SPECIAL SA&T MINUTES

SPECIAL SAFETY ADVISORY AND TRANSPORTATION COMMITTEE A Special Safety Advisory and Transportation Committee Meeting was held by video conference on February 8, 2021 at 6:45 p.m., with Chairman Taylor presiding. Members of Council present via video or telephone were Mr. Anderson, Mr. Sudler, Mr. Neil, Mr. Slavin, Mr. Rocha, Mr. Lindell and Council President Hare. Mayor Christiansen was also present. Mr. Wagner and Mr. Shelton (Safety Advisory and Transportation) were absent. Adoption of Agenda Mr. Neil moved for adoption of the agenda, seconded by Mr. Rocha and unanimously carried. COVID-19 Vaccine Information (Informational Item) Mr. Taylor introduced Dr. Richard Pescatore, Chief Physician of the Delaware Department of Health and Social Services (DHSS), Division of Public Health (DPH). Dr. Pescatore noted that Lieutenant Governor Bethany Hall-Long and Ms. Lisa Henry, Chief of Community Health Services of DHSS, DPH, were also present via video or telephone. Dr. Pescatore stated that they know with the COVID-19 vaccine, while it was developed quickly and safely harnessing technology that has been in development for the past 10 years, ever since the first SARS-1 epidemic. It utilizes a number of proprietary and cutting edge technologies that allow them to bring this safe and efficacious vaccine to the public. He advised that he would also speak about the rollout of the vaccine in Delaware and how much they were striving to ensure that the vaccine finds its ways into the arms of as many Delawareans as possible, while doing so quickly but safely, and doing so in a way that is representative of the racial and ethnic makeup of the state. Responding to Mr. Taylor’s questions regarding the COVID-19 Vaccine, Dr. Pescatore provided the following information: • A simple way to explain the vaccine is to think of it as a picture. One of the ways in society people prepare for encountering really anything is with a picture, so that when people see that thing in real life, people know how to identify it and make moves on it. That is all a vaccine is, a carbon copy, a picture of what the disease or the virus that causes COVID-19 is. • This vaccine was developed quite quickly, using a new technology that has been in development over the past decade. That technology uses greasy soap bubbles or lipid nanoparticles, which the very basis of the vaccine is made up of. The manufacturers of the vaccine looked for the genomic sequence of the vaccine in messenger RNA (mRNA), genetic material that makes up part of the virus. Manufacturers inserted that mRNA inside of those soap bubbles, so that the body could manufacture pictures of the Coronavirus, so that should someone be exposed to it in real life, their body knows how to combat the Coronavirus and keep them safe at all times. • About 25%, nearly a quarter of people who get these vaccines, will experience side effects. Most often that is pain or tenderness at the injection site, just like any other vaccine that they have received in their life. The other adverse reactions that have been reported include tenderness and swelling of lymph nodes in the area or underneath the armpit, some redness in the area or general side effects, including fatigue, headache, achy muscles and joints, chills, nausea, and vomiting and fever.

COUNCIL COMMITTEE OF THE WHOLE MEETING OF FEBRUARY 8, 2021 PAGE 2 • The side effects have been described whether someone uses the Moderna vaccine or the Pfizer-BioNTech vaccine, and are universal across both of these different vaccine candidates. Developing the side effects has no import as to the strength or difference in the immune response that one may receive and none of the side effects have been reported as debilitating or lasting more than a day or two. • This type of vaccine is a mRNA vaccine and is one that does not insert the Coronavirus into the body in any way, shape or form. Many people are familiar with the flu vaccine which in some years and in some manifestations is a live virus or killed or attenuated virus vaccine. Now, that is not what this vaccine is. This is simply a vehicle that has been created by the manufacturers of the vaccine and that vehicle is a cell made out of fat particles and that fat particle has mRNA or genetic material that has been implanted into it and that genetic material tells ourselves to look for something called the spike protein, a sort of signature of the Coronavirus that the body can recognize as an invader and something that it can attack. • Regarding efficacy, two studies when they report about 94% to 95% efficacy is for the development of COVID-19 of any severity, a cough, shortness of breath, a fever of any way, shape or form. They can redefine that efficacy endpoint and ask what is the most important to me, is it the development of any Coronavirus whatsoever, or is it the development of severe or debilitating Coronavirus. Both vaccines demonstrated 100% efficacy in preventing hospitalization or death and when they look at every vaccine that has yet been developed, the Pfizer vaccine, the Moderna vaccine, and early data on the Johnson & Johnson vaccine, which they believe may be approved in the coming weeks, all three of those vaccines have demonstrated 100% efficacy in preventing against hospitalization or death. Responding to Mr. Neil, Dr. Pescatore stated that information regarding both the Pfizer and the Moderna vaccines, data and results of all of their trials have been published in the New England Journal of Medicine, and those trials have been poured over by scholars all over the country. The data has been extrapolated into the lay press and discussed in the community, but the hard data, the official results of the trials are available on the New England Journal of Medicine website, free of charge to all who care to look at. Ms. Henry noted that they have taken what Dr. Pescatore has said and synthesized from the scientific studies and put it into Frequently Asked Questions (FAQs) and fact sheets that can be distributed to the public. Mr. Sudler asked on a scale of one to ten how identical is the DNA to the point where the body would recognize that similarity and activate the defense mechanism. Responding, Dr. Pescatore stated that the vaccine carries RNA (ribonucleic acid) which is different than what the body holds in cells which is DNA (deoxyribonucleic acid). Dr. Pescatore stated that the RNA in the vaccine is immediately taken by the body’s ribosomes and produces proteins that resemble proteins that are on the face of the Coronavirus. He noted that when it comes to that, it is a 10 out of 10 that the body is able to recognize that Coronavirus protein through the mRNA that is in the vaccine. Dr. Pescatore advised that RNA, in no way, shape or form, interacts with the body's own DNA, and in no way, shape or form can it alter the body's own genetic code. RNA is inherently extremely unstable and as soon as it is injected into the body the ribosomes begin to produce that Coronavirus spike protein, that mRNA degrades and disappears, and in no way enters the nuclei or the nucleus of the cell.

