[House Hearing, 118 Congress]
[From the U.S. Government Publishing Office]
INVESTIGATING PANDEMIC IMMUNITY:
ACQUIRED, THERAPEUTIC OR BOTH
=======================================================================
HEARING
BEFORE THE
SELECT SUBCOMMITTEE ON THE CORONAVIRUS PANDEMIC
OF THE
COMMITTEE ON OVERSIGHT AND ACCOUNTABILITY
HOUSE OF REPRESENTATIVES
ONE HUNDRED EIGHTEENTH CONGRESS
FIRST SESSION
__________
MAY 11, 2023
__________
Serial No. 118-29
__________
Printed for the use of the Committee on Oversight and Accountability
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Available on: govinfo.gov,
oversight.house.gov or
docs.house.gov
______
U.S. GOVERNMENT PUBLISHING OFFICE
52-163 PDF WASHINGTON : 2023
COMMITTEE ON OVERSIGHT AND ACCOUNTABILITY
JAMES COMER, Kentucky, Chairman
Jim Jordan, Ohio Jamie Raskin, Maryland, Ranking
Mike Turner, Ohio Minority Member
Paul Gosar, Arizona Eleanor Holmes Norton, District of
Virginia Foxx, North Carolina Columbia
Glenn Grothman, Wisconsin Stephen F. Lynch, Massachusetts
Gary Palmer, Alabama Gerald E. Connolly, Virginia
Clay Higgins, Louisiana Raja Krishnamoorthi, Illinois
Pete Sessions, Texas Ro Khanna, California
Andy Biggs, Arizona Kweisi Mfume, Maryland
Nancy Mace, South Carolina Alexandria Ocasio-Cortez, New York
Jake LaTurner, Kansas Katie Porter, California
Pat Fallon, Texas Cori Bush, Missouri
Byron Donalds, Florida Jimmy Gomez, California
Kelly Armstrong, North Dakota Shontel Brown, Ohio
Scott Perry, Pennsylvania Melanie Stansbury, New Mexico
William Timmons, South Carolina Robert Garcia, California
Tim Burchett, Tennessee Maxwell Frost, Florida
Marjorie Taylor Greene, Georgia Becca Balint, Vermont
Lisa McClain, Michigan Summer Lee, Pennsylvania
Lauren Boebert, Colorado Greg Casar, Texas
Russell Fry, South Carolina Jasmine Crockett, Texas
Anna Paulina Luna, Florida Dan Goldman, New York
Chuck Edwards, North Carolina Jared Moskowitz, Florida
Nick Langworthy, New York
Eric Burlison, Missouri
Mark Marin, Staff Director
Mitchell Benzine, Subcommittee Staff Director
Marie Policastro, Clerk
Contact Number: 202-225-5074
Miles Lichtman, Minority Staff Director
------
Select Subcommittee On The Coronavirus Pandemic
Brad Wenstrup, Ohio, Chairman
Nicole Malliotakis, New York Raul Ruiz, California, Ranking
Mariannette Miller-Meeks, Iowa Minority Member
Debbie Lesko, Arizona Debbie Dingell, Michigan
Michael Cloud, Texas Kweisi Mfume, Maryland
John Joyce, Pennsylvania Deborah Ross, North Carolina
Marjorie Taylor Greene, Georgia Robert Garcia, California
Ronny Jackson, Texas Ami Bera, California
Rich Mccormick, Georgia Jill Tokuda, Hawaii
C O N T E N T S
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Page
Hearing held on May 11, 2023..................................... 1
Witnesses
----------
Dr. Marty Makary, Chief, Islet Transplant Surgery & Professor of
Surgery, Johns Hopkins University
Oral Statement................................................... 6
Dr. Margery Smelkinson, Research Scientist
Oral Statement................................................... 8
Dr. Tina Tan, Professor of Pediatric Infectious Diseases,
Feinberg School of Medicine, Northwestern University
Oral Statement................................................... 9
Written opening statements and the written statements of the
witnesses are available on the U.S. House of Representatives
Document Repository at: docs.house.gov.
Index of Documents
----------
Documents entered into the record during this hearing are listed
below.
* Report, SSCC Democrats, ``The Atlas Dogma: The Trump
Administration's Embrace of a Dangerous and Discredited Herd
Immunity Via Mass Infection Strategy''; submitted by Rep.
Raskin.
* Letter, September 28, 2021, from Members of the GOP Doctors
Caucus to CDC Director Walensky; submitted by Rep. Miller-
Meeks.
* Study, Clinical Infectious Diseases, ``Comparing SARS-CoV-2
natural immunity to vaccine-induced immunity: reinfections
versus breakthrough infections''; submitted by Rep. Cloud.
* Study, Science, ``Ultrapotent antibodies against diverse and
highly transmissible SARS-CoV-2 variants''; submitted by Rep.
Cloud.
* Study, Nature, ``SARS-CoV-2 B.1.617.2 Delta variant
replication and immune evasion''; submitted by Rep. Cloud.
* Article, Lancet, ``Protective immunity after recovery from
SARS-CoV-2 infection''; submitted by Rep. Cloud.
* Letter, November 5, 2021, from the CDC to a FOIA request;
submitted by Rep. Cloud.
* Article, ABC, ``Hundreds of hospital staffers fired or
suspended for refusing COVID-19 vaccine mandate''; submitted
by Rep. Cloud.
Documents are available at: docs.house.gov.
INVESTIGATING PANDEMIC IMMUNITY:
ACQUIRED, THERAPEUTIC OR BOTH
----------
Thursday, May 11, 2023
House of Representatives
Committee on Oversight and Accountability
Select Subcommittee on the Coronavirus Pandemic
Washington, D.C.
The Subcommittee met, pursuant to notice, at 10:10 a.m., in
room 2247, Rayburn House Office Building, Hon. Brad Wenstrup
(Chairman of the Subcommittee) presiding.
Present: Representatives Wenstrup, Comer, Malliotakis,
Miller-Meeks, Lesko, Cloud, Joyce, Greene, Jackson, McCormick,
Ruiz, Raskin, Mfume, Ross, Garcia, Bera, and Tokuda.
Dr. Wenstrup. The Select Subcommittee on the Coronavirus
Pandemic will come to order. I want to welcome everyone.
Without objection, the Chair may declare a recess at any
time.
I now recognize myself for the purpose of making an opening
statement.
Today the Select Subcommittee is holding a hearing to
examine the role of both infection-acquired or natural
immunity, and the therapeutic acquired or vaccine-induced
immunity it should have and could have played in the public
health response to the pandemic and concerns as to why the
Federal Government decided almost wholly to ignore, at least,
the natural immunity. In the earliest stages of the pandemic,
COVID-19 was a novel virus, and there simply was no data.
Again, we aren't here to negate the significance of that
unprecedented time, but as data changes, so must our decision-
making based on data. And as time passed, more and more global
research emerged that infection from COVID-19 produced robust,
naturally acquired immunity.
Let's be absolutely clear. Natural or infection-acquired
immunity is real. It has been known for hundreds, if not
thousands, of years. Dr. Fauci himself even said so in 2004.
While speaking about the common flu, he said, ``The most potent
vaccination is getting infected yourself.'' And, yes, the flu
and COVID-19 are different, but the science regarding immunity
is the same and should be respected. However, instead of
following the science, public health leaders ignored the facts
and mandated vaccines for Americans without any regard for a
previous infection and immunity that may come from that and did
so with the threat of losing one's job. Nowhere in this process
was there an opportunity for one to confer with their doctor,
who they know and trust, to discuss risks and benefits to their
health.
This is part of the reason we are here today, to ask why
naturally acquired immunity was never robustly considered as
part of U.S. public health policy, to ask why science wasn't
followed. It is essential that we look back and examine the
policy decisions that were made, and at the end of the day,
science and scientific facts aren't political. For democracy to
be healthy, it needs to be transparent, and a transparent,
healthy, and free Nation doesn't shy away from the facts.
When the COVID-19 vaccines became widely available, 91
million Americans had been infected with COVID-19. Still, facts
and science continued to show that those who had antibodies
from previous infection had some form of protection against
reinfection. Yet the Biden administration attempted to mandate
vaccines, regardless of previous infection, for the military,
healthcare workers, large private sector companies, and Federal
employees. All around, this is bad public health. Between the
mandates and the vitriol showed toward natural immunity, these
decisions hurt Americans' trust in public health, a trust that
we hope to restore at the end of this process.
To be clear, no one ever advocated for a let-it-rip
approach. No one ever advocated for natural immunity to be the
end-all public health factor, just that it was to be
considered. Natural immunity could have been and, I believe,
should have been a force multiplier for good. We could have
used thousands of years of science to our advantage, but
instead, it was demonized. This should have been part of a
conversation between patients and physicians.
And I'll share a personal story. I got vaccinated with the
Pfizer vaccine in early January, February 2021 with so many
other Americans, especially Americans my age and older and with
comorbidities. In August 2021, I realized I must have had COVID
when I was cooking and could not smell garlic salt. I was fine.
My family was fine, including my 89-year-old mother. All that
being said, when I was scheduled to go on a trip to Germany, I
was told I needed to get boosted, and so I asked if here at the
Capitol if I could get my T-cell count and my antibody levels
before getting boosted. I was told that they couldn't do the T-
cell through their lab, but they could do the antibodies. I got
my results. On the results, it says a number of 40 confirms the
presence of circulating IGG antibodies specific for SARS-CoV-2
at high levels. At high levels, 40. My number was 821, yet I
was being told, not by a physician, that I needed to get a
booster. Why? No doctor involved.
See, public health needs to be educational not
indoctrinational. Why were personal medical decisions left up
to bureaucrats and politicians, not patients and doctors? I do
believe that vaccines saved innumerable lives. We knew from the
trials that mRNA-vaccinated people still got COVID. They, in
most cases, didn't get us sick and were less likely to be
hospitalized. We know that people with certain comorbidities
were more vulnerable to severe illness and death. Why did
bureaucrats and politicians mislead and confuse the American
people?
At a town hall event on July 21, 2021, President Biden
stated, ``If you are vaccinated, you are not going to be
hospitalized, you are not going to be in the intensive care
unit, and you are not going to die. You are not going to get
COVID if you have these vaccinations.'' After the town hall, he
stated to a reporter when asked about vaccinated people who get
infected, ``It may be possible. I know of none where they are
hospitalized in ICU or have passed away, so at a minimum, I can
say even if they did contract it, which I'm sorry they did, it
is such a tiny percentage and it is not life threatening.'' In
May 2021, when asked about new CDC guidance for vaccinated
people and masks, Dr. Walensky said, ``Data has emerged again
that demonstrate that even if you were to get infected during
post-vaccination, that you can't give it to anyone else.'' On
March 29, 2021, Dr. Walensky told MSNBC, ``Our data from the
CDC today suggested vaccinated people don't carry the virus,
don't get sick, and that it is not just in the clinical
trials.'' The director added, ``But it is also in real-world
data.''
A spokesperson for the CDC had to walk back their own
director's statements a few days later, telling the New York
Times, ``Dr. Walensky spoke broadly during this interview,''
adding that ``It is possible that some people who are fully
vaccinated could get COVID-19. The evidence isn't clear whether
they can spread the virus to others. We are continuing to
evaluate the evidence.'' At a White House briefing on April 23,
2021, Dr. Walensky offered, ``CDC recommends that pregnant
women receive the COVID-19 vaccine.'' However, the CDC didn't
recommend that pregnant women receive the vaccine. It only
stated that pregnant women can get the vaccine. While small,
those are very different statements.
On February 3, 2021, in a White House press briefing, Dr.
Walensky stated schools could reopen safely without vaccinating
teachers. She said, ``Yes, ACIP has put teachers in the 1b
category, the category of essential workers, but I also want to
be clear that there is increasing data to suggest that schools
can safely reopen, and that safe reopening doesn't suggest that
teachers need to be vaccinated in order to reopen safely.'' At
that time, the White House attempted to distance themselves
from Dr. Walensky, with the Press Secretary Jen Psaki stating
that Dr. Walensky was speaking in her personal capacity.
The Biden administration and CDC's false narratives about
the necessity and efficacy of COVID-19 vaccine and booster
misled the public with scare tactics and deception. These
statements fostered a lack of public trust in our health
authority during a time when the American people needed that
leadership and that truth and that trust the most. We are
holding this hearing today to look back to help prepare for a
future pandemic, to determine what went wrong, to recommend how
to do it better. Asking about the reluctance of the public
health elite to consider natural immunity is essential to this
question. That is what this hearing is about today.
Science is clear. While for some, no amount of protection
may be enough. However, natural immunity is real, it matters,
it should have been studied, and it should have been considered
fully, and health decisions should be made on a case-by-case
basis based on personal and scientific facts. I look forward to
a strong on-topic discussion today.
I would now like to recognize Ranking Member Ruiz for the
purpose of making an opening statement. Dr. Ruiz.
Dr. Ruiz. Thank you, Mr. Chairman. Today we are here to
examine the roles of both vaccine-induced and infection-
acquired immunity, both passive and active immunity, in
overcoming a deadly pandemic. This hearing comes at a sensitive
time for our Nation's public health as misinformation and
disinformation stemming from the COVID-19 pandemic has fueled
vaccine hesitancy and undermined the greatest tool we have to
protect against infectious disease, or, in fact, the only tool
we have that helps prevent against developing symptoms from a
natural infection that lead to long-term health effects,
hospitalizations, and death, all while reducing overall
transmission. It is my sincere hope that we approach today's
hearing with care and that my colleagues on the other side of
the aisle will not draw into question that which we know to be
fact, that the COVID-19 vaccines are safe, the COVID-19
vaccines are effective, and the COVID-19 vaccines save lives.
Let me take you back to the winter of 2020 before the
rollout of the lifesaving vaccines. Every day, Americans
battled a highly transmissible, rapidly changing deadly novel
virus. Let me repeat. Every day, Americans battled a highly
transmissible, rapidly changing deadly novel virus, and at the
height of the pandemic, we were losing more than 3,000 of our
fellow Americans daily to this lethal public health crisis,
more than 3,000 siblings, parents, grandparents, loved ones,
and neighbors lost to COVID-19 every single day. These were
some of the darkest times for our Nation.
And so today, as we end the public health emergency, as we
look back on the devastation wrought by this virus, we must
recommit to preventing future harm and saving lives in the
event of another pandemic. This includes looking at how we can
build on the Biden administration's implementation of the
largest, most successful vaccine administration program in
history that allowed us to safely reunite loved ones, reopen
schools, businesses, and workplaces, and now declare the end of
the public health emergency that we all faced.
In fact, according to the Commonwealth Fund, this
achievement prevented an estimated 3.2 million deaths and 18.5
million hospitalizations, plus it saved the United States over
$1 trillion in medical costs. Now, let's compare that to the
damage that a reckless mass infection strategy would have done
to our Nation. This strategy would have, at worst, encouraged
people to go out and get sick during a deadly, highly
transmissible airborne virus and, at best, willfully disregard
preventive precautions at a time when we knew little about
COVID-19 and its long-term impacts. Even worse, this reckless
strategy was embraced by those at the very top of the Trump
administration, such as pandemic advisor, Scott Atlas, who
pushed a dangerous mass infection strategy that would have
further strained our already over-capacity national healthcare
system. The strategy that Atlas and others embraced would have
pushed already overwhelmed hospitals to the brink, led to
further delays and care for patients suffering from chronic
conditions, and this strategy could have caused an estimated 3
million additional deaths, according to projections by the
Washington Post.
