[House Hearing, 118 Congress]
[From the U.S. Government Publishing Office]


                                     
 
                          [H.A.S.C. No. 118-7]

            COVID-19'S IMPACT ON DOD AND ITS SERVICEMEMBERS

                               __________

                                HEARING

                               BEFORE THE

                   SUBCOMMITTEE ON MILITARY PERSONNEL

                                 OF THE

                      COMMITTEE ON ARMED SERVICES

                        HOUSE OF REPRESENTATIVES

                    ONE HUNDRED EIGHTEENTH CONGRESS

                             FIRST SESSION

                               __________

                              HEARING HELD

                           FEBRUARY 28, 2023


                                     
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] 






                         ______

             U.S. GOVERNMENT PUBLISHING OFFICE 
 55-268          WASHINGTON : 2024 
 
 
                                     
  


                   SUBCOMMITTEE ON MILITARY PERSONNEL

                      JIM BANKS, Indiana, Chairman

ELISE M. STEFANIK, New York          ANDY KIM, New Jersey
MATT GAETZ, Florida                  CHRISSY HOULAHAN, Pennsylvania
JACK BERGMAN, Michigan               VERONICA ESCOBAR, Texas
MICHAEL WALTZ, Florida               MARILYN STRICKLAND, Washington
BRAD FINSTAD, Minnesota              JILL N. TOKUDA, Hawaii
JAMES C. MOYLAN, Guam                DONALD G. DAVIS, North Carolina
MARK ALFORD, Missouri                TERRI A. SEWELL, Alabama
CORY MILLS, Florida                  STEVEN HORSFORD, Nevada

                 Glen Diehl, Professional Staff Member
                 Ilka Regino, Professional Staff Member
                   Zach Calderon, Research Assistant
                   
                            C O N T E N T S

                              ----------                              
                                                                   Page

              STATEMENTS PRESENTED BY MEMBERS OF CONGRESS

Banks, Hon. Jim, a Representative from Indiana, Chairman, 
  Subcommittee on Military Personnel.............................     1
Kim, Hon. Andy, a Representative from New Jersey, Ranking Member, 
  Subcommittee on Military Personnel.............................     2

                               WITNESSES

Camarillo, Hon. Gabe, Under Secretary of the Army, Department of 
  the Army.......................................................     6
Cisneros, Hon. Gilbert, Under Secretary of Defense for Personnel 
  and Readiness, Department of Defense...........................     4
Ortiz Jones, Hon. Gina, Under Secretary of the Air Force, 
  Department of the Air Force....................................     8
Raven, Hon. Erik K., Under Secretary of the Navy, Department of 
  the Navy.......................................................     7

                                APPENDIX

Prepared Statements:

    Mr. Banks....................................................    33
    Mr. Camarillo................................................    45
    Mr. Cisneros.................................................    37
    Mr. Kim......................................................    35
    Ms. Ortiz Jones..............................................    61
    Mr. Raven....................................................    52

Documents Submitted for the Record:

    [There were no Documents submitted.]

Witness Responses to Questions Asked During the Hearing:

    [There were no Questions submitted during the hearing.]

Questions Submitted by Members Post Hearing:

    Mr. Bergman..................................................    71
    Mr. Waltz....................................................    71
            COVID-19'S IMPACT ON DOD AND ITS SERVICEMEMBERS

                              ----------                              

                  House of Representatives,
                       Committee on Armed Services,
                        Subcommittee on Military Personnel,
                        Washington, DC, Tuesday, February 28, 2023.
    The subcommittee met, pursuant to call, at 2:09 p.m., in 
room 2118, Rayburn House Office Building, Hon. Jim Banks 
(chairman of the subcommittee) presiding.