COUNCIL COMMITTEE OF THE WHOLE MEETING OF FEBRUARY 8, 2021 PAGE 3 Responding to Mr. Sudler, Ms. Henry stated she would send the link to the fact sheets previously mentioned after the meeting. Responding to Mr. Anderson’s questions, Dr. Pescatore provided the following information: • For the Pfizer shot, the second shot is due 21 days after administration, and for the Moderna shot, the second shot is due 28 days after administration. In the past few weeks, they have received notice from the Center of Disease Control and Prevention (CDC) that the second shot can be delayed up to six weeks following the first, that is 42 days. • Second shots can be obtained from a number of locations and pharmacies across the state, including Walgreens, Rite Aid, and CVS, even if someone did not get their first shot at that location. • DPH is working every day to increase access points for second shots, and promises that they are committed to ensuring that all individuals receive their second shot within that 42-day timeframe. • Looking at side effects and adverse reactions to the vaccine, there are a number of ways in which that is monitored, actively, through a system called the Vaccine Adverse Events Reporting System (VAERS), and passively through a system called V-safe that is administered from the CDC. • At this time, with millions of doses of vaccine that have been administered, there have been deaths that have been reported into the VAERS system, but as of yet, none of those deaths have been causally linked to receiving the vaccine. In some instances, it is a cause of death that is clearly not linked to the vaccine, so as yet, no deaths have been reported and verified as caused by the vaccine. • Regarding anaphylaxis, severe allergic reaction, the rate is about five to six cases per one to two million administrations of the vaccine. The vaccine, which to date demonstrates profound efficacy, 100% ability to prevent death and hospitalization and so far, no severe adverse events related to the administration of the vaccine, so as to include death or severe or permanent disability. • Regarding why children do not need to receive the vaccine, the vaccines have only yet been studied in the adult population for the Pfizer vaccine, individuals 16 years of age and above, and for the Moderna vaccine, individuals 18 years of age and above. Both companies have begun to test the vaccine in pediatric populations, years of age 12 and above. • Another reason why they have a little bit more comfort when it comes to the pediatric population is if they thought of a child's immune system like a bazooka, whereas an adult's immune system is like a sniper rifle. For a child, everything is an invader and everything that comes into their body, it fires a bazooka at and that is why kids get fevers all the time, because their immune systems fire bazookas at everything that comes near them, whether it be a severe illness or whether it be a common cold. Whereas by the time they are adults, their immune