Look, I am a doctor, and I took an oath to do no harm, so
it is pretty clear to me that we should not reverse course on
basic public health measures. We need to defend basic public
health in this country due to the politicization and the
disinformation and the misinformation that has been putting out
there that has caused the mistrust in basic public health
knowledge that have been proven time and time again from
previous pandemics and basic science to reduce harm and save
lives. Why would we willfully want to allow people, even
healthy individuals, to get sick by an active infection that we
know very little about, that now we know can develop long
COVID, even in patients who have been asymptomatic? And the
more you get actively infected, the more the risk that you will
get long COVID, as per the science.
So, because the fact of the matter is, while we can now end
the public health emergency because of an overall decrease in
hospitalizations and mortality, we must still work to address
long COVID and emerging variants, especially for high-risk
communities, immunocompromised individuals, and unvaccinated
populations. And yet the continued spread of disinformation--
``dis'' meaning purposefully causing confusion, mistrust, and
the misinformation, those who aren't willfully, but they are
just sharing this disinformation online about not just COVID-19
vaccines but vaccines overall--pose a serious threat to this
work and our ability to protect America's overall health. I am
concerned that people listening to this hearing will then say,
well, look if active immunity is the way to go, hell, I am
going to go get infected. I don't care about taking
precautions. That is not the approach or the message that we
should be interpreting from this hearing.
So look, the Brown School of Public Health, Brigham and
Women's Hospital, Harvard T.H. Chan School of Public Health,
and Microsoft AI for Health have found a growing distrust in
vaccines, has caused more than 300,000 preventable COVID-19
deaths. What is more, this dis-and misinformation has inflicted
serious damage on our efforts to combat diseases that we
previously had under control, like polio and measles, so this
should be troubling to us all. And I am not speaking here as a
Democrat. I am speaking here as an emergency physician, a
scientist who has taken an oath, and a public health expert
that has studied public health and practiced public health in
the field, who cares about Republicans and Democrats to stay
alive, to stay out of hospitals, to not get infected with an
active virus. Even though you may have mild symptoms, you may
develop long COVID. You may then carry it and transmit it to
somebody who is immunocompromised, who is at high risk of
getting hospitalized and dying.
So, for the sake of public health, for the sake of our
neighbors, regardless of political affiliation, I implore
everyone here today to remain focused on the facts and come
together to identify real solutions that put people over
politics to prevent future harm, save future lives, and ensure
America is stronger and better prepared in the future. Thank
you.
Dr. Wenstrup. Thank you, Dr. Ruiz. Our witnesses today are
Dr. Marty Makary. Dr. Makary is the chief of Islet Transplant
Surgery and a professor at Johns Hopkins University. He served
in leadership in the World Health Organization Patient Safety
Program, elected to the National Academy of Medicine, and has
published more than 250 peer-reviewed scientific articles. Dr.
Margery Smelkinson. Dr. Smelkinson is a research scientist and
microscopist with expertise in infectious disease. She received
her Ph.D. in biological sciences from Columbia University in
2007 and completed her postdoctoral fellowships at the
University of California-San Diego. And Dr. Tina Tan. Dr. Tan
is a Board-certified pediatric physician as well as a current
professor of pediatric infectious diseases at Northwestern
University Feinberg School of Medicine in Chicago.
Pursuant to Committee on Oversight and Accountability Rule
9(g), the witnesses will please stand and raise the right
hands.
Do you solemnly swear or affirm that the testimony that you
are about to give is the truth, the whole truth, and nothing
but the truth, so help you God?
[A chorus of ayes.]
Dr. Wenstrup. Thank you. Let the record show that the
witnesses all answered in the affirmative.
The Select Subcommittee--you may be seated--the Select
Subcommittee certainly appreciates you all for being here
today, and we look forward to your testimony.
Let me remind the witnesses that we have read your written
statements, and they will appear in full in the hearing record.
Please limit your oral statements to five minutes. As a
reminder, please press the button on the microphone in front of
you so that it is on, and the Members can hear you. When you
begin to speak, the light in front of you will turn green.
After four minutes, the light will turn yellow. When the red
light comes on, your five minutes has expired, and we would ask
that you please wrap up.
I now recognize Dr. Makary to give an opening statement.
STATEMENT OF DR. MARTY MAKARY, CHIEF
ISLET TRANSPLANT SURGERY & PROFESSOR OF SURGERY
JOHNS HOPKINS UNIVERSITY
Dr. Makary. Thank you, Chairman Wenstrup and Ranking Member
Ruiz. You are both good doctors. I respect both of you, even if
we have different opinions on some things. You have promoted a
very civil discourse here. I believe in civility, so I want to
thank both of you. I admire that.
Nothing speaks more to the intellectual dishonesty of
public health officials then their complete dismissal of the
data on natural immunity, making the U.S. an international
outlier in this academic dishonesty. Since the Athenian plague
of 430 B.C., natural immunity has been described. It was
protective against subsequent disease during reinfection or
prevented reinfection. Natural immunity works for every other
virus, with arguably the exception of influenza because
influenza is unique. It is got two spike proteins and a very
leaky polymerase enzyme. It is unique. Every other virus
practically that we know of that causes infections in humans,
there are two viruses that cause severe illness in humans that
are coronaviruses besides COVID. COVID is one of three
coronavirus has that causes severe illness in humans. The other
two both have long-lasting natural immunity.
So, it is very bizarre that public health officials bet
that this would break the rule, COVID would be different. Dr.
Ruiz, you mentioned you believe in vaccines. They are safe and
effective. I do, too, but I don't recommend the chickenpox
vaccine if you had chickenpox. CDC doesn't either.
Dr. Ruiz [continuing]. Virus than COVID-19. It is a
different virus than COVID-19.
Dr. Wenstrup. Let him finish his statement.
Dr. Makary. I don't recommend the chickenpox vaccine if you
had chickenpox, nor does the CDC. The same with many other
viruses. Over the last three years, there have been 200 studies
of natural immunity. The Lancet review of 65 studies from nine
countries concluded that natural immunity is at least as
effective. The data are clear. The evidence was there all
along, but health officials never talked about it, maybe
because the real story is they were worried somebody might try
to get natural immunity. So, let's not be honest with the
public. Was that the idea?
Public health officials, the government, and CDC, NIH
privately told me that is what their concern was about
acknowledging natural immunity, so they made ignoring natural
immunity a political badge. They dismissed it saying there was
uncertainty. We don't know how long it is going to last, as if
we knew how long vaccinated immunity would last. They had it
backward actually. Our Johns Hopkins study published in JAMA
was the third most discussed study of all JAMA publications in
2022, according to the JAMA website. We found antibodies
present up to two years later. We can have our opinions, but
let's not ignore this mountain of evidence.
Big Tech censored my study when I posted it calling it
vaccine-hesitant content. Government doctors were privately
saying we agree, but we don't talk about it. We had this sort
of intense paternalism. We saw this when women wanted home
pregnancy tests, and doctors were pushing for it, and the
medical elites said, no, women can't handle that information at
home. We can't have home pregnancy tests. They fought it for
years. Same with home HIV tests, medical paternalism.
Universities like my own put their head in the sand, ignoring
the data, forcing young, healthy male students to choose
between the risk of myocarditis--1 in 6,000 young males--or
getting kicked out of school, even though they had natural
immunity. That was common.
The media parroted whatever Fauci and the CDC fed them,
just like government officials when they fed the media there
were weapons of mass destruction in Iraq. Whatever government
leaders told them, they parroted without asking any questions.
And is anyone surprised that Pfizer or Moderna, which
controlled a lot of the narrative, they never talked about
natural immunity. Why would they, a reason not to get one of
their products? Many practicing doctors knew about natural
immunity, the power of it. European doctors, many tailored
vaccine recommendations factoring in natural immunity just like
you do with chickenpox, and they would tailor medications, and
that is the art of medicine.
Now, natural immunity isn't just an academic point. Lives
were lost because they ignored it. Thousands of Americans died
because public health officials ignored natural immunity,
because from December 2020 and April 2021, there was a limited
vaccine supply. Thousands of Americans were dying, just as you
said Ranking Member Ruiz. We had people dying to get the
vaccine. The vaccine was highly effective against the variant
at that time. It saved lives, and they couldn't get it because
we were giving vaccines to those already immune with natural
immunity. Why would you give two life preservers when some were
drowning with none?
If you think healthcare costs too much, we are dealing with
a massive nurse exodus, resulting in higher prices. Thirty-four
thousand nurses left in New York state alone. Now they are
hiring traveling nurses for twice and three times the cost.
That is translating into higher medical bills. If you are
healthy enough to fight in a war, you are probably extremely
low risk for COVID. Thank you, and I look forward to your
questions.
Dr. Wenstrup. Thank you, Doctor. I now recognize Dr.
Smelkinson for five minutes of remarks. Thank you.
STATEMENT OF DR. MARGERY SMELKINSON
RESEARCH SCIENTIST
Dr. Smelkinson. Chairman Wenstrup, Ranking Member Ruiz, and
Committee Members, thank you for inviting me to speak today. I
am a research scientist with 24 years of experience working in
the laboratory, primarily focusing on host-pathogen
interactions and infectious diseases. Currently, I am a staff
scientist in the Research Technologies Branch at NIAID, where I
perform collaborative research with investigators throughout
the Institute on projects that focus on infectious diseases,
rare and autoimmune diseases, and immunology. As a disclaimer,
I am here in my personal capacity and not speaking on behalf of
the NIH, NIAID, HHS, or the Federal Government.
The U.S. COVID pandemic response has been plagued by a
failure to adjust to emerging data and to account for
unintended consequences. One glaring example of this is the
handling of school closures, with the CDC guidelines
continuously at odds with evidence from other countries and
from school districts that opened in the U.S. in the fall of
2020. This disregard for data led to prolonged closures, and a
catastrophic decline in academic achievement, and a widening
equity gap. This was not the only area where our health
agencies failed to acknowledge evidence. They also failed to
recognize the protection against COVID afforded by natural
immunity.
Natural immunity refers to the immunological response that
an individual develops after recovering from an infection. It
is part of the adaptive immune response, which produces memory
B and T cells that remain in the body and can quickly respond
to the same pathogen if it is encountered again. For centuries,
natural immunity has been recognized as a vital defense
mechanism against reinfection, long before the precise cellular
mechanisms were understood.
Throughout much of the pandemic, though, messaging in the
U.S. was that there was no evidence of lasting protection from
COVID infection, but, in fact, we did know otherwise and early
on. In July 2020, a paper published in Nature showed a strong T
cell response in SARS CoV-2 recovered patients. It also
demonstrated that patients recovered from SARS, the first one,
also had T cells that were still reactive to the virus nearly
20 years later, a very good indicator that SARS CoV-2 immunity
would be similarly durable. Several more papers came out in
late 2020, early 2021, reaffirming these results and that even
a mild or asymptomatic infection could produce a strong and
long-lasting response. As expected, these immunological data
translated into low reinfection rates.
In February 2021, a U.S. study of 3 million people showed a
0.3 percent reinfection rate compared to three percent in those
without prior infection during the same time period. Two months
later the large Siren study of English healthcare workers
estimated that prior infection was associated with an 84-
percent lower risk of reinfection. By late 2021, there were
numerous studies, including a systematic review, which showed
that natural immunity was at least as effective as vaccine-
conferred immunity and waned more slowly.
The early data clearly showed that natural immunity was
strong. Other countries did acknowledge this by allowing
exemptions from mandates and passports, while the U.S.
continued to disregard it. In the short term, this provided
justification for mandates with no exceptions, an approach that
resulted in staffing shortages, particularly in the healthcare
sector where we could least afford to lose workers. It also
caused needless loss of life as vaccines were given to
essential workers with natural immunity instead of being
prioritized for the elderly. Additionally, the daily quarantine
of thousands of students could have been significantly reduced
if districts had at least made exceptions for students with
natural immunity, at least.
Disregarding the wealth of evidence of natural immunity led
to missed opportunities to implement policies that could have
been more effective and efficient in controlling the pandemic
and limiting collateral damage. Unfortunately, now vaccination
rates for other vaccines have declined, ironically increasing
society's vulnerability to infectious outbreaks. While some of
this may be due to missed medical appointments and school
closures, there has also been a significant loss of trust in
public health due to misleading messaging and inflexible
policies during the pandemic. Our health agencies must learn
from this unfortunate error of failing to be candid with the
American public and for the pervasive implementation of
policies that were not adequately supported by data. Thank you
Dr. Wenstrup. Thank you, Doctor. I will now recognize Dr.
Tan to give an opening statement.
STATEMENT OF DR. TINA TAN
PROFESSOR OF PEDIATRIC INFECTIOUS DISEASES
FEINBERG SCHOOL OF MEDICINE
NORTHWESTERN UNIVERSITY
Dr. Tan. Thank you. Chairman Wenstrup, Ranking Member Ruiz,
and distinguished Members of the Subcommittee, thank you for
holding today's hearing and inviting me to testify. As a
pediatric infectious diseases physician, I have cared for many
patients with serious illness due to COVID-19, and I am
committed to saving lives and providing my patients with the
best care possible and the best medical advice. And that is why
I recommend that all eligible individuals stay up to date on
their COVID-19 vaccinations. I greatly appreciate your
commitment to hearing from physicians like myself who have been
on the front lines of this pandemic since the pandemic started.
When SARS CoV-2 first emerged, it truly was a novel virus,
so we knew very little about it. Increasing knowledge, the
emergence of new variants, new tools, and increased population
immunity have all caused medical recommendations to change
appropriately over time. My testimony will cover what we now
know about the benefits and risks associated with immunity
after infection and COVID-19 vaccines, the appropriate roles of
physicians and the Federal Government in COVID-19 prevention,
and recommendations to improve public understanding of
vaccines.
Now, the term ``natural immunity'' to mean immunity after
infection, can be somewhat confusing. Immunity acquired from a
COVID-19 infection and immunity after vaccination are both
natural. Immunity after infection appears to provide protection
against future severe disease from COVID-19. The body of
evidence for immunity after infection, however, is more limited
than that for vaccine-induced immunity, and data suggests that
the best immunity comes from hybrid immunity, which is the
combination of vaccination and immunity after infection.
Relying only on immunity after infection to prevent COVID-
19 can be very risky. Unvaccinated individuals without prior
COVID-19 infection have an increased risk of severe disease,
hospitalization, and death. Before vaccines, patients with
COVID-19 completely overwhelmed hospitals, which compromised
our ability to provide care to all patients. COVID-19 vaccines
provide substantial protection against severe disease,
hospitalization, and death. The bivalent booster COVID-19
vaccines increases protection, and we must encourage more
people to receive this booster.
