who was not vaccinated, this was in 2004 so my work has been going on for a long time. We have more than 80 families that work around the country and we could see some progress. There is more access to the flu vaccine and availability two different populations and there aree lots of changes since that time. It feels because of the spillover from covid that we have too regained some ground. We are here and i guess we see ourselves as serving a very particular niche and focusing on education and letting people know why is it worth the 30 minutes out of your day to drop by if your work is doing it or make sure that your children get vaccinated each year because of what happened to our child and many other children and other families. Thank you joe for that. Spinning zero fantastic and i agree with all of them. I think we did make great headway prior to the covid 19 pandemic. We saw members decreasing biking to Vaccine Coverage and we have lost ground especially with the population so children as well as a pregnant people and compromised individuals. Thatmp said the covid 19 pandemc modernizes how we message so we try to keep up with not just social media but all the different ways to talk to trusted individuals not just Health Care Providers but alsoth Community Leaders and people who you trust the most to get advice from especially when it comes to protecting yourself and your families. We are working very closely with the lot of those who are influencers in the social community to get that trusted message out from trusted partners but the good thing about the influence of vaccine its been around for 50 years and its very safe. They are concerned about safety and thats another thing we are trying to specifically talk about theth concerns and when we know what the concerns are we can address them. And then trying to address it and not just coming from a federal cdc perspective. Coming from trusted Community Partners that most people will believe to get advice from. Thank each of you for your excellent answers but its one of the most challenging questions we had to face. Youve certainly given us great insight interaction. Dr. Tan i want to ask a related question to you. You have an extraordinary responsibility serving 850,000 people in Baltimore County. How do you work to ensure access to vaccines, diagnostics and therapeutics to some of baltimores most vulnerable residents . From a local Health Department perspective thats where the rubber meets the road and thats where we had to get the vaccines of the arms of people. I look at it from three perspectives. Preparation is extraordinarily important, education and vaccination. We must prepare to be able to give a goodly number of people of vaccination and how do we do that . In Baltimore County we have something every year that we call super saturday. Rwe have been doing it since age one and one and super saturdays that we have we have vaccine clinics in southern different districts simultaneously. So we are doing that to prepare for a possible pandemic but we are doing itdo every year always immunizing the community and getting them used to enable to be immunized inus that way. In addition to that we have what we call operation shortbread. We work with the girl scouts of america and we distribute cookies told the troops. And its a why would a help to cartman to be selling cookies . In the event we have two distribute antibiotics are vaccines we would do it in the same way believe that or not a girl scout cookie boxes the same size as a docsis like clinton box doxycycline box. So to do that in an efficient way operation shortbread and went covid hit and we hadd to vaccinate, we have multiple sites. He i was able with my team, we were able to vaccinate 500 people per hour. And less than a 15 minute wait. We were prepared. The other thing is education. We have gotuc to educate. We have a wonderful vaccine. If they dont take it thats a problem. We have got to get the word out and we talked about today is of getting the word out and talking to folks in being able to educate is important i do believe unfortunately we are very good at Public Health and Public Health is our job and everyone justice to a certain degree but what happens is that we forget. We forget about polio. We had wonderful vaccines that we have term mind about it. And vaccinations in general. We have got to vaccinate and we do that or health centers. Its important we do it with an equity lens and we look at different populations. So we look at the Homeless Population. We have always tried to get vaccine to the Homeless Population and we look at our homeless shelters. Its a very important population that we have. We also look at our Detention Centers and we try to ensure that they have vaccines there. We took it our home bound populations. We go into the home and people who are home bound and vaccinate them. We partner with our faithbased organizations. The partner with qualified Health Inspectors and partner with pharmacies in the partner obviously with their care providers. We do all these types of things to make sure from a Grassroots Level we can get the shots into all the different arms that we need to,o, specifically our vulnerable populations than and we do it with an equity lens. Overall i think its extraordinarily important that we prepare, that we educate and then we can vaccinate. I think you set the bar. We extraordinarily your efforts and leadership in showing the example youve demonstrated. We only wish other cities could