Monarez calls for vaccine committee transparency

Next is Senator Hickenlooper.

Thank you, Mr. Chair. Thank both of you for being here today and for your service. Time was really valuable. Let me ask you a rhetorical question. Secretary Kennedy told our colleagues on the Finance Committee about vaccine access. He said, most Americans are going to be able to get it from their pharmacy for free. Everybody can get it. But that's not true, is it?

My mom lives in Virginia. And she was unable to get it.

Great. I mean, I realize with you out of office, you don't have access to those informations, but about half of all American kids get free vaccines through the Vaccines for Children Program. This is now at a standstill, waiting for guidance from the CDC. States by Colorado are trying to lead by issuing separate guidance for their states about vaccine access. Obviously, that's a lot of friction and a confusion. Many insurance plans defer to federal recommendations to determine coverage of vaccines, leaving many families with bills that can range into the hundreds of dollars just for vaccines. And pharmacies across the country from the confusion, they're not sure if they can administer the vaccine or even if they have it in stock. So I think we've got a real problem to navigate that we've got to be able to look at it. Dr. Monarez, during your tenure as CDC director, your short-lived tenure, you tried to implement guardrails to reinforce the Advisory Committee on Immunization Practices, or ACIP. Given the secretary's actions, do you still agree that we need those guide rails or guardrails? Yeah, what I was trying to implement was what I had testified here on June 25, is transparency, accountability, and integrity to the processes. And what I had proposed was transparency measures such that any information that was going to be used by the ACIP in a deliberative manner be made available to the public six weeks in advance of the ACIP meeting, a sufficient time that scientists, public health practitioners, and others would be able to see the information, see the data--

Of course. --and then watch the ACIP meeting, understand how that evidence was used to support the decisions, the recommendations that were coming forward. And then I'd propose that perhaps we would have a backend transparency period of time, where, if there was new information that had been introduced or the way that the information was contextualized at the ACIP meeting, that we would have a second public comment period, so that if there was additional--

I understand why you would have that. And obviously, those guardrails would still be needed. Is this something Congress should work on? If I can ask both of you that. I would highly encourage all of us, whether it's congressional action or others, to make sure that we do have the appropriate transparency and accountability measures. The ACIP deliberations are critically important, and they impact real lives. And so the more that we can do to ensure that we are achieving radical transparency, accountability, and evidence-based decision-making, I would highly encourage it.

And FACA does have provisions, the Federal Advisory Committee Act. And so I do think this is a perfect opportunity for Congress to ensure that CDC is following those processes. Those processes are there for a reason to ensure that there's transparency, gold standard science, and that the public has the opportunity to engage. Transparency becomes one of the keys. We're talking about trust here. And without transparency, you're never going to have trust--

Correct. --in the modern world. In terms of pandemic preparedness-- and Dr. Houry, I'll talk to you, and I love seeing where you did your training in Denver, Colorado, at Denver Health, which is my medical provider, just so we're completely clear.

I thought you meant Tulane, but that's OK. [LAUGHS]

I love both. I want my nine seconds back. Dr. Houry, given the layoffs, somewhere in the process of over 2,000 employees have been fired or attempted to be fired. In your testimony, you mentioned the CDC has seen a 60% decrease in flu samples and a 70% decrease in COVID samples. That's alarming. That's striking to me. What's the reduction? What's that attributed to? So a lot of that is attributed to withdrawing from the World Health Organization. Many countries don't view us as the same level of partner. That's something that can be overcome, but it takes leadership to really proactively reestablish those partnerships so that we're not flying blind. We know what pathogens are out there. Right. And I'll yield. I'll just leave a question. What keeps you up at night? What keeps you both up at night? Very concisely.

The next outbreak. And I don't believe that we'll be prepared.

I'm concerned about the future of CDC and public health in our country. Given what I have seen, if we continue down this path, we are not prepared not just for pandemics, but for preventing chronic health disease. And we're going to see kids dying of vaccine preventable diseases.

Thank you both very much. Appreciate it. Yield back to the chair.