An April 2022 study found the vaccine effectiveness of the
bivalent MRNA vaccine booster was 72 percent for COVID-19-
related hospitalizations and 68 percent for COVID-19-related
deaths. Several studies have also indicated that COVID-19
vaccination appears to reduce the risk of long COVID. A March
2023 study found that vaccinated individuals had less than half
the risk of developing long COVID.
COVID-19 vaccines are safe, and side effects after a COVID-
19 vaccination tend to be mild and temporary, very similar to
those experienced after routine vaccinations. And we know that
CDC has conducted extensive monitoring of the adverse events
associated with vaccines, and the risk associated with getting
a natural COVID infection are far greater than the risk
associated with receiving a COVID-19 vaccine.
Now, we know that physicians are considered one of the most
trusted vaccine messengers, and 2021 AMA survey showed more
than 96 percent of U.S. physicians had been fully vaccinated
for COVID-19. And as an ID specialist, I have educated other
physicians and healthcare personnel about COVID-19 disease and
COVID-19 vaccines. We must better leverage the role of
physicians to increase vaccine uptake for COVID-19 and other
vaccine-preventable diseases. And to do this, we must expand
our physician work force.
Unfortunately, nearly 80 percent of the counties here in
the United States don't have a single infectious disease
physician, and in 2022, only 56 percent of adult ID training
programs and only 46 percent of pediatric ID training programs
filled, and high medical student debt draws many physicians to
more lucrative specialties and subspecialties.
The Federal Government has an important role to play in
COVID-19 vaccinations, and those roles have evolved over time.
The Federal Government provided critical resources,
information, and partnerships to support rapid equitable
vaccine administration. It also instituted vaccination
requirements, and the concept of vaccine requirements is not
new. We know that seasonal influenza vaccination requirements
for healthcare personnel have been in placed at many
institutions for years and really have decreased the amount of
transmission occurring from healthcare personnel to the
patients they care for.
Prior to the Delta variant, COVID-19 vaccine offered
incredibly powerful protection against infection. Reducing
transmission could limit the development of variants, ease
pressure on hospitals, and save lives. The trajectory of the
pandemic, however, has changed. While vaccines remain highly
effective at preventing severe disease, hospitalization, and
death, they are no longer as effective in preventing infection
and transmission. And in addition, most people in the U.S. now
have some immunity. Policies should evolve based on the latest
data, and data do not support mandatory COVID-19 vaccination
requirements at this time.
The other thing that I just want to mention is that routine
childhood vaccination rates significantly dropped during the
pandemic and remain below pre-pandemic levels, and this is
driving outbreaks of diseases, such as measles, pertussis, and
polio, with very troubling public health consequences and
economic costs.
I thank you for your attention to the important issue of
vaccination and this opportunity to testify.
Dr. Wenstrup. Thank you, Doctor, and I agree with the grave
concern about the other vaccines that aren't being administered
out of fear at this time.
I now recognize myself for questions, but I do want to say
some things. You know, to imply that those that support the
idea of studying and considering and researching natural
immunity implies that you are against the vaccine, that is
false. That should not be implied, and it doesn't mean that the
vaccines weren't beneficial and weren't lifesaving, and the
emergency use authorization, I felt, was very appropriate,
especially for the most vulnerable because of what we knew at
the time. But since vaccinated people still got COVID, and we
knew that from the trials, you can't say that vaccinated people
won't get long COVID because they can still get COVID.
And to say that the vaccines are safe, safe as we know it
at the time, but we don't have a five-year study. We don't have
a 10-year study. We saw 18-to 40-year-old males getting
myocarditis after vaccination. Those are things we need to
continue to study and to consider. To make a blanket statement
that they are safe is not fair. Safe as we may know it at a
certain point, but we are seeing things. In this Committee, we
will be looking at our VAERS system, the reporting of adverse
events from vaccines. It is important that we do that and make
sure that it is working, and it is to be honest, and it is to
be trusted.
So, what we have seen throughout the pandemic is the public
health establishment disregarding natural immunity. I mean,
that has been very clear. We have all lived through that. Let
me go down the line, starting with Dr. Makary. Is natural
immunity to COVID-19 a real thing that should have been
considered, recognized, and studied?
Dr. Makary. Absolutely. We lost a million people from the
work force roughly because natural immunity was ignored. A
million people leaving the work force isn't good for public
health.
Dr. Wenstrup. Doctor?
Dr. Smelkinson. Yes, I think when it came to mandates, we
should have absolutely made exemptions for people with natural
immunity to save the work force and to save our precious
vaccines for those that were truly vulnerable, which is what
many other developed countries did.
Dr. Wenstrup. Do you think mandates should have been
implemented without a consultation with a physician?
Dr. Smelkinson. I think that mandates, when there is a
public health benefit, can be justified. So early on when the
vaccines were rolled out, when they did seem to reduce spread,
they were justified, but exemptions should have always existed
for those with natural immunity.
Dr. Wenstrup. Then to that point, I will tell you, during
the Trump administration, I made the recommendation that
America needs to be hearing from the doctors that are treating
COVID patients, not politicians, and that would be much more
greatly embraced by the American people. Dr. Tan?
Dr. Tan. I agree that you get natural immunity after
infection, and I think that is important, but I think early on,
we didn't understand or have the data to really support that,
you know, natural immunity would be the only thing to rely on.
And we knew that as individuals got COVID infection, they were
at much higher risk for going on to developing complications,
now known as long COVID and multi-system inflammatory syndrome,
both in children and adults.
Dr. Wenstrup. I think we all agree that early on, no one
knew exactly what, so we were all clamoring for a vaccine, but
at the same time should have been looking at natural immunity
as well and take it into consideration in the overall treatment
of a patient, as I pointed out with my own numbers there. In
the summer of 2021, the CDC removed all references to natural
immunity. Dr. Makary, do you know why?
Dr. Makary. They never talked about it. They upheld
something I would call the Novak Djokovic doctrine. That is, no
one who is unvaccinated, regardless of prior recovery from
COVID, was allowed in the United States under the false
pretense that vaccines prevent transmission, that natural
immunity was not a real thing, and that there was no risk
whatsoever to the vaccine. And just a quick note. I don't like
the conversation framed around all or nothing, entirely relying
on natural immunity. Doctors' custom tailor treatments all the
time and you know what? If somebody had a natural immunity
early on, maybe we recommend one dose or space out the doses or
hold off on the booster, but this all-or-nothing cult around
vaccine ignores the Fraiman Study that found that 1 in 662 two
doses results in a severe adverse event.
Do doctors do a proper informed consent with that risk? In
the early days of COVID when we were losing a thousand people,
that risk is acceptable. Now it is not acceptable. We can't
have a five-year-old girl gets 77 mRNA doses in her average
life span. That is what people are promoting without any data.
Dr. Wenstrup. I had a situation where a gentleman called me
about his son, and he said just to go to school he has to get
vaccinated. He has a perfectly healthy son, and I recommended
one dose of the Pfizer. It would give him some immunity. Most
of the myocarditis incidents were coming after the second dose,
so get one dose. Get immunity that way, which the majority of
it comes from that first dose, yet he was denied. He was denied
accepting that. I said get a doctor's note. The school board
was deciding this, not the patient and the doctor.
The CDC website at that time, Dr. Makary, also said, ``Get
vaccinated regardless of whether you already had COVID-19.
Studies have shown that vaccination provides a strong boost in
protection in people who have recovered from COVID-19.'' Any
thoughts on that?
Dr. Makary. Well, the CDC's own data showed that if you
were vaccinated and had prior immunity, that is the so-called
hybrid immunity, or you just had natural immunity, you hit the
same ceiling of hospitalization rates during the Omicron wave.
So, one dose may be reasonable, but we fired 81,000 soldiers
just in one swath for not having both doses. That is arrogance,
paternalism, and medical elitism. That isn't the humility the
American public expects. That is why child vaccination rates
are down unfortunately.
Dr. Wenstrup. Of course. Care to comment on that?
Dr. Tan. Well, I mean, we know that vaccine hesitancy has
existed as long as vaccines have existed. You know, with Edward
Jenner and the smallpox vaccine, there was vaccine hesitancy
then. I think with the COVID-19 vaccines, I think there was a
misunderstanding in the general public about the role that they
would play, at least, you know, in preventing the serious
disease and infections and hospitalizations and death that may
occur in individuals. And I think that is why it is so
important to really protect those individuals, especially those
individuals that have immunocompromised conditions. And
children do serve as a vector of transmission to those
individuals in the household.
Dr. Wenstrup. If I could before I turn it over to the
Ranking Member for questions, you know, I have recommended any
chance I get to say this vaccine is different from the other
vaccines, and really this mRNA vaccine has been more of a
therapeutic than the other vaccines have proven to be as far as
prevention. And I think that people need to know that, and our
public health system today should be shouting that from the top
of their lungs to parents of young children to make sure they
get those other vaccines. But when they say you must get this
one as well, I think that is an injustice, and that is harming
our system, if that is what they are advocating.
I yield to the Ranking Member for his questions.
Dr. Ruiz. Thank you. I am going to put my doctor hat on
right now. Natural infection creates an immune response in
immuno-competent people. We have known that. We have known that
for a very long time. Nobody ever denied that. Nobody ever said
that getting an infection doesn't create an immune response,
OK? The immune response and protection depends on several
factors and varies based on viral load, age, and immuno-
competency, so it is not an easy, standard response that
everybody is going to have. However, natural infection with
this virus causes severe illness, hospitalization. With this
virus, not the chickenpox, can send you to the ICU. With this
virus, natural infection can cause deaths, 3,000 per day, in
fact. You know, this virus that mutates and that has an immune
response that wanes leads to the need of re-boosting your
immunity.
The goal is to boost your immunity to mount a rapid and
strong immune response so that you don't get symptoms, miss
work, or transmit it to a high high-risk loved one or go to the
ICU or, God forbid, die. That is the goal here, people. Let's
take a step back. Who wants to get sick and miss work? Who
wants to transmit this to your little one or your elderly, you
know, grandparent even if you have been vaccinated? So, the
best way to avoid symptoms from a natural infection or the risk
of long COVID or hospitalizations or death is by boosting your
immune response passively with a vaccine, OK?
Now it sounds like the narrative being pushed is to get
infected with COVID-19, and if you get infected, then you don't
need a vaccine, or prefer to get a natural infection over a
vaccine for a deadly virus, or that if you get infected, then,
disregard the vaccine or the booster. That seems to be the
narrative here. That is just wrong, guys. It is just wrong,
contrary to medical and public health practice, and it violates
the oath of doing no harm.
Look, let me clarify some things. Vaccines don't cause long
COVID. Vaccines do not cause long COVID. Natural infection
causes long COVID, OK? Active infection, even mild infections
cause long COVID. Let me clear up another misinformation
already stated. Yes, vaccines help reduce transmission. They
help reduce transmission. It is not 100 percent you get a
vaccine; you are not going to get infected. It is not 100
percent you get a vaccine; you are not going to spread it
somewhere. Again, the immune response, boosted by a vaccine,
hopefully is strong enough, rapid enough to defeat the viral
load and how fast it replicates in order to prevent it from
reaching a level to where you are symptomatic, and you are
transmitting it to other people.
So, with people who have that fast, strong immune response
boosted by a vaccine, you are going to be able to prevent
getting infected, and you are going to be able to prevent
transmitting it to other people, definitely hospitalizations
and definitely death. But some people who are vaccinated may
have received a larger viral load, a mutated virus, and their
immune system may not have responded fast enough, and they
still may get infected. They still made transmit it, and there
may still be hospitalization. Yes, some may still even die. So,
it is not a simple black or white, 100 percent or not. It is
understanding physiology and the mechanism of the immune
response.
So, when President Biden took office, he hit the ground
running to expand access to lifesaving COVID-19 vaccines. On
his first full day in office, President Biden issued the
National Strategy for the COVID-19 Response and Pandemic
Preparedness. The Biden administration's National Strategy
leverage the Defense Production Act to rapidly increase our
supply of vaccines, stand up vaccination centers in communities
across the country, and mobilized the public health work force
to support a comprehensive COVID-19 response. So, thanks to
President Biden's leadership and investments from Democrats'
American Rescue Plan, which every House Republican opposed, we
were able to get more than 600 million shots in arms, laying
the groundwork to safely reopen 99 percent of schools, reignite
our economy, and resume everyday life.
Dr. Tan, as a fellow physician, I deeply admire your
commitment to protecting your patients, our Nation's kids from
the constantly evolving threat of infectious diseases like
COVID-19. How do vaccines work to protect patients and forge
stronger immunity, even among those who have already
experienced infection?
Dr. Tan. So, as you mentioned, vaccines work by boosting
the immunity, and we do know that hybrid immunity actually is
one of the strongest immunities in preventing hospitalizations,
severe COVID disease, and death. It also has been shown that it
prevents the development of multi-system inflammatory syndrome,
both in children and in adults. And one thing about MIS-C in
children is that many of the children who develop this are
unvaccinated, and when they do develop it, many of them either
have mild or very little in the way of symptoms. So, you cannot
predict who is going to go on to develop MIS-C.
Dr. Ruiz. Thank you. Thank you. The Biden administration
pursued a multi-pronged approach to encourage uptake of the
COVID-19 vaccine and save lives. Alongside decisive action to
increase supply and accessibility, the Biden administration
instituted commonsense requirements for healthcare workers and
Federal workers to get vaccinated. And as the novel coronavirus
evolved, the Federal Government move decisively to roll out
safe and effective boosters to better protect the American
public from new variants.
Let me be clear. These actions saved lives. According to a
Commonwealth Fund study published in December 2022, the Biden
administration's COVID-19 vaccination strategy prevented 3.2
million deaths and 18.5 million hospitalizations, and without
COVID-19 vaccines, the United States would have experienced 4.1
times more deaths and 3.8 times more hospitalizations. Dr. Tan,
how have vaccines helped us to reduce the ongoing threat posed
by COVID-19, particularly in communities that were hardest hit
by the pandemic?
Dr. Tan. So, the vaccine also helps to prevent transmission
of the disease to other individuals so that, you know, we know
that the more the virus is allowed to circulate in the
community, the more it is going to mutate, and the more
individuals are going to become infected.
Dr. Ruiz. Thank you. So, this is my last question. So, you
know, as we look to prevent and prepare for future pandemics, a
crucial component of our work must be investing in the
infrastructure to rapidly develop and deploy safe and effective
vaccines. Look, the decision to concomitantly invest in
producing the vaccine while we were in the R&D phase helped us
rapidly deploy this, so there are lessons learned that we
should incorporate in the next response. And in your written
testimony, Dr. Tan, you mentioned the need for investments in
vaccine infrastructure, infectious disease physician
recruitment, research to better understand and combat vaccine
misinformation and disinformation, and increased coverage for
vaccines. Dr. Tan, why are these measures so important for our
future public health preparedness?
Dr. Tan. This is incredibly important because these
measures will allow us to protect the largest number of
individuals so that we don't have another devastating pandemic
where you are going to have lives lost when they could have
been saved with the use of an effective vaccine. And, you know,
by building infrastructure for vaccines in both the adult and
the pediatric populations, you are going to be able to save
more lives all across the age span.
