Susan Monarez, President Donald Trump’s nominee to lead the Centers for Disease Control and Prevention, appeared for a confirmation hearing Wednesday during a critical time for an agency that’s in the midst of a reorganization and pressure from the administration on vaccine policy.
Monarez, previously deputy director of the Advanced Research Projects Agency for Health under the Health and Human Services Department, is well-respected in scientific circles and that could clear the path for her Senate confirmation. She was picked for the job after the Trump administration pulled the nomination of former congressman Dave Weldon, whose views on vaccines had worried some senators.
On Wednesday during the hearing before the Senate Health, Education, Labor and Pensions Committee, Monarez largely declined to distance herself from the decisions of HHS Secretary Robert F. Kennedy Jr., including firing members of a CDC vaccine advisory committee and his handling of the U.S. measles outbreak.
Instead, she said members of the CDC’s Advisory Committee on Immunization Practices, which met for the first time Wednesday with new members selected by Kennedy, should “use science and evidence to drive that decision-making.”
“We absolutely need highly trained scientists and medical professionals to be able to participate in the ACIP meeting,” she said.
Sen. Bill Cassidy, R-La., chair of the committee, expressed concerns about the credentials of the people Kennedy selected, describing them as lacking “broad vaccine and immunology immunological expertise.”
“There are concerns about the rushed nature of this process,” Cassidy said.
“Part of the concern is that the people on the panel, although scientifically credentialed, no one has the experience with immunizations or the kind of knowledge to say, ‘Wait a second, the evidence that you’re presenting, there’s a lot more evidence to say it’s not true,'” Cassidy said.
He raised concerns that HHS is backing away from mRNA technology, which was used to create the COVID-19 vaccines. Kennedy and some new members of ACIP have questioned the safety of mRNA vaccines.
“If we turn our back on that platform, we’re turning our back on solutions to Lyme disease, which is terribly debilitating, to HIV, which is a scourge,” Cassidy said.
If members don’t have experience with mRNA vaccines, Monarez said, they should “be able to understand complicated scientific information, and they have to have the temerity to ask questions to make sure that they have clarity of understanding of information that is being presented to them.”
Cassidy had previously called on HHS to delay Wednesday’s ACIP meeting until “fully staffed with more robust and balanced representation — as required by law — including those with more direct relevant expertise.” Many of the picks have scientific backgrounds, but not in virology or immunology.
Sen. Lisa Murkowksi, R-Alaska, urged Monarez to ensure ACIP members are qualified and “are not going to cause further doubt about the credibility of the committee.”
“I would hope that one of the things that you would be looking to do is make sure that these individuals are going to be looking at the science in front of them and leave their political bias at home,” Murkowski said.
Throughout the hearing, Monarez declined to directly answer several questions, including whether the U.S. should have ended its financial support of a global vaccine distribution organization, whether HHS will add more seats to the ACIP committee, what is the No. 1 cause of death among kids, or whether she agreed with Kennedy’s comments that it is difficult for measles to kill a healthy person.
“We know that measles can be fatal in 1 in 1,000 individuals,” she said after being pressed on Kennedy’s comments by Sen. Patty Murray, D-Wash.
Monarez mostly focused her testimony on the administration’s goal of returning CDC’s mission to “preventing, detecting and responding to infectious diseases and emerging threats.”
Under a reorganization, many of the CDC’s other functions will be moved outside the agency, including to the new Administration for a Healthy America. That includes work on maternal mortality and tobacco and opioid use.
“There’s critical work to be done in preventing chronic diseases and addressing other issues like maternal mortality and addressing issues like neurodegenerative disorders,” she said. “I will make sure that I’m laser focused on the mission at hand at CDC, but also as supportive as I can be to the secretary’s goals and making America healthier again and transitioning those other programs to other parts of the agency.”
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