replicate that extraordinary and comprehensive approach. I want to open this up to each of you to whatever extent you can and dont feel compelled to answer this question but i think its an important one. We cant and our session without talking about it. Nobody wants to talk about it, another pandemic but there is that threat that after four and the last 100 years its not a question of if but when. I think it would be helpful to know and to have your perspective on how you look at that and how we are preparing so i will open it up to anybody who wishes to answer the question. I can start. If the way the cdc has taken the approach to being ready in preparing and being a posture of readiness and lj mentioned this is our extra time. This is what we do every year. We have influence a season and innate than if we dont have a robust season like in the past couple of years we are still ready. We are still ready with data getting into analyzing whats happening in putting that information out to make it available on a weekly basis on other web sites do to make sure that vaccines. Gov has availability for vaccines because we dont know whats going to happen. Theres so much unpredictability so it but we do every year in the u. S. And the global space for where innocent analysis gets us ready for being ready for a pandemic. We have seen the infrastructure and also innovating where we can. The pandemic gave us many opportunities and tools to innovate in advance and enhance a lot of our Surveillance System so we can have better data faster more that and more Information Available and they can share that and make it available for Public Health partners to get that message out. We are doing a good job at staying strong but keeping up with it is a concern that we have ended concerned it wille e ready for another pandemic. Stick let me jump in and say think one of the most important things the doctor dugan mentioned with data and the other was surveillance. Surveillance in realtime that we are beginning to get as a result of working with the cdc and that the cdc is doing with the flu and other respiratory viruses allows us to react in real time but the surveillance gives us a sense of whats coming as well. That allows us to perhaps as was said if you see one season youve seen all seasons. Having some knowledge of what might be coming down the path and looking at the Southern Hemisphere dates drink port and one of theof things that came ot a covid one of the great things it came out a covids i think the country is better prepared because of the work we did with covid. As dr. Dugan talked about the work we have done with communitybased organizations and bringing in that trusted messenger all about burkett to be preserved and sustained and developed further. That is what we are going to rely on when the next pandemic t hits. It would be a shame if we lost any of that. I think its imperative of all of us to keep sustaining that infrastructure of communitybased organizations database organizations private partnerships that have served us well for covid. One of the great things that came out a covids now the immunization registries and the state are finally there. Now we just need to get people registered intoo them. Before covid we werent there but now we are finally there. We need to capitalize on that great work that came out with the covid pandemic. I would be remiss if i did not mention from a practical where the rubber meets the road issue we are having at this time and thats going to be our staffing. Covid 19 put us in a challenge and many of my experienced, welltrained folks retired. And they are now moving away and i dont have a lot of folks who are coming up and coming into Public Health to do that work. They think its extraordinarily important as we are preparing that we understand and recognize we need a workforce who can actually put the vaccines into the arms on the local level and having that infrastructure continued to build. So we have learned our lesson. We have a lot more information. We have to prepare and continue to build the infrastructure so that we are ready and prepared when it occurs. How many folks inin this room for covid went to a drivethrough facility at least one time . Alot. Whats interesting to me that no one mentioned is that we have been doing drivethrough flu pilots for a decade or more and learnings were shared from different communities that do 5000 someone would do a thousand someone would do 10,000. Some of what you saw with covid was actually tied in with the seasonal flu so it goes the other way asit well. Really excellent answers. We are out of time but i do want to give the audience an opportunity to ask a question or two. We have a microphone right here. Anyone want to pose a question . I have many more. They are a couple of questions here. What end are there additional tools and resources needed from congress to better assess the flu or to better address the flu at this point in time . Who wants to answer that . I will take the first step on that. Its a great way to highlight the coalitions work here. What representative larson talked about with influenza act in this idea of maintaining the resources andnt the funding to sustain the infrastructure we created from covid and as joe pointed out the infrastructure that existed before covid that we used in covid so they want to make sure we sustain that and continue to build upon that. Thatat is what congressman larsn was talking about in these recommendations and sustaining the