Dr. Ruiz. Thank you. I yield back.
Dr. Wenstrup. I now recognize the Chairman of the full
Committee, Mr. Comer, for five minutes of questions.
Mr. Comer. Thank you, Mr. Chairman, I want to thank our
witnesses for being here.
The pandemic has definitely undermined trust in public
health. We have heard time and time again, those in positions
of public trust in the Biden administration making misleading
or false statements regarding COVID-19. Now, I want to run
through some of these statements and ask each of our witnesses
if, at the time those statements were made, if science and data
supported these statements.
On June 22, 2021, Dr. Fauci said, ``It is as simple as
black and white. You are vaccinated, you are safe. You are
unvaccinated, you are at risk. Simple as that.'' Yes or no, Dr.
Makary, does science and data support that statement?
Dr. Makary. Not anymore.
Mr. Comer. Dr. Smelkinson.
Dr. Smelkinson. I mean, it did appear like that. In the
summer of 2021, it did seem like the vaccines were doing pretty
well at suppressing infection and spreading it, but shortly
thereafter, it was not, and they didn't look at that in the
trials.
Mr. Comer. Dr. Tan?
Dr. Tan. I think at the time, based upon the science that
was available, the statement was appropriate, but I think now,
the pandemic is evolving----
Mr. Comer. Right.
Dr. Tan [continuing]. So that we have to be agile enough to
really go along with that.
Mr. Comer. Right. On May 16, 2021, Dr. Fauci said, the
vaccinated became ``a dead end for the virus.'' Dr. Makary, did
science and data support that statement?
Dr. Makary. In April 2021, we knew vaccines didn't stop
transmission.
Mr. Comer. Dr. Tan?
Dr. Tan. It stopped transmission in some individuals but
not 100 percent stopping.
Mr. Comer. Dr. Smelkinson.
Dr. Smelkinson. I agree with what they both said. It
didn't, 100 percent.
Mr. Comer. On May 19, 2021, Director Walensky said, ``Even
if you were to get infected during post-vaccination that you
can't give it to anyone else.'' Dr. Makary, did science and
data support that statement?
Dr. Makary. No.
Mr. Comer. Dr. Smelkinson.
Dr. Smelkinson. No.
Mr. Comer. Dr. Tan.
Dr. Tan. You were less likely, but it is not 100 percent.
Mr. Comer. On March 29, 2021, CDC Director Walensky said,
``Vaccinated people don't carry the virus, don't get sick.''
Dr. Makary, did science and data support that statement?
Dr. Makary. It did not.
Mr. Comer. Dr. Smelkinson?
Dr. Smelkinson. I mean, again it may have appeared that way
for a while, but the trials didn't look at that.
Mr. Comer. Dr. Tan?
Dr. Tan. Yes, the trials didn't look at that, so the
appearance was yes.
Mr. Comer. Finally, on June 21, 2021, President Biden said,
``If you are vaccinated, you are not going to be hospitalized,
you are not going to be in the ICU unit, and you are not going
to die.'' Yes or no, Dr. Makary, did science and data support
the President's statement?
Dr. Makary. We thought that early on, but they denied the
overwhelming data that that was not true and made that
statement after that data were clear.
Mr. Comer. Dr. Smelkinson.
Dr. Smelkinson. That was around the time where
breakthroughs were happening more rapidly, so I think that we
could have seen that that was going to devolve into more
reinfections.
Mr. Comer. Dr. Tan.
Dr. Tan. I think there was some support for that, but, you
know, nothing is 100 percent, so I think science and data at
that time was evolving.
Mr. Comer. Dr. Makary, by July 21, 2021, were there
vaccinated Americans that had caught COVID-19?
Dr. Makary. Absolutely.
Mr. Comer. Were there vaccinated Americans in the hospital
for COVID-19?
Dr. Makary. Absolutely.
Mr. Comer. Were there vaccinated Americans that had died
from COVID-19?
Dr. Makary. Absolutely.
Mr. Comer. Dr. Makary, was the President lying?
Dr. Makary. There was a lot of misinformation spread by
public health officials that we had to close schools, that
vaccinated immunity was much stronger than natural immunity,
that the ideal dosing interval was three or four weeks, that we
had to boost young people with no evidence to support it. On
long COVID, on ignoring natural immunity, there was a lot of
misinformation spread during the pandemic, a lot spread by the
CDC.
Mr. Comer. And I think this is why there is a lack of trust
in American public health. Our leaders were unwilling to speak
the truth and unwilling to follow the facts, and that is a big
deal. Mr. Chairman, I appreciate the topic of this hearing.
This a very important hearing. We have got a lot of work to do
in America to regain the trust of the American people in public
health. With that, I yield back.
Dr. Wenstrup. Thank you. I now recognize the Ranking Member
of the full Committee, Mr. Raskin, from Maryland for five
minutes of questions.
Mr. Raskin. Thank you very much, Mr. Chairman. I just want
to start with a small semantic problem. Some people are
contrasting natural immunity with vaccination, but actually,
natural immunity is, well, natural, and our bodies will create
antibodies in response to an infection whether it is by
contracting the disease or in response to receiving a
vaccination. So, in both cases, natural immunity is operating,
and nobody is naturally immune to COVID-19. It creates an
implication that somehow some people just will never get it,
and I don't think there is any studies that demonstrate that.
So, if you can activate a natural immunity response either by
getting it or by having a vaccine, why not let COVID-19 just
wash over the whole population and create herd immunity, which
seems to be the subtext of some people's remarks here. It will
be cheaper than vaccination, and you don't have to run a
government campaign to have people get the disease. They will
just get it if you let it run wild.
Well, that was precisely the strategy advocated by key
Trump advisors during the Trump administration, and I sat on
the Select Subcommittee on the Coronavirus Crisis where we
dealt with witnesses and people who specifically advocated
this. We revealed in a report last year, which I would love to
submit for the record, Mr. Chairman, called the ``Atlas Dogma:
The Trump Administration's Embrace of a Dangerous and
Discredited Herd Immunity Via Mass Infection Strategy,'' from
June 2022. I would ask unanimous consent to accept that report.
But the administration embraced this massive infection strategy
promoted by pandemic advisor, Scott Atlas, a Fox News pundit
with no background in infectious diseases, who amazingly was
hired by the White House in the middle of the pandemic in July
2020. So, can I just ask for unanimous consent to enter this
report into the record?
Dr. Wenstrup. So, ordered.
Mr. Raskin. Thank you.
Mr. Raskin. Dr. Deborah Birx, who was then the coronavirus
coordinator for the Trump White House, told the Select
Subcommittee in a transcribed interview that she was constantly
raising the alert about the dangers of Dr. Atlas' views on this
pandemic. She warned that his wildly irresponsible herd
immunity strategy was not implementable, and leading public
health experts agreed at the time. Dr. Tan, why is mass
infection, just letting the disease run over the population, a
bad idea, even though it will activate natural immunity?
Dr. Tan. Well, the problem is that you are going to have a
lot of individuals that are going to get seriously infected.
They are going to be hospitalized, which is going to completely
overwhelm the system, and there are going to be far more deaths
if you let somebody just get infected to be infected. We see
that with the chickenpox parties that used to be held where
people would know someone that had chickenpox. They would bring
their children over to get infected. Some of those children
would develop super infections with bacteria that landed them
in the hospital with limb loss, other types of disfigurement,
as well as deaths. So, trying to have somebody just get a
natural infection for immunity is a very risky and dangerous
way, and vaccines are the safest way for you to get immunity.
Mr. Raskin. It will lead to mass unnecessary suffering and
death----
Dr. Tan. Correct.
Mr. Raskin [continuing]. And spread of the disease. Well, a
systematic review published in Nature in January 2023 found
that hybrid immunity was more protective than immunity after
infection alone against the Omicron variant, and the
effectiveness of previous infection against hospital admission
or severe disease was 74 percent and against reinfection 24
percent. That is just having gotten it. But hybrid immunity,
meaning you get the shot two, you 97 percent immunity against
severe disease and hospital admission, and 41 percent against
reinfection as opposed to 24 without it. So that improves the
odds, too.
So, I guess my question is to you is do false and
misleading claims about herd immunity and natural immunity
ultimately undermine people's willingness to get vaccinated,
and why is this debate so politicized and polarized?
Dr. Tan. Well, I am a practicing clinician, so I can't
comment on the politicization of it, but I can say that there
already is some hesitancy with regards to receiving routine
vaccinations, and with all the misinformation that was
disseminated, it really fell on the COVID-19 vaccine to sort of
push that to a different level.
Mr. Raskin. I yield back. Thank you.
Dr. Wenstrup. I now recognize Mr. Malliotakis from New York
for five minutes of questions.
Ms. Malliotakis. Thank you very much, Mr. Chairman. Thank
you to those testifying today. You know, ignoring the science
of natural immunity led to prolonged lockdowns, school
closures, vaccine mandates, people being fired, losing their
livelihoods, particularly in a city like mine, New York. We had
a labor shortage. We had many issues as a result, and early on,
we knew that naturally acquired immunity was present for COVID-
19, and just about everyone in the world was studying COVID-19
and finding individuals developed the natural immunity. Various
studies showed that reinfections were rare, protection lasted
around one year, individuals who were previously infected with
COVID-19 were likely to benefit from the vaccination and the
natural immunity, right, and a previous COVID-19 infection
offers at least the same level or even superior protection as
two doses of a Moderna or Pfizer vaccine.
But even with all this data, the CDC and the Biden
administration began to present a false message that receiving
a COVID vaccination and booster was the only way to protect
yourself against the virus. President Biden made multiple
statements that simply did not follow the science, as those
testifying today are affirming. He said, ``If you are
vaccinated, you are not going to be hospitalized. You are not
going to be in ICU unit. You are not going to die.'' That was
false. He said, ``You are not going to get COVID if you have
these vaccinations.'' That was also false. Dr. Fauci says,
``You become a dead end for the virus.'' That was also false.
And in New York City, all public employees, including
teachers, police officers, firefighters, those frontline
workers, they were mandated need to get this vaccination or be
terminated. And as a result, nearly 15,000 city workers were
fired for not complying, many who had been recently infected.
So, since I joined Congress in 2021, I have fought for my
constituents against these arbitrary and unscientific policies.
I led a lawsuit that ended Mayor de Blasio's vaccine passport
where you could not even walk into a restaurant to get a
sandwich unless you were vaccinated. I joined a lawsuit that
struck down President Biden's vaccine mandate on the private
sector. We fought New York City to drop vaccine mandates on the
private sector and on the public sector and reinstate those
that were fired. We also voted to lift that vaccine mandate on
members of our military.
Dr. Smelkinson, let me start with you. Did President Biden,
Governor Cuomo, and Mayor de Blasio do a great disservice to
our economy and society by not incorporating natural immunity
into their policies?
Dr. Smelkinson. Yes. I mean, the data showed that natural
immunity was as protective as vaccinated immunity, and when we
are talking about equitable policies, lower-income minority
communities tended to be less vaccinated, and relatedly, they
also tended to have more natural immunity. So, these vaccine
passports that were enacted were actually quite inequitable as
well since they didn't make exemptions.
Ms. Malliotakis. I agree, and that is why we sued to stop
it. How was natural immunity not even a factor in these policy
decisions that negatively impacted so many Americans?
Dr. Smelkinson. I can't answer why it has been disregarded
because other countries have acknowledged it. I mean, that is
why these studies were run. When the vaccines came out, they
started getting busy on figuring out how does the vaccine
compare to natural immunity. There was a big Israeli study to
get at the prioritization of the vaccines. And so, I don't know
why they disregarded it.
Ms. Malliotakis. OK. Dr. Makary, do you have any inkling
there?
Dr. Makary. I think you just heard why people don't want to
recognize natural immunity. They associate with a let-it-rip,
try-to-get-the-infection strategy. No one is saying that. No
one. None of us have said that vaccines save lives. None of us,
not even the Great Barrington Declaration folks or Scott Atlas.
Look, I get it. You may not like Trump but look at Sweden's
deaths and look at Michigan's deaths. As you know, it is not
fair to compare Florida and New York because they had
infections at different times seasonally, and medicine advanced
and it is lowering the infection fatality rate. But Sweden and
Michigan are perfect comparisons: same population, same percent
of older people, identical populations. In the end, 37,000
deaths in Michigan; half, 17,000 in Sweden.
Ms. Malliotakis. Thank you. I need to get one last question
in because we recently were successful in getting the state and
city universities of New York to roll back their vaccine
mandates. Remember, these are young healthier Americans who are
attending our universities. Should private universities follow
that and rescind their vaccine mandates?
Dr. Makary. Yes.
Ms. Malliotakis. And Dr. Smelkinson?
Dr. Smelkinson. Yes, of course.
Ms. Malliotakis. Dr. Tan, I will even let you answer there.
Dr. Tan. I think in certain situations, yes, they should
rescind it. And, again, we are in a different time than we were
back when all this was occurring.
Ms. Malliotakis. Thank you very much.
Dr. Wenstrup. I now recognize Dr. Bera from California for
five minutes of questions.
Dr. Bera. Thank you, Mr. Chairman. I think we have to be
really careful here because in this debate and dialog, we need
to make sure we aren't sending a message to the public that
vaccines are bad, right? You all would agree with that. I also
think it is very dangerous to think in black and white that
infection-acquired immunity was totally discounted. It wasn't.
I mean, for folks that were on the front lines. As a doctor and
former chief medical officer, you know, when we didn't have
vaccines and we were running short on health workers and so
forth, we were in consultation with our hospitals and folks
that, you know, got infected, survived. We understood that they
have some natural immunity, and they often were the ones that
were going back and taking care of COVID patients. There was
also consideration when we did have antibody tests, do you go
out and do mass availability of these antibody tests to
determine who has had it and who hasn't had it, and so it was
not black and white.
I also understand from a public health perspective, when
you are trying to launch a mass vaccination campaign, you often
will think about things in broad terms, and mandates sometimes
do compel folks to get that vaccine. Should we have been a bit
more nuanced? Of course. Should we create exceptions for folks
that say, look, I have already had COVID who are hesitant to
get that vaccine, who may want to get that antibody test and
demonstrate that they have got sufficient natural infection-
acquired immunity? Yes, we should always have flexibility. We
should always be nuanced.
Should politicians and elected officials be speaking in
broad terms and generalities? No. I have never said that the
vaccines were going to prevent illness because no vaccine is
100 percent. Are they reducing transmission? Yes. Are they
reducing severe illness? Yes. Are they reducing death and
morbidity and mortality? Yes. Those are all factual statements
that, you know, we get. I also think we have to be very careful
because we know COVID-19 is continuing to mutate, and while you
may have natural immunity to a prior variant, we can't say with
100-percent uncertainty a new variant will not emerge where
that prior immunity is going to be protective. We can also say
the same thing about a prior vaccine, right? Part of the
reason, you know, Dr. Makary, that you said we constantly
update our influenza vaccine is because it is constantly
mutating, and prior influenza vaccinations don't protect
against new mutations.