  OPENING STATEMENT OF HON. JIM BANKS, A REPRESENTATIVE FROM 
     INDIANA, CHAIRMAN, SUBCOMMITTEE ON MILITARY PERSONNEL

    The Chairman. The hearing will now come to order. I want to 
welcome everyone to our first hearing of the Military Personnel 
Subcommittee of the 118th Congress. Today's hearing is focused 
on COVID-19's impact on the Department of Defense and its 
service members.
    I want to thank our witnesses for being with us today and 
for their service and support of the Department of Defense 
[DOD] and the military departments. I also want to thank the 
thousands of service members, Active Duty, Reservist and Guard 
members who answered the call and put service in front of self 
to support COVID-19 operations throughout the United States. 
Let alone those serving in our Department of Veterans Affairs 
[VA] and civilian healthcare facilities who were on the front 
lines in the battle against COVID-19 and, of course, the men 
and women serving as emergency responders, whether they were 
police, firefighters, or in any other capacity. We could not 
have beaten COVID-19 without your efforts. Thank you.
    Although not the focus of today's hearing, I would be 
remiss if I did not mention the need to understand the origins 
of COVID-19 and the role that China played in a pandemic that 
kills over 1.1 million innocent Americans to include 96 
military service members. There is no doubt that China must be 
held accountable for its actions in the COVID-19 pandemic. Now 
for this hearing, I understand there was a flurry of activity 
late on Friday afternoon and through the weekend within DOD and 
the services releasing implementing guidance on the COVID-19 
vaccination rescission.
    This is good news for our service members and their 
families. However, the timing of the release of these policies 
essentially two business days before this hearing is awfully 
curious. I think this committee's aggressive oversight was 
instrumental at getting the implementing guidance released.
    There is nothing like the threat of a hearing and the 
potential to be called to task for not complying with a statute 
to prompt action. While I am glad to see DOD and the services 
now implementing the rescission, note the National Defense 
Authorization Act [NDAA] was signed into law on December 23, 
2022. The Secretary of Defense's [SECDEF's] initial guidance 
was issued on January 10, 2023.
    All of the rescission guidance should have been completed 
within 30 days of signing the NDAA. Yet here we are at the end 
of February, almost March before this guidance was promulgated. 
I am also disappointed in the lack of responsiveness of DOD and 
the military department to get back to the committee on 
questions that are important to our oversight responsibilities 
and also to our service members, so much so that Chairman 
Rogers and I found it necessary to write a letter to Secretary 
Austin with a whole host of questions on COVID-19.
    I note that Office of the Secretary of Defense [OSD] chose 
to send their reply to this letter last night, giving us little 
time to review their responses. I also have to mention that 
many of our committee members are disappointed with DOD's 
issuance of its reproductive healthcare policy, or as many call 
it the `DOD abortion travel policy'. While this will not be the 
focus of today's hearing, the release of this policy was ruled 
out with no advance discussion with the committee and services 
as another example of the Biden administration using the 
Department of Defense as a social reform laboratory.
    Finally, because this is our first hearing in 2023, I would 
like to acknowledge that this year marks the 50th anniversary 
of our transition to an all-volunteer force. Fiscal year 2022 
was the single worst year for military recruiting since that 
transition. And it is important for this subcommittee to figure 
out why.
    As far as our hearing today, I am looking forward to this 
discussion and affording our members the opportunity to ask 
their questions on DOD's response to COVID-19. I want to 
welcome all of our witnesses, first, the Honorable Gilbert 
Cisneros, Jr., the Under Secretary of Defense for Personnel and 
Readiness, Department of Defense, secondly, the Honorable Gabe 
Camarillo, Under Secretary of the Army, Department of the Army, 
and the Honorable Frank Raven, Under Secretary of the Navy, 
Department of the Navy, and the Honorable Gina Jones, Under 
Secretary of the Air Force, Department of the Air Force. Before 
hearing from them and our witnesses, let me offer Ranking 
Member Kim an opportunity to make his opening remarks as well.
    [The prepared statement of Mr. Banks can be found in the 
Appendix on page 33.]