workforce, sustaining the access to vaccines. Thats a would love to see from congress and a private Nonprofit Organization to continue to fund the structure that we came out a covid with and not lose all of that. Thats one of the biggest challenges. In 2009 h1n1 pair was a lot of work did we develop and if the structure to get the vaccines out to the people and unfortunately despite many people saying lets not have that happen it went away. When covid hit we were not ready again and our job or at my job isnt abdicated his to not let that happen again. Lets keep that funding at the cdc and two surveilled the data thats necessary so when the next pandemic hits we are ready to. The lot of those recommendations are being followed. Such a great answer. Anymore questions . I think there was one over here. Thank you. We are fortunate to have vaccines this year to protect against all three of those problems that affect us are his. Covid and the flu. How do we keep covid front and center when we introduce novel vaccines in that crowded space . Its really an unprecedented time where we in Public Health and the public space have more tools than ever. To date myself when i started graduate school they said in ours the vaccine was coming and its finally here. Its really exciting at the same time influence and flu we are all here today to focus on the fluoc and highlight all of these stories and the impact that its impact that its had. Last year was a great example of how the season can be where we can have a lot of flu activity so we are working in that space in getting that message and word out. We hope that flu doesnt speak for itself with another severe season where it becomes front andd center. But i think as we are keeping up with the momentum with covid 19 rsv and the interest is up its part of the repertoire that we now have. Part of it is speaking with a Public Health agencies and the privatesector and to message about all of them together. Anybody else . Thanks for that question. The other thing to remind all those they are our great vaccines. Thats a great vaccine into rsv vaccine and a really great flu vaccine. The affect us is of the flu vaccine cant be measured in the terms of the number of flu it prevents but the hospitalizations and in terms of the deaths that were prevented to people were vaccinated. And get a population we havent talked less about is the population have chronic illnesses that make them more susceptible to complications and they dont know they have it. If they got vaccinated they would be protected as well so we need to make sure we continue to educate about the impact of influence across the population. That being said influenza ishe a vaccine that we have the most information on and as dr. Dugan everyone else said its something we have given a lot of doses to people and we know its incredibly safe. One of the things i would say is to keep influenza, we use influenza and this is whats going to bring her patience and and bringing them and we can use that opportunity to highlight all the other preventive vaccines we can give them for the rest of the season is coming up but also beyond that. We almost accept the fact that children had toto take vaccines. This is the 21st century. Adults, we had to take vaccines and thats the reality. We just mention three but you still have others. We have got tetanus and whooping cough. We have got to do so many other vaccines that thats the reality of the situation. So its protecting us from all these illnesses and i think we are going to have to embrace it. We have to embrace the fact that we are already taking vaccines and its not just for children. I had to get a tetanus shot. I got my flu shot at the same time and i can tell you the flu shot hurts a lot less. A lot less. Thats a great way to end a conversation. Flu shots hurt less. I can attest to that myself. Incredibly or out of time. We could certainly continue this conversation for a least another hour but i want to thank congressman larson and dr. Dugan are panelists for an interesting and enlightening and informative session. I think each of you in the room for joining us and those of you who are watching on line. Find out more about the coalition at our web site flew coalition. Org. For those of you who are congressional staffers please encourage your members to cosponsor this legislation. I think its so critical in a more bipartisan support we can show the more likely it is we will get the traction we need to pass it. I look forward to working with each of you and ensuring our country seasonal and pandemic flu preparedness is ready to meet the threat. I know we have a lot of work to do but the American People deserve no less so with that, thank you. [applause] [inaudible conversations] [inaudible conversations] under the law, under the present to records act after the National Archives as a surgeon determines what records would be responsive to the specific request from per example the chairman of the committee then we have to notify the president of Whose Administration those records come from as well as the current incumbent president. In this case president obama would be for Vice President bidens record in the course of President Biden himself as the incumbent president. Then there is a least a 30day period in which they have time to review those records. And it enters a period in which we are able way to provide access and requested the chairman of the committee or whoever is under the access requests. [inaudible conversations]