So, we just have to be open to that because we may see a
new variant emerge next fall that our current vaccines don't
protect against, or prior infection doesn't protect against.
And I think we have got to be really, really careful in our
messaging. Now, we also may see a new mutation emerge where
prior vaccines are very protective and prior infection is very
protective, so we have got to be open to that possibility as
well. But I think for those of us who are on this Committee, I
think we have got to be very careful in making sure we don't
feed into vaccine hesitancy.
Let me ask a ``yes'' or ``no'' question. I think I know the
answer to it. Separating out the COVID-19 vaccine, all of you
believe that routine childhood vaccines, measles, vaccines all
of that are incredibly important. Dr. Makary?
Dr. Makary. The routine child immunizations are important.
Dr. Bera. Dr. Smelkinson?
Dr. Smelkinson. Yes, of course.
Mr. Bera. Dr. Tan?
Dr. Tan. Absolutely.
Dr. Bera. So, again, I would hope all of colleagues,
Democrats and Republicans on this, understand that we have a
responsibility. Look, we can debate efficacy of COVID-19
vaccines, we can debate efficacy of natural immunity, but we
need to be really careful that doesn't spill over. You know, we
are seeing measles vaccination rates drop. We are seeing, you
know, routine childhood vaccinations drop, and that is a real
dangerous scenario that keeps me awake at night because COVID-
19 is not measles. Dr. Smelkinson, as we think about lessons
learned, and this is about natural immunity versus, you know,
we can look at the Swedish data, and Sweden wasn't the best in
the world. It wasn't the worst in the world. It was kind of
middle of the road. Their own internal studies have suggested
that there were things that could have been done differently.
Dr. Makary. That is right.
Dr. Bera. They took a different approach. We should
continue to look at these approaches, but what Sweden did
incredibly well that helped them end the pandemic is they
launched a mass vaccination campaign fairly quickly and
actually have higher vaccination rates than we have in the
United States. Now, again, they are doing an internal study. I
would hope we could do that study to get a sense of what we did
right and what we did wrong, and that is what I would hope this
Committee does.
Dr. Makary. If I could just point out, Sweden does not
recommend the COVID-19 vaccine for children under 12. They did
good in their vaccine rollout, better than us, but not by a
lot. So, I think there are a lot of factors that went into
play, but I appreciate every comment you made, Congressman
Bera. Thank you.
Dr. Wenstrup. I now recognize Dr. Miller-Meeks from Iowa
for five minutes of questions.
Dr. Miller-Meeks. Thank you, Mr. Chair, and I appreciate
the comments, but I am going to clarify some misinformation by
my colleagues. No. 1, as a physician and as a former director
of public health, it is understood in medical vernacular and
public health circles that natural immunity refers to immunity
after infection or infection-acquired immunity, not immunity
from vaccine. Would you agree, Dr. Makary?
Dr. Makary. It has always been the case.
Dr. Miller-Meeks. Dr. Smelkinson?
Dr. Smelkinson. I mean, it is all the same cells being
generated. In that sense, I guess it is natural, both of them,
but one is a therapeutic and one is from the virus.
Dr. Miller-Meeks. Correct. And Dr. Tan?
Dr. Tan. No. I mean, agreed that, you know, you are
generating the same cells to produce immunity to protect
yourself, so in that sense, they are both natural.
Dr. Miller-Meeks. Correct, but when we say, ``natural
immunity,'' we are referring to infection-acquired immunity. I
want us to have the same language, and the reason that is
important is because, although I agree with almost everything
Dr. Bera said, where I disagree, was that natural or infection-
acquired immunity was not discounted. I can tell you that I was
censored. I was reported to the Board of Medicine in my state.
I was, you know, threatened to be taken off platforms. I have
been on this Committee now. This is my third year. I have asked
this question of Dr. Fauci and of Dr. Walensky and of public
health directors behind me, who even into 2021 and 2022, were
reluctant to acknowledge that there was infection-acquired
immunity. And let me say I was vaccinated. I gave the COVID-19
vaccines in all 24 of my counties.
And when you talked about natural immunity, no one was
suggesting that people go out and attend a COVID-19 party and
not get vaccinated. What we were asking for, the nuance that
you mentioned, which was that we acknowledge that there is
infection-acquired immunity, and, therefore, we risk stratify
who we recommend vaccinations to, especially when you don't
have enough vaccine to go around, and it is extraordinarily
costly. That prepares us for the next pandemic, how we risk
stratify.
And this also goes into the concept of herd immunity, which
is, again, that doesn't distinguish between natural immunity or
vaccine-acquired immunity. It is the percent or the prevalence
of the population that is immune. I even put forward a bill
because of this difficulty with recognition of natural
immunity. It was if public health professionals and medical
doctors lost their sense of their education in denying that
there was such a thing. I put forth a bill to mandate testing
by all insurance companies of both humoral immunity and T cell
immunity so people could document that they were immune and
then not be fired from a job in the military or in the
healthcare work force or another job.
And so, if I sound passionate about this, I am extremely
passionate about it because we have to get the science right.
We have to get the messaging right, and the message was very
wrong when we didn't acknowledge infection-acquired immunity.
We can do both. We can walk and chew gum. We can say there is
infection-acquired immunity, but depending upon your risk
level, it could be very detrimental for you to wait to get
infection-acquired immunity. We can do both of those things,
and it is important to do them.
So, I apologize. You can see the lack of responsiveness I
got from four public health officials. We knew early on in 2021
about infection-acquired immunity, about a better level of
immunity from both infection-acquired and COVID vaccine. And,
Dr. Makary, you conducted one of the first long-term studies to
look at COVID antibody levels nearly two years after infection.
You know, what was it like trying to do this study, and did the
NIH or CDC support your inquiry?
Dr. Makary. It was nearly impossible to study natural
immunity. My Johns Hopkins colleagues and I published a study
on natural immunity, basically drawing the blood of people who
had COVID in the past and did not have vaccines, to measure
their antibody levels, and we found those antibodies were
present and durable up to nearly two years after infection. Why
did the NIH or CDC not invite people who were infected in the
early days to test their blood? No one was supposed to talk
about natural immunity. It was misinformation, even if it was
scientifically valid, because they thought maybe somebody might
try to get the infection, so let's not be honest with the
American public. That is the basis for it, and that is what
public health officials told me privately.
Dr. Miller-Meeks. So, like me, you have no idea why they
ignored it.
Dr. Makary. There was no money for it, they didn't want to
talk about it, and they wanted to promote an indiscriminate,
all-or-nothing vaccine strategy that meant all the vaccines
could be four today or seven, depending on your age, or
nothing. And if you don't do all of them, you are not fully
vaccinated, and you don't meet the criteria of the Novak
Djokovic doctrine. You are not allowed to travel into the
United States. You are not allowed to play tennis outdoors. It
was an absolutism. That is what ruined public health
credibility is not being honest.
Dr. Miller-Meeks. And I apologize. Did this also lack of
acknowledgement of infection-acquired immunity play into how
often we recommended people to be boostered and the age at
which they should both get COVID-19 vaccine and boosters, even
if they had both infection and vaccine?
Dr. Makary. Yes, for public health officials, it was all or
nothing. Doctors on the ground were customizing their vaccine
recommendations. You have had COVID twice, including four
months ago? I am not going to recommend the booster because you
are young and healthy, and there is no data to support it. That
is how doctors practiced medicine, but that was labeled
misinformation by the medical elites.
Dr. Miller-Meeks. Thank you so much, and if I may, I would
like entered into the record a letter that the Doctors Caucus
sent to Dr. Walensky in September 2020 asking questions, and
making inquiries into infection-acquired immunity, and looking
at real-world evidence and data and research from other
countries.
Dr. Wenstrup. Without objection.
Dr. Miller-Meeks. Thank you, sir. I yield back my time.
Dr. Wenstrup. I now recognize Mr. Mfume from Maryland for
five minutes of questions.
Mr. Mfume. Thank you very much, Mr. Chairman. I want to
take exception with something that I heard here in this
hearing, and that is that racial minorities across our country
had a greater sense of immunity and were impacted less by this
disease. In fact, infection-acquired immunity and all the other
things were even more dangerous in minority communities, both
when looking at death rates and broader inequalities in the
healthcare system. In fact, the total cumulative data that we
have and is available to all of us show that black Americans,
Hispanic, American Indians, Native Alaskans, Native Hawaiians,
and Pacific Islanders all suffered higher rates of COVID-19
cases and deaths. That is the record, so the suggestion from
some that, well, it was not that bad in these minority
communities I think is a biased, xenophobic, and absolutely
incorrect proposition to be putting forward. So let the record
really reflect that those communities got hit harder, and those
deaths rates were higher, and those cases went up.
I think what we ought to do here is to sort of transport
ourselves back to the dark, difficult days of COVID. We are
looking back now is if we are looking through Alice in
Wonderland's looking glass at what took place, and we all run
the risk of being Monday morning quarterbacks. What we were
dealing with we were dealing with in real time. Were there
assumptions that were incorrect? Yes. Were there efforts
underway to try to grab and get ahold of this? Yes. Did some of
them work? No. Did some of them work? Yes. But when you are in
the middle of a crisis, you are not trying to look to find the
perfect way out. You want a way out to be able, particularly in
this case, to save lives. So, it is great to look back and say
if we could have, should have, would have, but the fact of the
matter is that this entire Nation was dealing with something in
real time.
People were washing their hands and told they need to wash
them 20 to 30 times a day. Many of us thought that this disease
was transmitted by touching. Others thought it was transmitted
because of closeness. There were quarantine times that varied
from 7 days to 17 days. Students on college campuses and other
young people were afraid to get a vaccine because the social
media posts were saying it will create infertility among you.
We were washing our groceries as they were being dropped off at
our door before, we brought them into our homes. So, we were in
real time, and in real time you are going to get some things
right and you are going to get some things wrong, but at the
end of the day, the real key is to try to find a way to save
lives.
Now, my bigger concern, Mr. Chairman, is that we don't play
into the notion of vaccine hesitancy. It takes us down a dark,
difficult path and one that we all, I hope, don't want to go
down, particularly when we see now that measles, mumps, and
even polio are starting to reemerge in this country because of
hesitancy, in many instances by parents who don't want to get
vaccines for their children, and in other instances just
because people have this boogeyman theory that somehow or
another, if you put something in your arm that has been
scientifically and medically researched and approved that it is
going to distort you, change your DNA, create a monster, or do
something far worse.
So, I hope and really pray that this hearing does not add
to this notion of vaccine hesitancy. Is it important to look
back? Absolutely, yes. That is the only way we can identify
things that we agreed with, disagreed with, things that worked
and didn't work. But to assign blame when we were all trying to
figure this out together, I think, is absolutely the wrong way
to go, and that means Republican blame, Democratic blame,
Independent blame. We were all in real time.
So, it troubles me when I continue to see the sort of
political machinations that are taking place, pointing the
finger and blaming, and say we created a worse problem than we
had. Actually, I thought we did pretty good getting out of the
problem that we did have, and I think we have our larger
medical community to thank for that and the number of people
who were on the line, who were not physicians but regular men
and women who worked in jobs where they were very susceptible
of becoming ill, who went to work every day, who we don't even
talk about now because we took them for granted.
So, we have come a long way since we were in the middle of
this crisis, and I think it is important to always keep that in
consideration and in the right context. I yield back. Thank
you, sir.
I now recognize Mrs. Lesko from Arizona for five minutes of
questions.
Mrs. Lesko. Thank you, Mr. Chair.
Dr. Wenstrup. Actually, if I may before you begin. We will
reset the clock. Mr. Mfume, you made a statement that I could
recognize from the panel that they are confused on who you
thought made a statement, and I would like them to have the
opportunity to maybe clarify or rectify or respond to the
accusation of what someone said, you know----
Mr. Mfume. Sir, you are the Chair, so you----
Dr. Wenstrup. Which doctor? Which doctor? I would like to
let them have the opportunity----
Mr. Mfume. Dr. Smelkinson.
Dr. Wenstrup. Thank you.
Dr. Smelkinson. Yes. Thank you for giving me the
opportunity to respond. I actually do agree with you, and I
said that the lower-income communities did tend to have more
natural immunity. They were more impacted by COVID-19. They
also tended to be less vaccinated. I think that those things
are linked. When it came to the vaccine mandates that made no
exemptions for natural immunity, my point was that those
mandates were not very equitable because if you are if you are
not making exemptions for natural immunity, those communities
weren't able to live up to the mandate.
Dr. Wenstrup. Thank you. Mrs. Lesko, you are recognized.
Mrs. Lesko. Thank you, Mr. Chair, and this is a great
discussion because the purpose of this Committee, from my
understanding, is to try to learn from what we did right and
what we did wrong so when the next pandemic comes along, we
aren't going to repeat it, hopefully.
So, my first question is for Dr. Makary. In October 2020,
Rochelle Walensky, who would later become CDC director, co-
authored a memorandum published in the Lancet that stated,
``There is no evidence for lasting protective immunity to SARS
CoV-2 following natural infection.'' Was there any data at the
time that would have supported her statement or refuted her
statement?
Dr. Makary. Well, first of all, the absence of evidence
isn't the evidence of absence, and she should have known that
all other viruses yield natural immunity with ultra-rare
exceptions, including the two other coronaviruses that cause
severe illness in humans. Both were studied to have long-term
immunity, so I think it was intellectually dishonest. But even
worse, she dug into her position as the data were overwhelming,
even to this day the Djokovic doctrine in place yesterday in
America prevented teachers at federally funded schools from
working. We won't allow people with natural immunity to work
unless they have the full vaccine primary series. Well, guess
what? We are hurting children from ignoring natural immunity.
It is not historical. It is not looking back and blaming.
It is right now. A hundred and sixty schools in Missouri have
gone down to a four-day school week because they don't have
enough teachers. They have left. Hospitals are understaffed.
Response times are longer for first responders, not because of
a historical mistake. They are still ignoring natural immunity.
Even at my university, you can't go to school without the
primary vaccine. Even if you have had COVID three times and
were in the ICU with myocarditis, you still need to get the
COVID vaccine. That is intellectually dishonest.
Mrs. Lesko. Thank you. That is very passionate, very
appropriate because our last hearing we had was about school
closures and how that adversely affected students. You know,
did you bring this up, and I haven't done the research. So, did
you bring up the natural immunity, and were you shut down? Were
you censored?
Dr. Makary. I was not censored. I always cited data, but I
can tell you that natural immunity was considered
misinformation by our public health oligarchs as they spread
their own misinformation on many other topics.
Mrs. Lesko. And a related question to all three of you, in
the early stages of the pandemic, do you believe that Federal
public health officials were aware of the centuries-old
knowledge of infection-acquired immunity?
Dr. Smelkinson. Yes, they were definitely aware of that,
but even if they thought SARS CoV-2 was different, certainly by
mid-2020, there was a lot of immunological data showing that
recovered patients had a very robust B cell and T cell
response, and they were seeing that it was lasting over many,
many months, so they did, and it was very similar to the T
cells that were made by SARS-1 that were still reactive almost
20 years later. So yes, I think they knew early on that natural
immunity was strong.