 STATEMENT OF HON. ANDY KIM, A REPRESENTATIVE FROM NEW JERSEY, 
       RANKING MEMBER, SUBCOMMITTEE ON MILITARY PERSONNEL

    Mr. Kim. Thank you, Chairman. Thank you. This is our first 
hearing of this vital subcommittee. We are charged with 
supporting our service members and their families. And I can 
think of nothing our Congress can do that is more meaningful 
than that.
    We can and should review how the pandemic affected the 
Department of Defense. Nearly three-quarters of a million 
people affiliated with DOD were infected by COVID-19. Thousands 
were hospitalized and hundreds died.
    Every loss of life is tragic, and we hope that the actions 
taken during the pandemic minimized the loss. We also cannot 
ignore the toll that the pandemic had on our service members 
and their families who were facing child care closures, delayed 
Permanent Change of Station [PCS] moves, and limited access to 
healthcare. While I recognize the value of reviewing the 
actions of DOD during this heart of the pandemic, including a 
mandate that is no longer in effect, I look forward to working 
with the Chairman, and my colleagues, in a bipartisan manner on 
other matters more immediately impacting our national security 
and the quality of life of our service members and their 
families, from troubling data on military suicides across the 
services to chronic child care shortages across military bases, 
the challenges accessing healthcare.
    There are many areas where I am confident we can find 
common ground on matters under the purview of our subcommittee. 
Yes, there are deep divisions in our politics in Congress. But 
if ever there was a place where we can come together, it would 
be in this committee charged with supporting those that protect 
us.
    Let's focus on where we can come together and get things 
done and not immediately jump to where we have divisions. Since 
the COVID-19 pandemic began, DOD has remained agile on two very 
important fronts. First, the Department played a critical roll 
in meeting the whole of government needs by providing 
healthcare workers and logistics, expertise, among others.
    In addition, the Department responded to shifting force 
health protection guidance. As we start today's hearing, I 
believe DOD and the services have all complied with the NDAA 
provisions rescinding the COVID-19 vaccine mandate. And while 
the vast majority of service members across all components 
complied with the vaccine requirement, a small percentage of 
them decided for various reasons to either refuse to vaccinate 
or seek an exemption.
    There are legitimate questions to discuss here. For those 
who sought an exemption, I want to know from each of the 
military departments how they established its COVID-19 vaccine 
exemption process and whether those processes were standardized 
as required by the NDAA. I am particularly interested on this 
issue as it relates to discharge characterizations which is an 
important factor since these characterizations impact benefits 
after the servicemember has transitioned to civilian life.
    But as we engage in this discussion today, let's keep the 
politics out of it and approach with calm and civility. Let's 
keep perspective that decisions were made in the chaos of the 
pandemic with a focus on saving lives. We can seek to learn 
best practices and always improve in how we care for those who 
serve us.
    Let's keep in mind the perspective the vaccine requirements 
are not new to the military. As Congressional Research Service 
points out that, quote, ``the U.S. military instituted its 
first vaccination program in 1777 when General George 
Washington directed the Continental Army to be protected from 
smallpox.'' Let's keep perspective that there are currently up 
to 17 vaccines required for service members, some of all and 
others based on jobs and deployment.
    And I will end by just simply reading this statement that 
House Armed Services Committee Chair Mike Rogers released in 
2021 when he was a ranking member and the vaccine mandate was 
first sought. He said, quote, ``vaccines protect our men and 
women, many of whom live in cramped and crowded conditions from 
the spread of disease while at home or deployed across the 
globe. Teleworking isn't an option for the Soldiers, Sailors, 
Marines, Airmen, and Guardians who work every day to confront 
near-peer rivals and non-state terrorists. We must not allow 
COVID-19 to be a hindrance on our force.''
    Secretary Austin earlier confirmed that, as of Mid-July, 
this is in 2021, over 70 percent of Active Duty troops had 
received at least one vaccine shot. That is encouraging news 
and I hope that number reaches 100 percent quickly. I yield 
back the balance of my time.
    The Chairman. I thank the ranking member. I ask for 
unanimous consent to allow members not on the subcommittee to 
participate in today's hearing and be allowed to ask questions 
after all subcommittee members have been recognized.
    Each witness will have the opportunity to present his or 
her testimony. And each member will have an opportunity to 
question the witnesses for 5 minutes. We respectfully ask the 
witnesses to summarize their testimony in 5 minutes or less. 
Your written comments and statements were made part of the 
hearing record. With that, Under Secretary of Defense for 
Personnel Readiness, Mr. Cisneros, you may make your opening 
statement.
    [The prepared statement of Mr. Kim can be found in the 
Appendix on page 35.]