COUNCIL COMMITTEE OF THE WHOLE MEETING OF FEBRUARY 8, 2021 PAGE 4 systems have matured quite a bit and they are sniper rifles. They know how to recognize certain diseases because they have either been vaccinated against them or been previously exposed to them and it fires a shot right at that disease, which is why a fever is a little rarer in adults than it is children, so children are protected. • They know that children develop neutralizing antibody responses that are far greater than adults. They know that they have rates of severe illness and hospitalization which are far less than adults and while they will continue to study the vaccine in children as yet, children cannot and should not receive the COVID vaccine. Responding to Mr. Anderson regarding access, Ms. Henry stated they have been working with community-based organizations and partners throughout the state to bring vaccination to the local level and working with partners who know the community who can help register people and educate people who are hesitant to get the vaccine. Ms. Henry advised that some of the larger events that they have had throughout the state early on did not really get to address equitable distribution access to a computer. There were a lot of challenges and barriers for that so they are really committed to being in the community and working with community partners that includes connecting partners with healthcare facilities, such as hospitals, in Kent County with Bayhealth, along with the federally qualified health centers and other independent providers, including the Division of Public Health to ensure that the vaccine is getting everywhere and to everyone who needs it. She noted that right now, they were working in the age group of 65 plus. Responding to Mr. Taylor, Dr. Pescatore stated that patients with auto-immune disease and underlying comorbidities were included in both the Moderna and the Pfizer trials and no signal of a decreased antibody response was seen in any of those populations. He noted that the current data they have would suggest that all individuals have a similar response to the COVID vaccine, whether they are immunized or not. The only current exclusion would be receipt of a previous vaccine within the previous 14 days. Responding to Ms. Caldwell, Dr. Pescatore stated that the vaccine is recommended as a two-shot interval, when someone receives just one shot, it would be anticipated that they would have a diminished response to the vaccine. He noted that for the Pfizer vaccine it is estimated that the efficacy would be somewhere around 52% as compared to 95% if they were to complete the two dose interval and for the Moderna vaccine, the efficacy would be somewhere around 80% as compared to 95%. Responding to Ms. Caldwell regarding seasonality to the COVID shot like the flu vaccine, Dr. Pescatore stated that they simply do not know. He noted that they do not have enough data and they have not been doing this long enough to know if there is going to be a seasonality to the Coronavirus, like there is to the flu in the setting of their current vaccine efforts. Dr. Pescatore stated that there are a lot of people who are optimistic that this will be a one-time administration of the vaccine and booster shots may not be needed, but as yet, they do not have the data to make a definitive statement on that. Responding to Mr. Taylor, Dr. Pescatore stated that the Johnson & Johnson vaccine, which has submitted data to the U.S. Food and Drug Administration (FDA) for consideration of emergency use authorization, just like the Pfizer and Moderna vaccines. He noted that it is a single dose of vaccine which they hope gains approval in the coming weeks. It is anticipated to undergo review by the FDA in the next 12 or 13 days and anticipated that it will receive emergency use authorization shortly thereafter.

COUNCIL COMMITTEE OF THE WHOLE MEETING OF FEBRUARY 8, 2021 PAGE 5 Ms. Henry stated they are currently in Phase 1B with a focus on those that are 65 years and older. She advised that they started with Phase 1A, which were frontline healthcare workers and first responders and are transitioning into a Phase 1B of 65 years and older while they still vaccinate people who are in Phase 1. They have not started on the second half of Phase 1B, which are essential workers in other businesses and after Phase 1B, they would transition into Phase 1C. Ms. Henry advised that there is not a specific date where that happens, a lot of what they do for vaccination is driven by the supply of the vaccine, so the more vaccine they were to receive in the state helps them get through those phases quicker. Responding to Mr. Taylor, Ms. Henry stated currently, in Phase 1B with 65 years and older, they have approximately 180,000 people in the state who are over the age of 65 and currently they get somewhere between 15 and 20,000 doses of vaccination a week in the state. She noted that she did not know that she could speak to how that correlates with the executive order that just reopened some businesses, but they definitely would appreciate more vaccines coming into the state from the federal government. Lt. Governor Hall-Long stated that she understood there were a lot of questions and hopefully there would be another opportunity for herself or others to come back. She invited the Committee members and the community to participate in ongoing calls they have been having with faith leaders, Latino leaders, and Black leaders in the community. Lt. Governor Hall-Long stated that vaccinations are the most important, but in the meantime, until they have persons vaccinated, it is going to be so important that they do the masking and those behaviors. She noted that the vaccine is not a treatment, it is a preventative measure and they need to get to herd immunity. Lt. Governor Hall-Long thanked Committee members for having these sessions and for getting the messages, fact sheets, and materials to residents explaining it is safe and is not a vaccine that has COVID in it. She advised that there is a lot of misunderstanding and some think because there is a spike protein, there is somebody monitoring them, or it is going to affect their health, or their fertility. Lt. Governor Hall-Long stated that they understood why there is a concern, but there are choices, and soon they will have the single shot. Dr. Pescatore stated that there is nothing more important than communication when it comes to public health. He encouraged everyone to get the vaccine when it becomes available to them and if they had any questions or concerns he was more than happy to be a resource. Mr. Taylor thanked Ms. Henry because of what she is doing in the African-American community is absolutely fantastic. He noted that African-Americans historically have been very skeptical when it comes to vaccinations and unknown medical procedures of any kind. He stated that Ms. Henry was assisting in alleviating those fears and that they were grateful. Mr. Sudler moved for adjournment of the Special Safety Advisory and Transportation Committee meeting. The motion was seconded by Mr. Anderson and unanimously carried. Meeting adjourned at 6:54 p.m. Ralph L. Taylor, Jr. Chair, Safety Advisory and Transportation Committee RLT/JT/mr S:\AGENDAS-MINUTES-PACKETS-PRESENTATIONS-ATT&EXH\Committee-Minutes\2021\02-08-2021 SPECIAL SA&T MINUTES.wpd