Dr. Tan. I think they knew that there was some natural
immunity. I would imagine that the question they were asking is
how much do you need to be protective. And, you know, at the
time because there was so much disease going around, they had
to make very difficult decisions as to what was going to be
beneficial for the majority of the individuals.
Mrs. Lesko. Did you want to add anything?
Dr. Makary. If I could just add, because in my role as
editor-in-chief of Medpage Today, the second largest trade
publication read by doctors in the first two years of the
pandemic, I asked has anyone seen a healthy person who has
recovered from COVID show up in an ICU. The answer was always
no. Maybe there is somebody out there, but by and large, it
protected against severe disease in the first two years. It was
always right in front of our eyes. A New England Journal of
Medicine study where the editors are your friends and they
called it misinformation, that was establishment group-think,
and the reality is we always knew those precious lifesaving
vaccines should not have been going to people, first in line
already immune with natural immunity, as thousands died a day.
So, it was not a philosophical point. Thousands of
Americans died from natural immunity and over a million people
left the work force, and we are still suffering in schools and
hospitals, in all sorts of settings because of that ignorance.
And they still haven't issued any kind of apology, rehiring, or
back pay in the vast majority of those instances.
Mrs. Lesko. Thank you, and I yield back.
Dr. Wenstrup. I now recognize Ms. Ross from North Carolina
for five minutes of questions.
Ms. Ross. Thank you, Mr. Chairman. I'd like to start out I
know we have pointed a lot of figures and a lot of places on
both sides of the aisle, but I want to commend the Biden
administration's work in delivering and deploying COVID-19
vaccines. And there is no doubt that the strong coordination
between public health organizations, governmental agencies, and
healthcare professionals helped save countless lives. And that
happened in my home state of North Carolina, where our
Department of Health and Human Services went to every corner of
the state, worked with Latino medical professionals, worked
with the Native-American community, helped the African-American
community overcome vaccine hesitancy from, you know, a history
of racial discrimination. And we need to praise the people who
made sure that people who needed vaccines got them as quickly
as they possibly could, and these efforts are a testament to
our Nation's ability to respond to a health crisis.
The rapid development, which I would give the Trump
administration credit for, the delivery and the administration
of vaccines was not only critical for our domestic response but
played a major role in the international community and was
instrumental in saving lives around the world. We sent vaccines
around the world, and our vaccine strategy strengthened our
relationship with many of our allies and reaffirmed our
commitment to addressing the pandemic on a global scale. I
would also like to address the fundamental representation that
some, not all, of my colleagues on the other side of the aisle
have made, which is that somehow infection-acquired immunity
replaces the need for a vaccine. We need them both. We need
them both.
While COVID-19 infections do confer immunity, it does not
reduce the role that vaccines play in safely promoting
widespread immunity. For example, any argument that assumes
that everyone will survive a COVID-19 infection fails to take
into account various risk factors that people face,
particularly the elderly, and we saw that in nursing homes,
people with underlying conditions and people who are
immunocompromised. And many of those people live in households
with young, healthy people who might bring COVID into the home.
My brother has lupus and lives in a household with teenagers.
Dr. Tan, what risks do infections pose to the communities that
I mentioned?
Dr. Tan. Actually, you bring up a really good point.
Infection in those communities, so immunocompromised, the
elderly, the very young under a year of age, and those with,
you know, underlying comorbidities, infection really
significantly increases the risk of the development of
complications, hospitalizations, and dying from COVID-19.
Ms. Ross. And did we see people dying?
Dr. Tan. Absolutely.
Ms. Ross. And does vaccination reduce the threat of
infection posed to these particular communities?
Dr. Tan. Absolutely.
Ms. Ross. Also, I want to talk about long COVID. Long COVID
has been shown to be more frequent and more severe among people
who are not vaccinated. Dr. Tan, how do other effects of long
COVID factor into the vaccine versus infection-acquired
immunity conversation?
Dr. Tan. So that is a very good point in that we know that
if someone is vaccinated, they are significantly less likely to
develop symptoms of long COVID, and the same is true for multi-
system inflammatory syndrome, which is one of the consequences
that we see both in children and adults, but much more in
children. And those that are unvaccinated are much more likely
to go on to develop MIS-C as opposed to those that are
vaccinated.
Ms. Ross. In the few seconds that I have left, Dr. Tan, in
your written testimony, you note, ``The body of evidence for
infection-acquired immunity is more limited than for vaccine-
induced immunity.'' Can you explain this a little bit more?
Dr. Tan. So, you know, I think what we are learning is that
with vaccine-acquired immunity, we know that it does provide
protection and that the amount of protection has changed a bit
with regards to the emerging variants of Omicron that have now
become the main players for COVID now. And so, with that, we
are able to produce a vaccine that is going to be effective and
provide better immunity against the Omicron variants. Likewise,
we know from one of the studies that the immunity that you get
from infection-induced immunity prior to the Omicron does not
protect as well against preventing reinfection with an Omicron
variant.
Ms. Ross. Thank you, and I yield back.
Dr. Wenstrup. I now recognize Mr. Cloud from Texas for five
minutes of questions.
Mr. Cloud. Thank you, Mr. Chairman, and I wanted to take a
moment and kind of clear up some of the, really, misinformation
even coming from this campaign. The Ranking Member has alluded
a number of times, along with some Members of his side of the
Committee, that that those of who are saying the public
officials should have considered naturally acquired immunity
and the data there, and the over millennia of scientific
understanding about that, that we were somehow advocating for
COVID-catching parties, it is ridiculous and itself is
misinformation.
Using that same logic model, I could claim that they are
advocating that the government public officials should be lying
to the American people in order to enforce mandates and do
other kinds of things that happened to keep people out of their
profession, to keep medical experts who were speaking to this
issue out of their scientific understanding and data, that they
should have been banned from Big Tech, and conspiring with Big
Pharma to do that. I am not making that accusation, but that is
exactly what the same logic model would do.
And so, I think it is about time that we get back to
talking about what happened because vaccine hesitancy is an
issue. I am thankful that the vaccine was created. I am
thankful that was developed, and for those that it helped. What
is a big issue and even a bigger issue, and certainly within
jurisdiction of this Committee as a subcommittee of government
oversight, is to make sure that our taxpayer-funded public
health officials aren't conspiring against the very people they
are supposed to be serving.
Time and time again, the American people were told by Dr.
Fauci and the Biden administration to take the vaccine, and at
the time it was experimental at best. The data was very new. It
was necessary, you know. There was emergency use authorization
because we didn't know what we were dealing with, but then it
began to be mandated on the people. People lost jobs. Suddenly
vaccine passports are made a reality. And if the shutdowns
weren't damaging enough, we had medical people that were taken
out of the industry when they were supposed to be helping
people. These people, many of them decided not to take the
vaccine, not because of conspiracy theories or anything like
that, but just because they had a natural immunity. Many
studies early on, or at least certainly a few months into it,
gave us data that this was an issue that should have been
concluded.
I would like to submit to the record an August 2021 study
later published in the Journal of Clinical Infections and
Infectious Diseases, which found that natural immunity offered
up to 13 times more protection than vaccine immunity versus
Delta, suggesting that winning vaccine efficiency and robust
and durable immunity for previously infected persons; an August
2021 study published by the Journal of Science, which found
broad antibody response from infection-derived immunity that
protected against a wide variety of COVID variants; a September
2021 study published in Nature, which showed natural immunity
offered as good or better protection against the Delta variant;
a November 2021 article in the Lancet regarding natural
immunity, which stated that ``Protection from reinfection is
strong and persists for more than 10 months of follow-up,'' and
also asked why naturally immune persons weren't given the same
considerations as vaccinated people; a November 2021 response
to a FOIA request by the CDC in which they stated they could
not provide any documentation of naturally immune persons
getting reinfected and then being transmitted to someone else;
and a September 30 ABC article that was titled, ``Hundreds of
Hospital Staffers fired or Suspended for Refusing COVID-19
Vaccine Mandates,'' that talked about President Biden mandating
vaccines for the healthcare industry.
Mr. Cloud. Dr. Makary, I would like to ask you about the
ethical concerns you have about the Federal Government
mandating or compelling medical treatment that provides such
treatment that Big Pharma basically can benefit from.
Dr. Makary. I heard from many parents who said, look, my
child, we are concerned about myocarditis. Maybe they had
myocarditis in the past and they are being told you still need
to get the vaccine. They already had high levels of antibodies.
A nurse, who was going to get fired for not being vaccinated,
already had high levels of the antibodies that neutralize the
COVID virus, but they were antibodies that Dr. Fauci didn't
recognize. And so, we had a million people leave the work
force, and hospitals are understaffed.
So, Dr. Fauci in early 2022 sees the mountain of evidence
out there on natural immunity, including the studies you cited,
and he says, you know what? We have got to address this. A
Biden administration official has a phone call with Dr. Fauci
and four invited doctors, loyal friends of the Biden
administration who supported mandates and restrictions. And
they ask them, should we give credit for a vaccine if you had
natural immunity. The vote was tied 2-2, and Dr. Fauci says,
you know what? We are just going to continue to ignore natural
immunity, and we have the Djokovic doctrine that lives up until
yesterday. Why would you put such a critical vote on policy in
front of a straw poll of a couple like-minded friends?
Mr. Cloud. That is tragic, literally. I yield back.
Dr. Wenstrup. Mr. Cloud, without objection, the articles
you referenced are submitted for the record.
Mr. Cloud. Thank you, Mr. Chairman.
Dr. Wenstrup. I now recognize Mr. Garcia from California
for five minutes of questions.
Mr. Garcia. Thank you very much, Mr. Chairman. I was mayor
of Long Beach for the last eight years, so we have a large
public health department, about half a million people, so I saw
firsthand the impact of our vaccine rollout and how important
it was to public health. And our region and broader L.A. County
was hit really hard during 2020/2021 during that winter surge,
of course, before vaccines were available. Our regional
healthcare system was at a breaking point. ICUs were full. On
certain days, we were losing dozens of lives across L.A.
County. It was a horrific experience. In my city alone we lost
1,300 people from our community. We know that across the
country, we have lost over 1.3 million American lives. One of
those lives was my mother. Another was my stepfather. I know
the impacts of this pandemic and how destructive it can be on
families.
I want to remind us that during that time, there was a
Regional Quality Health Index on the quality of air, and the
amount of crematoriums that were actually having to be in
operation where damaging air quality. That is how horrific the
time was, and I think it is important to remember how bad the
pandemic actually impacted us because I think we have a
tendency to forget the lives impacted and the real impact to
our economy as well.
We did everything we could to get folks vaccinated in Long
Beach. We were the first city to vaccinate 99 percent of our
seniors in California, the first city in the state of
California to vaccinate our teachers. Both the Governor and the
President called our approach a national model, but I am very
concerned about the attack on vaccination efforts. I am very
concerned when folks within the Congress, even on this
Committee, put out disinformation about what vaccines are.
There are 3 million Americans today that are likely alive
thanks to vaccinations. We know this, and despite this, many of
our colleagues in the majority have chosen to undermine COVID
vaccinations in general. I want to also point out that
misinformation hurts our efforts. We know that Republicans in
general are 2 1/2 times more likely to believe misinformation,
and studies have shown that states with higher vaccination
rates have had significantly fewer COVID deaths, so these are
facts.
I want to share some examples of this harmful
misinformation today and the rhetoric that has actually led to,
I think, huge public health emergencies in this country. This
is one tweet that has actually been sent out by a Member of
this Committee, which essentially says that we are suggesting
that COVID vaccines are associated with nearly 6,000 deaths and
actually encouraging folks to not get vaccinations. Dr. Tan,
what do you think about this claim about the 6,000 deaths
around vaccinations?
Dr. Tan. Well, in this country, we have a very, very robust
vaccine system that looks at all the different potential
adverse effects that may be associated with vaccines. So, the
problem is that some of these deaths, even though they are
reported, it may have been the vaccine was given, but the death
was not due to the vaccine itself.
Mr. Garcia. Absolutely. Absolutely right, and actually to
say, no, do not get the vaccine is completely irresponsible.
Would you agree with that?
Dr. Tan. I agree.
Dr. Jackson. Mr. Chairman, point of order.
Mr. Garcia. Dr. Tan----
Dr. Jackson. Mr. Chair?
Mr. Garcia [continuing]. I also would like to go to the
second----
Dr. Wenstrup. The gentleman will suspend.
Dr. Jackson. His remarks are clearly disparaging and
sullying a Member of Congress.
Mr. Garcia. I am just clearly pointing out facts from
public statements.
Dr. Wenstrup. The Chair reminds the gentleman from
California to observe proper decorum. The issues we are
debating are important ones that Members feel deeply about.
While vigorous disagreement is part of the legislative process,
Members are reminded that we must adhere to established
standards of decorum in debate. It is a violation of House
rules and the rules of this Committee to engage in
personalities regarding other Members or to question the
motives of a colleague. Remarks of that type aren't permitted
by the rules and aren't in keeping with the best traditions of
our Committee. The Chair will enforce these rules of decorum at
all times and urges all Members to be mindful of their remarks.
Mr. Mfume. Mr. Chairman?
Dr. Wenstrup. You may proceed.
Mr. Mfume. I have a point of order on this side.
Dr. Wenstrup. You are recognized.
Mr. Mfume. Mr. Chairman, I don't know that the gentleman
from California was disparaging anyone. He put up a tweet, that
is a fact, that exists online, available for anybody to look
at. And so because we customarily throughout the Congress will
take quotations and quotes and use them once they appear in the
public record, I think this is in keeping with that, and I
don't think this was an effort to disparage but an effort to
instead point out what a particular Member or Members of this
Committee may have put out themselves in the public space that
we all refer to as social media.
Dr. Jackson. Mr. Chairman, I believe that the Member said
she was clearly trying to cause harm.
Dr. Wenstrup. At this point, it is the ruling of the Chair
that the gentleman may proceed. However, I remind the gentleman
to be cautious and to understand the decorum as he proceeds
with his remaining time of 1 minute and 46 seconds.
Mr. Garcia. Thank you very much. I will just read the next
few public statements. I appreciate that. This next tweet
actually, and I will just go ahead and read what it says here,
it says, by a Member of this Committee, ``The FDA should not
approve the COVID vaccines. There are too many reports of
infection and spread of COVID-19 among vaccinated people. These
vaccines are failing and do not reduce the spread of the virus
and neither do masks.'' You can read the rest of it here. Dr.
Tan, what do you think about this tweet, about the FDA not
approving vaccines? Do you think that is helpful or hurtful in
vaccine information and misinformation?
Dr. Tan. I think it would be hurtful if the FDA did not
approve the COVID vaccines because we know that COVID vaccines
saved millions of lives----
Mr. Garcia. Thank you.
Dr. Tan [continuing]. By their approval and their use.
Mr. Garcia. And I will show you one last one just to ensure
that we were on track, and, again, I will just read the tweet.
It is a public statement. This tweet actually says that
``Vaccinated employees get a vaccination logo just like the
Nazis forced Jewish people to wear a gold star. Vaccine
passports and mask mandates create discrimination against un-
vaxed people who trust their immune systems to a virus that is
99 percent survivable.'' Do you think that this tweet which
compares vaccinated people to Jewish folks living under the
Nazis, what kind of impact would this have, you think, on
public health?