STATEMENT OF HON. GILBERT CISNEROS, UNDER SECRETARY OF DEFENSE 
       FOR PERSONNEL AND READINESS, DEPARTMENT OF DEFENSE

    Mr. Cisneros. Chairman Banks, Ranking Member Kim, and 
members of the subcommittee, thank you for the opportunity to 
testify before you today on the status of the Department of 
Defense's actions to confront the COVID-19 pandemic, protect 
our personnel across the total force, and ensure that the U.S. 
military can fight and win whenever needed in defense of the 
United States. Since the pandemic began, the civilian and 
defense and military leaders of the Department across two 
administrations has led a highly effective response to an 
invisible, novel, and evolving threat. I appreciate the 
opportunity to share our experiences.
    The pandemic was nothing short of a national and global 
tragedy. More than 1.1 million Americans' lives were lost to 
COVID-19, including 96 service members. People are my top 
priority, and we all mourn the loss of our people to this awful 
disease.
    The Department's response to the COVID-19 pandemic was 
historic and complex. Members of the Armed Forces on Active 
Duty and the Reserves and National Guard helped staff and 
operate testing and vaccination sites, provided medical and 
logistical support to stressed hospitals and overburdened 
civilian medical systems and transported critical medical 
supplies when global supply chains froze. The nation is 
stronger thanks to the Department's swift and effective actions 
which helped save the lives of many Americans, both in and out 
of uniform.
    The Department of Defense and military services took bold, 
necessary steps to protect the force and its ability to operate 
and respond to this new threat. These consist of multi-layered 
approaches to force health protection including distancing, 
masking requirements, testing, staggered work schedules, remote 
work when possible, pre-deployment restrictions of movement, 
and mass immunization of the force. And when the COVID-19 
vaccination became available, our service members received the 
vaccine to protect themselves, their teammates, and their 
family members.
    Today, more than 2 million service members, over 96 
percent, are vaccinated against COVID-19. Vaccination 
requirements for military personnel are not new and are 
important to maintain individual medical readiness and reduce 
risk to mission. A small fraction of service members who did 
not request or receive an exemption or accommodation from the 
requirement to be vaccinated against COVID-19 refused to 
receive the COVID-19 vaccine even after receiving a lawful 
order to do so, and approximately 8,100 were subsequently 
separated.
    Compliance with lawful orders is not optional in the 
military. And leaders within the military service took 
appropriate disciplinary action, including separation when 
appropriate to maintain good order and discipline. The 
combination of these measures enabled the U.S. military to 
continue crucial operations amid a challenging global threat 
environments.
    These policies continue to succeed at protecting our people 
and the nation's security. The Department's prompt and 
effective actions saved countless lives and ensured critical 
mission readiness to defend the United States against all 
national security threats. In December 2022, for the first time 
in history, Congress passed legislation to rescind the 
vaccination requirement for service members.
    The Department has complied with the NDAA requirement. On 
January 10, 2023, Secretary Austin signed a memorandum 
rescinding the COVID-19 vaccination requirement as required by 
statute and indicating that the Department will continue to 
promote and encourage COVID-19 vaccination for all service 
members. One February 24th, Deputy Secretary of Defense Hicks 
published a memorandum directing DOD component heads to 
formally rescind policies, directives, and guidance related to 
COVID-19 vaccination requirements as soon as possible, if they 
had not done so already and to certify in writing to my office 
that these actions have been completed no later than March 17, 
2023.
    Let me be clear. As we sit here today, there is no COVID-19 
vaccination requirement for service members or any other 
Department of Defense personnel. The military services no 
longer require COVID-19 vaccinations for accessions to or 
retention in their respective military service.
    This includes all new military accessions, enlisted and 
officer, as well as Cadets and Midshipmen and Officer 
commission programs. The Department continues to encourage 
service members and civilian employees to receive the COVID-19 
vaccine and boosters. In this year of major milestones, the 
50th anniversary of the all-volunteer force and the 75th 
anniversary of President Truman's executive order to provide 
equality of treatment and opportunity for all service members.
    The dedication of our total force to ensure mission 
readiness and defend America's national security is a critical 
message for young Americans. I appreciate the opportunity to 
showcase the collective power of our Department against an 
overwhelming challenge, the COVID-19 pandemic. I look forward 
to your questions. Thank you.
    [The prepared statement of Under Secretary Cisneros can be 
found in the Appendix on page 37.]
    The Chairman. Thank you.
    Mr. Camarillo.

