Witnesses from federal health and science agencies testified before House and Senate committees on the COVID-19 response and COVID-19 vaccines during the week of March 15.
“Efforts to develop COVID-19 vaccines were possible due to investments made by Congress and through extraordinary public-private partnerships,” Chairwoman Diana DeGette (D-Colo.) said in her opening statement at the House Energy and Commerce Oversight and Investigations Subcommittee’s March 17 hearing that focused on increasing COVID-19 vaccinations.
National Institute of Allergy and Infectious Diseases (NIAID) Director Anthony Fauci, MD, noted the importance of historic investments in the National Institutes of Health (NIH) in preparing for a rapid response to the pandemic. “Perhaps the most important success story in this terrible outbreak that we've been experiencing has been a success with vaccines. But this did not start in January when the virus was recognized. It began with research decades earlier, particularly within the NIH and particularly within the vaccine research center, where basic preclinical and clinical research to develop vaccine platforms like mRNA and vector borne expression of protein,” Fauci said in his opening statement.
“In addition, the NIH has utilized and pivoted its extensive domestic and international clinical trials network that we set up decades ago for HIV and influenza,” Fauci added, in describing NIH’s ability to use existing structures to participate in COVID-19 clinical trials.
Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky, MD, MPH, shared in her opening statement that more than 110 million doses of the COVID-19 vaccine have been administered, with more than 39 million individuals being fully vaccinated.
Several members addressed health equity in the distribution of vaccines. “Qualifying for a vaccine doesn't help if you can't actually get one and targeting populations who are at higher risk has not always translated to those populations getting vaccinated,” Rep. Raul Ruiz (D-Calif.) stated. He applauded the utilization of retail pharmacies and federally qualified health centers in vaccine distribution but added that obstacles including the lack of internet access, transportation, and language barriers still drive inequitable vaccine access.
Members also questioned witnesses on CDC’s return to school guidance for children and a timeline for vaccine availability for those under the age of 16. Fauci stated that clinical trials for high school and elementary school aged children are ongoing. He noted that it looks like high school students will be available to get vaccinated in the beginning of the fall and that he hopes there is enough data to be able to vaccinate younger children by the first quarter of 2022.
In her testimony, Walensky also highlighted the needed investment in public health infrastructure, particularly in bolstering the public health workforce, modernizing CDC’s data infrastructure, and increasing capacity at public health laboratories. “In that context, I believe that not only do we need one-time support, but we need longitudinal support in order to be able to maintain that infrastructure so it's ready to go for preparedness in future pandemics,” Walensky stated.
In the March 18 Senate Health, Education, Labor, and Pensions (HELP) Committee hearing, Ranking Member Richard Burr (R-N.C.) also highlighted NIH’s utilization of existing clinical trials networks and establishment of new public-private partnerships through programs like RADx and Operation Warp Speed in his opening statement. Looking ahead to future pandemic preparedness, Burr added, “We need ways to rapidly identify candidates for tests, treatments and antivirals, and vaccines. This is an area primed for partnership with academia and especially the private sector.”
Burr also urged the CDC to utilize outside partnerships for testing and surveillance during future outbreaks. “CDC can no longer be in charge of all testing in the early days of a novel threat. …[L]ean on your private sector partners – commercial labs, academic centers, and large-scale test makers … to rapidly develop diagnostics that serve as one of the great assets during an outbreak of an emerging infectious disease.”
HELP Committee Chairwoman Patty Murray (D-Wash.) added, “Even when we are all safe from COVID-19, our work to recover will not be over. We have to rebuild our country stronger and fairer. That work needs to start with building a stronger and fairer public health infrastructure—which is why I introduced the Public Health Infrastructure Saves Lives Act last week,” [see Washington Highlights, March 12].
Murray also shared her intention to work with bipartisan members of the HELP Committee to hold hearings on lessons learned from the pandemic in working towards bipartisan legislation to “address those lessons.”
Walensky noted CDC’s coordination of SARS-CoV-2 variant sequencing efforts, with a goal of sequencing 25,000 samples per week. “In all, the U.S. is currently sequencing about 4% of the roughly 400,000 weekly cases. These partnerships with commercial labs, state and local health departments, and academic and research institutions will continue to grow and the amount of sequencing will increase in coming weeks especially with the investment in sequencing included in the American Rescue Plan,” she added in her written testimony, noting the $1.75 billion recently provided to the CDC for variant sequencing [see Washington Highlights, March 12].
Members in both chambers addressed patients experiencing COVID-19 symptoms for many months, also referred to as long-COVID, including Sen. Time Kaine (D-Va.) in describing his own long-term neurological symptoms. Fauci cited studies indicating anywhere from 25% to 40% of individuals experience enduring COVID-19 symptoms, adding that “the NIH has been now given an appropriation of $1.15 billion to study this disease,” through the year-end Consolidated Appropriations Act, 2020 (P.L. 116-93) [see Washington Highlights, Dec. 23, 2020]. The NIH has begun solicitating proposals to better understand the underlying causes of these symptoms.