Dr. Tan. I think it would have a negative impact on public
health, and I respectfully disagree with that particular
sentiment that has been put forth. I mean, we know that
vaccines are lifesaving, and they should be made available to
everyone so that there is no disparity.
Mr. Garcia. Thank you very much, Dr. Tan. I really
appreciate that. I think it is really important for us to
remind the Committee and the public about public statements
that are made by Members of this Committee, particularly as
questions are asked, and so thank you very much, all, for your
service. I yield back.
Dr. Wenstrup. I now recognize Dr. Joyce from Pennsylvania
for five minutes.
Dr. Joyce. Thank you, Mr. Chairman. Let's regain the focus
of this hearing, which is, and again, ``Investigating Pandemic
Immunity: Acquired, Therapeutic, or Both.'' In January 2022,
data from the CDC Morbidity and Mortality Weekly Report showed
that during the Delta surge, case rates for individuals with
previous infection and no vaccinations were nearly four to five
times lower than case reports for those individuals who were
only vaccinated. CDC data showed the hospitalization rates also
followed that similar pattern. Yet despite this data and
decisions made by other nations, including the EU, to recognize
the recovery from COVID-19 on the same level as vaccination
status, the administration still maintained or fought to
maintain a variety of vaccine mandates, either through CMS, the
Department of Labor, that failed to account for the importance
of natural immunity.
Dr. Makary, in your opinion as a physician, what impact has
the administration's disconnect between the data and the policy
regarding natural immunity had on the credibility of the CDC
and actually the Biden administration at large?
Dr. Makary. Well, there were a lot of broken promises,
regardless of what political party somebody is a member of. The
promise by the Biden administration and Dr. Fauci is that we
would not have vaccine mandates. That was a broken promise.
They ignored natural immunity right up until this day in all
their policies, and this has resulted in damaged public trust.
Now, we have been for centuries building public trust in
the medical profession. A lot of that went down the drain when
they lied to the American people saying that schools have to be
closed for two years and cloth masking of toddlers was
important to stop the transmission. They never even gave us the
proper data on COVID and children. Ask any pediatrician or
public health official or CDC official or Fauci or Walensky how
many healthy children have died of COVID in the last three
years. They can't tell you. Was it 90 percent of the deaths in
children with special medical conditions? That matters because
when you have a healthy young male who is at the lowest risk of
COVID and the highest risk of myocarditis, you might want to
modify the vaccine recommendation if they already have
circulating antibodies from natural immunity. They did not, and
that was the intellectual dishonesty we saw from public health
officials.
Dr. Joyce. Thank you. Dr. Makary, do you feel the processes
by which the CDC drafts and formulates, seeks input from
internal and external stakeholders, and finalizes its
recommendations and guidance, including morbidity and mortality
weekly reports, are sufficient, and do they properly reflect
the views of the outside or any contrarian opinion?
Dr. Makary. No. The CDC's own non-peer-reviewed journal,
called MMWR, MMWR is a joke. It is a joke. They publish their
own flawed studies. They weaponize research. They looked at a
small sliver of data from the state of Kentucky. It was the
most horrific methodologic study you could possibly design, and
they conclude, hey, natural immunity is no good. The study was
entirely flawed, and everybody falls for it. The medical
community claps like seals and this is great, ignoring the 130
studies at the time and the incredible historical record, all
the way back to 430 B.C. that natural immunity is effective.
And we never saw people the first two years who were healthy
come back with severe disease after they recovered, and that
should have been a sign that we were being deceived by the
weaponization of research itself.
Dr. Joyce. And you bring in an interesting discussion
point. You called it a joke, but the American people are not
laughing. The American people want to understand, does natural
immunity work? And we have evidence now that it does. Many of
us on this panel felt the CDC was very slow in reporting data,
specifically related to vaccines and natural immunity, that
they did have throughout the pandemic. How can we promote
better data stewardship through the CDC, and, most important,
how do we restore the trust in the CDC with a public, which I
stated, are not laughing, with a public that is increasingly
skeptical with the mandates, with a public that does not
respect top-down government approaches. Is there a way through
this?
Dr. Makary. We need an apology from public health
officials. We need to have scientific debate, not using
censorship, but instead using scientific evidence, and I think
we need some humility from public health officials. Neither
vaccinated immunity nor natural immunity are perfect. Let's not
try to suggest the other side is all evil, but it is not an
either. We can be honest with the public about the data and
still recommend safe practices today.
Dr. Joyce. Thank you for the discussion about honesty. I
thank you for being here today, and, Mr. Chairman, I yield.
Dr. Makary. Thank you.
Dr. Wenstrup. I now recognize Dr. Jackson from Texas for
five minutes of questions.
Dr. Jackson. Thank you, Mr. Chair. As discussed here today
in this hearing, the science we had at the time when vaccine
mandates were put in place supported the concept that
infection-acquired immunity not only provided protection but
looks like it actually provided superior protection compared to
immunity acquired by the vaccine. This is also something that
we probably knew was true based on many other studies of other
coronaviruses, such as SARS and MERS.
It was stated earlier that natural immunity was not
disregarded in the healthcare system. I just want to point out
that that is absolutely not true. Natural immunity was
discounted in the medical community, and that was evidenced by
the large number of healthcare workers that were subsequently
fired because they refused to get the vaccine, ones that had
documented COVID infections and had recovered from it.
And that brings up a point. A point was made earlier that
you needed to rely on antibody testing, and that made it
impossible to use natural immunity as a reason to let people
come to work or stay at work and not be dismissed. That is also
not true, and it is somewhat of a ridiculous excuse that was
used in the efforts to undermine any ability to be able to use
natural immunity for the purpose of keeping people at work or
school or wherever. You didn't need that. If you had otherwise
healthy individuals with documented COVID and they had
recovered, you could reliably credit them with natural
immunity. We know this, right? If they tested and people were
testing extensively, if they tested and they tested positive,
they went home and they recovered from their infection, they
came back, you could reliably say they had the infection, they
recovered from it, and they would have a natural immunity. We
know this for a variety of reasons, some of which I just
described.
Dr. Tan, I want to ask you to speak on a few things. Can
you speak on why hospitals nationwide fired rather than hire
unvaccinated nurses, physicians, and other staff with
infection-acquired immunity?
Dr. Tan. I don't have a comment on that. I don't know the
reason that hospitals did that, but, you know, I think now
there is more data on the fact that you do have immunity after
infection, and that immunity can play a role in be being
protective. But I can't comment on why hospitals would have
fired individuals.
Dr. Jackson. I mean, this kind of stuff is still going on
today, and we obviously know this now, and it is still
happening today. Why did hospitals implement the vaccine
mandates without providing exceptions for staff with infection-
acquired immunity? Do you know the answer to that?
Dr. Tan. I don't know the answer to that. I can say that it
was probably because they wanted to protect as many patients as
possible from not getting COVID from the person taking care of
them. And again, the pandemic has evolved, so that, you know,
when some of this was occurring early on, it was a matter of
trying to protect the patients and the people providing care to
the patients so that we didn't have COVID being transmitted in
the hospital setting.
Dr. Jackson. Can you tell me how many staff members were
let go or put on leave at your hospital for not getting the
COVID-19 vaccine?
Dr. Tan. So, people were not fired at my hospital.
Dr. Jackson. So, if they refused the vaccine, they were
allowed to continue to work and provide care to patients?
Dr. Tan. In certain places in the hospital, yes.
Dr. Jackson. So, no one at your hospital was dismissed at
all for refusal to get a COVID vaccine?
Dr. Tan. I don't about ``at all,'' but if there were a
number, it was really very, very small. I mean, we really tried
to retain as many individuals as possible.
Dr. Jackson. Well, I wish I could say that was the case all
over the country, but it definitely wasn't. It wasn't in the
area that I represent. There were many healthcare workers that
either had the choice of leaving voluntarily or being fired
because they refused to get the vaccine, and many of them are
doing it because they understood that they had natural immunity
because they had previously had an infection and had recovered
from it. Some of them had actually been sick more than once and
had recovered, and they had been tested multiple times, and it
was well-documented.
And I just think it led to a lot of problems, and it
probably led to a lot of excess deaths. We had these shortages
nationwide when we had providers that were sitting at home, not
able to take care of patients. With that, I would yield back,
Mr. Chair.
Dr. Wenstrup. I now recognize Dr. McCormick for five
minutes of questions.
Dr. McCormick. Thank you, Mr. Chair. I am happy you are
here. I consider you experts. I consider you highly qualified
to be in front of us today, and yet I find it somewhat ironic,
as we did our pre-interview, before you started testifying, we
talked about the number of patients that we treat, and it is
ironic that there are a lot of people out there that consider
themselves experts without your intelligence, without your
experience, without your acumen that were able to censor people
like myself, who has seen more patients than probably all three
of our experts here today, for COVID, that is.
And indeed, as a matter of fact, probably in all the
hearings we have had so far, all the experts that have come and
testified before us are very smart people and have so much
great expertise, and yet I was censored, censored by the
government, who had not treated one COVID patient, censored by
experts who had seen a minimal, if any, patients, and that was
allowed. Matter of fact, it was encouraged by the government.
When the President's press secretary says we are openly working
with media outlets ``to decide who to censor.'' That is our
government talking about censoring experts. So, I wanted to
point that out, the irony already.
I think it is really important when we talk about treating
patients and when we are exposed. By the way, it may surprise
you to know that I am one first people to ever get a
vaccination in America because I was on the front lines of
COVID, and it was a novel virus, and I didn't know if I had
immunity or not. Now, I knew it had been around for a while
because we had all kinds of weird fevers and symptoms, so
probably I might have had some immunity, but I got the
vaccination because I believed in the science.
But as science developed and so did our immunity, the irony
is that once we were known to be immune, once I had the
vaccination and I continued to be exposed to thousands of
patients, the booster shot continued to be explained to be
something that is beneficial, even when the CDC admitted that
it was at best minimally effective for the highest-risk
patients. And yet still, we are pushing it on pediatric
patients who had been exposed and symptomatic with no studies
on the side effects of this vaccination.
So how am I supposed to trust a government that is pushing
something with no evidence and possible real harm when our
whole Hippocratic Oath starts with ``do no harm?'' And so, I
wanted to ask you, sir, I have read your book, and I think you
are an expert in the field. I want to ask you what do you think
this does for the trust in our government, our CDC, and those
people who play politics with medicine.
Dr. Makary. I think public health officials need to come
clean and say we got natural immunity way wrong. We were so
wrong on this, long after the data were available. We are sorry
lives were ruined. If you look at what social media and Big
Tech did to any data, scientific or an experience of a parent,
on vaccine complications, it is entirely un-American. You have
a rate of myocarditis of 1 in 6,000, and when parents asked
about that, shut up. You shouldn't be asking those questions.
If you posted any study that pointed out the complications, it
was censored.
Ask any pediatrician recommending the COVID vaccine, three
shots for a young healthy 12-year-old girl, what is the rate of
myocarditis. Ask them what do you think of the Swiss study that
two percent of people after the vaccine had an elevated
troponin, an indicator of heart damage, as you know as a
physician. Ask them about that.
Dr. McCormick. So, I am unlimited time, so I couldn't agree
with you more. Here is the problem. We in America have been
very shorted on the studies allowed to find out the damage of
vaccinations. And, in fact, I am sure any immunologist would
know that once you are immune to something and you are exposed
to it repeatedly, you are likely to have a hyper-immune
response because your body is already prone. And it is
something that causes you hyper-coagulability or inflammation
that can cause a stroke, a heart attack, a DVT, or any sort of
pleural thickening in your lung, things that are life
threatening to expose yourself to a pathogen, even if it is a
vaccination, and that immune response that could cause real
harm has not been studied. We have not had an honest
conversation.
And I point out another point of hypocrisy in our
government, by the way. These same people that worry about
disease in our population are the same ones who opened up the
Southern border, and, ironically, they limited our travel,
United States citizens' travel, and business by their
vaccination status and their testing status. Meanwhile, they
let hundreds of thousands, maybe actually millions of people
across the Southern border without a test, without a
vaccination, and indeed, disseminated them during the worst
part of the pandemic all over the United States. Hypocrisy.
Hypocrisy.
And by the way, my ER was overwhelmed, overwhelmed by an
incredible amount of people who were infected by COVID, and you
had civilians, citizens paying taxes, waiting behind in line
for people who were not only not paying taxes but not paying
their bills so that they could pay the bills for those people
who were are waiting behind. Think about that and let that set
in as you pay your taxes this year. With that, I yield.
Dr. Wenstrup. I now recognize Ms. Tokuda from Hawaii for
five minutes of questions.
Ms. Tokuda. Thank you, Mr. Chairman. Let's set the record
straight on the role COVID-19 vaccine policies and boosters
have played in reopening America's schools and businesses,
preventing hospitalizations, and, most importantly, saving
lives. In the winter of 2020 when we were battling a new surge
of COVID-19 hospitalizations and deaths, we needed to meet the
moment and rapidly deploy safe, effective vaccines to the
American people. Thanks to Democrats' American Rescue Plan, we
did just that.
The American Rescue Plan included $7.5 billion for vaccine
distribution and administration nationwide, quickly getting
shots in those arms. Of these funds, $20 million went to my
home state of Hawaii, which helped fully vaccinate over 80
percent of Hawaii residents, one of the highest vaccination
rates in the country. The rollout of COVID-19 vaccine has been
so successful and, in large part, thanks to the American Rescue
Plan's bold investments and the Biden administration's decisive
leadership to protect Americans' health and safety with
commonsense policies that encourage vaccinations across the
board.
In fact, after President Biden announced vaccination
policies for Federal employees and contractors in July 2021, we
saw a 40 percent increase nationwide in vaccination rates in
just four months. Coupled with additional measures to protect
healthcare workers and robust Federal investments in vaccine
distribution, these policies have resulted in a decline in
COVID-19 deaths by 95 percent and hospitalizations by 91
percent.
Let's put this another way. In the first nine months of the
pandemic, the U.S. recorded 798 COVID-19-related deaths. By
comparison, we saw less than half that amount in the following
two years from December 2020, when vaccines were first made
available, through November 2022. That is a huge deal.
Dr. Tan, as a physician who has been on the front lines of
the pandemic, had we not taken these clear, decisive,
coordinated steps to get people vaccinated as quickly as
possible, would more people have died? Would more Americans
today be experiencing severe illness? Would hospitalization
still be strained in terms of the number of patients coming
through our doors?
Dr. Tan. Absolutely.
Ms. Tokuda. Thank you. Now, we know that if we relied
solely on immunity through infection, which was what we had
part of the vaccination being developed when we saw more than
twice the amount of deaths than we have in the last two years,
the situation in the United States would have been much worse.
The state where I am from in Hawaii, we saw quick adherence to
vaccination requirements. This led to a record amount of
vaccinations, but also what it led to was the lowest death
rates and rates of infection across the country.