STATEMENT OF HON. GABE CAMARILLO, UNDER SECRETARY OF THE ARMY, 
                     DEPARTMENT OF THE ARMY

    Mr. Camarillo. Chairman Banks, Ranking Member Kim, 
distinguished members of the subcommittee, thank you for the 
opportunity to appear before you on behalf of the soldiers in 
the United States Army. The Army's response to the COVID-19 
pandemic allowed us to keep our people safe and fulfill 
critical mission requirements. I'm particularly proud that as 
part of an interagency team, the Army took a significant role 
in acquiring and distributing COVID-19 vaccines, medical 
treatments, ventilators, gloves, and other equipment to places 
where they were needed the most.
    The Army showed yet again that in times of crisis, we will 
answer the nation's call. Unfortunately, COVID-19 took hundreds 
of lives in the Army community. But we took deliberate steps to 
protect our personnel.
    Across two administrations, the Army took decisive action 
to protect our soldiers, civilians, and their families and to 
prevent additional deaths. Those efforts included instituting 
teleworking policies, contact tracing protocols, and 
implementing Secretary of Defense Lloyd Austin's requirement to 
vaccinate our service members in 2021. These steps followed 
department-wide policy and expert medical advice.
    Our efforts enabled the Army to continue to participate in 
training events and exercises, conduct operations worldwide, 
and to maintain a high level of readiness throughout the 
pandemic. The Army implemented the vaccine requirement 
carefully. We first educated the force on the benefits of the 
vaccine.
    We also explained the exemption process to each of our 
soldiers. For soldiers who requested religious accommodations, 
the Army gave each a careful and individualized review to 
ensure that we upheld constitutionally protected First 
Amendment rights. Our deliberate review process considered the 
specific facts of each individual case, seeking to determine 
whether accommodations were feasible.
    We also processed numerous medical exemption requests based 
on a physicians recommendation. Soldiers who refused the order 
to be vaccinated without an approved or pending accommodation 
or exemption request were subject to adverse administrative 
actions. Beginning in February of 2022, regular Army Soldiers 
who continued to refuse the vaccination order were subject to 
involuntary separation.
    Given the unique circumstances in the National Guard and 
Reserve, we took a deliberate, methodical approach to Reserve 
component vaccine implementation. Our efforts resulted in the 
Army successfully administering vaccinations to over 900,000 
soldiers, achieving a vaccination rate of over 94 percent 
across the total force, including 98 percent in the Active 
Component and over 91 percent for the Reserve Component. 
Following last year's NDAA, the Army promptly implemented the 
law and terminated its requirement to vaccinate all soldiers 
against COVID-19.
    We also directed commands to suspend involuntary 
separations and any adverse administrative actions based solely 
on a soldier's refusal to comply with the order to become 
vaccinated. And ultimately to further reinforce our compliance 
with the NDAA, on February 24th, Secretary Wormuth rescinded 
the Army's prior directive implementing the COVID-19 vaccine 
mandate and governing enforcement. This new policy describes 
how the Army will handle remaining issues related to the 
rescinded mandate, including cases in which soldiers have 
pending religious accommodation requests for multiple vaccines.
    It also makes clear as has been the case since Secretary 
Austin ended the vaccine mandate in January that receiving the 
COVID vaccine is not a requirement for joining the Army. 
Soldiers who disagree about how their cases were handled can 
seek relief through the Army Board of Correction for Military 
Records. I remain deeply proud of the Army's response to the 
global pandemic and our collective efforts over two 
administrations to promote our people's health and well being. 
As the pandemic showed us, our soldiers are always ready to 
defend our nation and to contribute to our security and well 
being. Thank you.
    [The prepared statement of Under Secretary Camarillo can be 
found in the Appendix on page 45.]
    The Chairman. Thank you.
    Mr. Raven.