Something else I would like to touch upon is the importance
of vaccines keeping pace with the highly infectious variants we
are seeing emerge today. Dr. Tan, we know that immunity from
infection alone doesn't adequately protect against variants.
Can you explain how COVID-19 booster shots have been critical
to protect us against emerging variants but also helping us to
keep schools open, a topic we have discussed in this Committee,
businesses up and running, and the rest of society safe as we
reopen and try to keep our communities clean of infection as
well?
Dr. Tan. Yes. The bivalent boosters give you specific
immunity to the Omicron subvariants, and that is currently what
is circulating at this time. And by having high immunity to
that, you basically are protecting individuals so that they are
able to go out into the community and resume more activities of
daily life, such as going to work, going to school, patronizing
local businesses, meeting with family members, et cetera.
Ms. Tokuda. Thank you. You know, in the small remaining
time I have left, I wanted to touch upon one other topic.
Unfortunately, misinformation about vaccine safety, a side
effect of the COVID-19 pandemic, has undermined confidence in
long trusted safe and effective vaccines. UNICEF has warned
parents of the danger presented by vaccine misinformation. The
world is experiencing the largest global decline in decades in
the number of children receiving basic immunization, and today
these declining vaccination rates are driving outbreaks of
previously controlled diseases, like polio, whooping cough, and
measles.
Doctors, I understand, take a Hippocratic Oath--we just
heard about it--to do no harm. As we see a resurgence of once-
dormant diseases as a result of vaccine misinformation, how
harmful is this erosion of vaccine confidence to the health and
wellness of our children, our families, and our communities?
Dr. Tan. It is normally negatively impactful. If we start
to see outbreaks of vaccine-preventable diseases, you are going
to get a lot of morbidity and mortality that may be associated
with that are occurring, especially in the pediatric
population, in people that are immunocompromised and in the
elderly. So, we need to be able to control these diseases
because all of these diseases are and can be fatal.
Ms. Tokuda. Thank you. If I am hearing you right, you know,
eroding confidence and vaccines results in deaths. Thank you
very much, Mr. Chair. I yield back my time. Thank you, Dr. Tan.
Dr. Wenstrup. I now recognize Ms. Greene from Georgia for
five minutes of questions.
Ms. Greene. Thank you, Mr. Chairman. While some Members on
this Committee have decided to use their time to disparage me
and my tweets and provide misinformation at this very important
Committee hearing, I would like to talk about the biggest
spreader of misinformation, and that would be the President of
the United States. As a matter of fact, just months before the
FDA approved the experimental COVID vaccines, President Biden
said if you get vaccinated, you won't get COVID. Then it just
so happened, one year later, the press secretary announced that
after four vaccine doses, COVID vaccine doses, that President
Biden tested positive for COVID again and was experiencing mild
symptoms. That is quite a lot different than if you get
vaccinated, you won't get COVID-19. That is spreading
misinformation.
Also, I would like to talk about how the definition of
``vaccine'' was changed, and this is really important to talk
about. Pre-2015, the CDC's definition of ``vaccination'' was
``an injection of a killed or weakened infectious organism in
order to prevent the disease.'' Then in 2015 to 2021, the
definition of ``vaccination,'' according to the CDC, is the
``act of introducing a vaccine into the body to produce
immunity to a specific disease.'' Produce immunity. Then just
right after, literally right after, the FDA approves the
experimental COVID-19 vaccines, they changed the definition of
``vaccination'' again. The new definition was changed to ``the
act of introducing a vaccine into the body to produce
protection from a specific disease.'' Talk about spreading
misinformation. I think that it is our governing bodies and the
Biden administration and many Democrats that were spreading
misinformation about these so-called vaccines.
And I am going to tell you right now, I don't think these
are vaccines at all. A vaccine would stop the spread of a
disease. A vaccine would provide immunity, but obviously the
President of the United States got four COVID-19 vaccines and
still tested positive for COVID. Dr. Makary, what is the
difference there if after four COVID-19 vaccines, clearly
vaccine so-called immunity, if the President had had natural
immunity, would he have continued to get tested or promoted
this experimental vaccine?
Dr. Makary. I don't know. I do know that people who are
against the COVID vaccine and I may not see eye to eye on
everything, but I understand why they are angry. I understand
where they are coming from because they have been lied to time
and time again, even recently. The bivalent vaccine we heard
from the White House podium; the data are crystal clear. Oh
really? It was approved based on data from eight mice. Where is
the randomized-controlled trial? Instead, they weaponize
research in the government and say, OK, here is a non-
randomized trial. People who got the bivalent did better. Well,
guess what? They are a different type of person. They are a
different risk profile.
That is the ultimate failure of our government is the lack
of a critical appraisal of important research on vaccines, on
vaccine complications, and on so many other issues like natural
immunity.
Ms. Greene. I agree with you, and I actually support many
vaccines but not an experimental vaccine that was government
mandated on the public. Dr. Tan, you said that COVID vaccines
are safe and side effects are mild. I would like to talk to you
about so-called, according to you, mild side effects. Let's
talk about how nine days after receiving the vaccine, a 6-foot-
9 healthy 17-year-old, Everest Romney, was admitted to the ICU
with blood clots in his brain. Anyone who talked about the
incident on social media was censored. Nine months later, he
was admitted for a second time. Doctors found another blood
clot, a deep vein in his right leg and potentially permanent
heart inflammation.
Let's talk about myocarditis, like the NCAA Division 1
student athlete golfer, John Stokes, diagnosed with myocarditis
four days after receiving a second dose. On his own Tik-Tok
video in the hospital, he was explaining what happened to him.
That was not misinformation that was his own testimony, and
many other athletes and especially young men, who have had
myocarditis. And it can be a lifelong, disabling condition, as
you know. So how can you call those side effects mild?
Dr. Tan. In the vast majority of individuals, the side
effects from COVID-19 vaccine are mild and temporary, and that
is why the VAERS System in this country works so well because,
you know, of the billions of doses of----
Ms. Greene. I will remind you that there are 948,617 VAERS
reports about the COVID-19 vaccine. That is way higher than the
flu, and that is much higher than the Zoster vaccines. Thank
you. I yield back my time.
Dr. Wenstrup. Thank you, and I want to thank all of our
witnesses here today for your testimonies. It is greatly
appreciated. And at this time, I would now like to yield to the
Ranking Member Ruiz for a closing statement, if he would like
one.
Mr. Ruiz. Yes. Thank you, Mr. Chairman. We have heard a
number of different perspectives today, and I want to bring us
back to where we started. In the early days of the pandemic, we
were dealing with a deadly, highly transmissible and highly
mutating virus. As we planned our public health strategy, we
prioritized saving lives and the prevention of future harm, and
keeping our healthcare system at or below capacity, and that
strategy was successful.
As I said at the beginning, the Biden bind administration's
implementation of the largest, most successful vaccine
administration program in history prevented an estimated 3.2
million deaths. As an added bonus, it saved the United States
over $1 trillion in medical costs. So, as we wrap up this
conversation and as we have future conversation in this
Subcommittee, I just ask that we keep our eye on the ball and
focus on the prevention of harm and the prevention of getting
infected.
This will almost always involve the proven public health
measures that we know work, such as vaccines that are known to
be safe in a public health perspective, effective, and vaccines
that have saved lives, and let us be cautious about the impacts
our words can have. Nuance is good, yes, but we cannot get to a
place where we are explicitly or implicitly sowing distrust in
COVID vaccines by focusing on the small percentage of, for
example, the severe side effects when we know at a population
base, it is safe and the symptoms are mild, and it has helped
us get to where we are today.
So, we have a process to study vaccines, and they were
studied, and we know who are at high risk because of those
studies. And there are contraindications to people getting this
vaccine, and there are risks, or some people, and those are the
people that physicians use the data to recommend not getting
the vaccines, so let's be nuanced. Let's use our words
carefully, and let's sow trust in public health measures.
Let's go back to understanding that this virus spreads from
airborne oral aerosols to the public and that any covering
blocks that aerosol from leaving your mouth. Now, some
coverings are better than others, some aren't as good, but by
reducing those molecules, you reduce the risk of transmission.
So, yes, masks help to reduce the risks of transmission. Just
like if these molecules are transmitted by your mouth when you
speak, you cough, you scream, or sing, the further you are, the
less likely you will come by being infected with a droplet that
either you breathe in through your nose, your mouth, your eyes.
So yes, in these circumstances, social distancing is a
preventive measure, public health measure.
So, vaccines do work. Vaccines are safe. I do not wish
anybody, regardless of whether a natural infection can cause a
more robust immune response, to go and get infected or to want
to get infected or to disregard the importance of a vaccine. I
don't want a Republican or a Democrat or anybody to get the
symptoms to have enough viral load to transmit it to a more
higher-risk person, or to risk themselves being hospitalized or
even death. And those who have been vaccinated, if you fall
under the category of being high risk or not immunocompetent,
then I would still recommend to take all the precautions
because you can still get sick, and you can still be
hospitalized, and you can still die.
So, it is nuanced, and, you know, we have to work within
that nuance. And I do believe that in future pandemics, we
shouldn't be stuck, that are unknown viruses that can kill
people, that are rapidly transmissible, that we should be
focusing on just disregarding safety precautions by saying that
getting infected is going to be a protection. So, let's just be
careful on the way we present this, and let us work always to
put people over politics. Those are my hopes for this
Subcommittee, and thank you, Mr. Chairman. I yield back.
Dr. Wenstrup. I thank the Ranking Member, and I will say
that I continue to look forward to working with Dr. Ruiz
through this process over the next year and a half as we have
worked well together in the past, and I think we will continue
to do our best to, possibly have differences of opinions, which
doctors sometimes do, and move forward with something that we
can present to the American people as a better pathway for the
next pandemic.
You know, we are advocating for a multi-pronged strategy to
defeat COVID or the next pandemic. A majority of Americans have
had COVID and have had infection-acquired immunity. We can
learn a lot from that, and we should try to. I don't believe
that herd immunity was ever the Trump White House's strategy. I
know people talked about it, but I don't think that was ever
the strategy. Protecting the most vulnerable I saw was, as we
saw an emergency use authorization for the vaccine, and it was
there for the elderly and those with comorbidities, and that
was always a priority. And reality suggested that this
contagious disease would continue to spread throughout the
Nation.
Understanding infection-acquired immunity and protections
it offers is essential, in my opinion, or to resume normal life
in America and end things like lockdowns. It needs to be
considered, and false statements, no matter where they were
coming from, especially if they are coming from leadership
position, is wrong. And we can look at studies and we could
look at comparing Sweden and Michigan. You know, Michigan had
severe lockdowns and mandates. Sweden did not. Sweden had half
the deaths. What is up with that, right? Why can't we look at
that?
So, you know, as doctors, if you are honest with yourself,
as doctors, researchers, you can look at a study and say this
is a flawed study, or this was a very good study. This is a
very good study without any type of bias whatsoever. We know
how to do that, and we need to do that and not pretend. You
know, I am curious because I haven't ever seen anything on the
initial studies, and I was very involved. We were involved
with, as the Doctors Caucus, looking at was taking place with
Operation Warp Speed and understanding the technology, but also
how the studies were being conducted. Normally before FDA
approval, you have 8,000 to 10,000 people in a study. They had
30,000 to 40,000 people, and I applaud those brave Americans
that got in these studies that helped us produce a vaccine.
The one thing I am curious about is those that got the
placebo and got COVID, did we look at their immunity from it?
Did we make that part of our study? As far as I know, we did
not. We missed that. We should have done that. That should have
been part of what we were doing, lesson for the future, in my
opinion. You know, we have two or three doctors on this very
Committee that have actually been treating patients during
COVID, and, you know, I can tell you that they feel, and they
said today that, you know, infection-acquired immunity was
ignored, and when they spoke about it, they were censored.
These are facts that are coming out. We got to address
this, and quit playing politics with it, and say that was a
wrong thing for any government to do on behalf of the health of
the American people. Look, I got vaccinated. I also was out in
military uniform with the National Guard testing people,
driving up testing. I was out giving shots with the National
Guard and when my local hospital said can you come out, or can
you come out to the fairgrounds and vaccinate people as they
are coming through to be part of this mission. So, when the
implication is that, you know, people on one side or the other
are saying, oh, it is natural immunity only, that is not true,
and it doesn't help this Committee when we have comments like
that coming from this Committee. Let's be serious about what
people were actually doing and saying and what their concerns
are.
And by the way, an opinion is far different from
misinformation, and if we aren't allowed to have opinions in
the medical community anymore, then we are doomed. We are
absolutely doomed going forward. More times than one, I would
say to a patient, here is what I believe, and if I see some
hesitancy, I would say, I would like you to get another
opinion, and I think that is a wise thing to. So, when we have
opinions, it is not necessarily misinformation, but the fact of
the matter is false statements were made by many.
Whether they intended them to be false or they knew they
were false, I don't know, but they were false statements that
were being made, and some of these people served on both
administrations that were doing this. You know, I don't think
it helped with that. That does dissipate trust in our public
health system. As I said earlier, I had recommended under the
Trump administration let America hear from the doctors treating
COVID patients every day, not someone sitting in a lab, not
someone that is not bedside with anybody. Let them tell us what
is actually going on, and I think that is a lesson learned that
we have to move forward.
And I heard Miss Ross say she gave credit to the Trump
administration for creating a vaccine, but I don't think it
helps when a candidate for office says, well, if it is made
during the Trump administration, I am not going to take it.
That didn't help build public confidence in what was going on.
You know, we talked about say something safe. The honest
discussion you have with your patient is we think this helps
and here is why, but also honest is, I don't know what I will
say five years from now or 10 years from now, and here are some
of the adverse events that we are seeing. And you have a
discussion with your patient, and you decide what what's best
for you.
Look, many people got COVID. They got infection-acquired
immunity. It is not necessarily that they didn't want to get
the vaccine. It is because it was not available to them. And
there is a lot of information we could have gained from those
people that got COVID and how their body responded to it. You
know, some didn't even know they got COVID. Some people got
tested or checked for antibodies and found out, oh, I must have
had it. I don't know when. This is all important information
and data, and it is very important.
And you know what? You are not supposed to hear from Dr.
Facebook or Dr. Social Media. You are supposed to talk to you,
Dr. Tan, you Dr. Makary, you, Doctor. That is who people need
to go talk to, and we have to supply doctors with accurate data
without flawed studies. That is the important thing. That is
one of the takeaways that we need to come away with from this
Committee.
One thing I never heard about, and I have never heard
anyone discuss or studying, the possibility of hyper-immunity.
You have had COVID. You have had the vaccine. You get the
booster. What are the effects of that? Those are fair
questions. Hyper-immunity is real. So, I hope that we can
continue to go down this path and have good conversations,
conversations with experts and amongst ourselves to where we
can really have some good results and good recommendations to
make for the future.
With that and without objection, all Members will have five
legislative days within which to submit materials and to submit
additional written questions for the witnesses, which will be
forwarded to the witnesses for their response.
Dr. Wenstrup. If there is no further business, without
objection, the Select Subcommittee stands adjourned.
[Whereupon, at 12:43 p.m., the Select Subcommittee was
adjourned.]