 STATEMENT OF HON. ERIK K. RAVEN, UNDER SECRETARY OF THE NAVY, 
                     DEPARTMENT OF THE NAVY

    Mr. Raven. Good afternoon, Chairman Banks, Ranking Member 
Kim, and distinguished members of this subcommittee. I 
appreciate the opportunity to appear before you today to 
discuss the actions of the Department of the Navy to combat the 
COVID-19 pandemic and recently announced policies on COVID-19 
vaccinations. I want to state up front; the rescission of the 
COVID-19 vaccination mandate is in effect.
    Within the Department of the Navy, including our service 
academy, there are no limitations for accession, assignment, or 
deployment based on COVID-19 vaccination. We have updated 
policy and distributed new guidance in accordance with the law 
to ensure this direction is clear and consistently enforced. It 
is said that adversity doesn't build character, it reveals it.
    The adversity brought by the COVID-19 pandemic has revealed 
that the Department of the Navy's character is strong and true. 
On behalf of Navy Secretary Del Toro and the senior civilian 
and military leadership of the Navy and Marine Corps, I want to 
convey how proud we are of the Sailors, Marines, and civil 
servants. We are proud to have led in the development, 
distribution, and widespread administration of a vaccine to 
fight a deadly disease that to date has killed over 1.1 million 
fellow Americans, including 18 uniformed members of the Navy 
and Marine Corps.
    We are proud of our leaders at every level who implemented 
and enforced the lawful COVID-19 vaccine mandate that 
ultimately led to a vaccination rate of 97 percent for service 
members and 91 percent for Department of the Navy civilians. We 
are proud of our people who maintained high levels of 
readiness, including medical readiness through vaccinations, to 
ensure our Navy and Marine Corps could support and defend our 
nation and our way of life despite the enormous challenges of a 
global pandemic. These challenges included battling a 
contagious disease while training future service members in the 
close quarters of our recruit training depos or deploying 
across the globe in the tight confines of a Navy ship.
    And we are especially proud of what our sailors and marines 
did to help our nation in direct response to the pandemic, 
deploying thousands of Active and Reserve forces across the 
nation, so to your own districts, to increase our medical 
capacity as well as facilitate logistical and medical supply 
requirements. Safeguarding the health and welfare of a force is 
indispensable for the success of any military organization. 
This continues to be a priority for the Department of the Navy.
    Although the COVID-19 vaccine mandate has been rescinded, 
we will not relax our vigilance to protect our people and their 
mission. We will continue to promote vaccinations to maintain 
medical readiness across the force and to make the COVID-19 
vaccination widely available. I'm confident that our high 
vaccination rate across the Department of the Navy [DON] both 
saved lives and kept our service members in the fight.
    The DON, through the continued support of Congress, is 
focused on producing, deploying, and sustaining naval 
expeditionary forces that will perform successfully across the 
globe in the full range of military operations, from 
maintaining deterrence during peacetime to defeating with 
overwhelming force when necessary. COVID-19 will not likely be 
the last disease to threaten the readiness of our military. We 
have many lessons learned from our COVID-19 response to ensure 
we are minimizing addressable risks and are prepared to take 
decisive action in further crises as we did to battle COVID-19 
to maintain the credibility and capability of our forces.
    Throughout this pandemic, your fleet remains strong. Your 
Marines and Sailors are, have been, and always will be ready 
and able to provide worldwide response 24/7. I look forward to 
answering your questions. Thank you.
    [The prepared statement of Mr. Raven can be found in the 
Appendix on page 52.]
    The Chairman. Thank you.
    Ms. Jones.

STATEMENT OF HON. GINA ORTIZ JONES, UNDER SECRETARY OF THE AIR 
               FORCE, DEPARTMENT OF THE AIR FORCE

    Ms. Jones. Good afternoon, Chairman Banks, Ranking Member 
Kim, distinguished members of the Armed Services Committee and 
this subcommittee. Thank you for the opportunity to appear 
before you today. It is my pleasure to be able to discuss the 
Department of the Air Force's highly effective efforts 
throughout the COVID-19 pandemic.
    The steps used to protect our total force, both military 
and civilian, enabled the Department of the Air Force [DAF] to 
continue protecting the nation and defend its interest around 
the globe at the time of unprecedented challenge. I will also 
address the efforts underway to implement the rescission of the 
mandate while continuing to take care of our personnel and 
execute global missions on a daily basis. I am grateful to be 
sitting here today speaking without a mask on with the 
relatively high confidence that I will remain healthy.
    And that if I fall ill, the risk of death from the effects 
of COVID-19 are far less likely than early in the pandemic. 
Additionally, I'm grateful that we have efficacious treatments 
should they be needed. This was not the case 26 months ago.
    December 2020 when the Food and Drug Administration [FDA] 
first granted the emergency use authorization for the Pfizer 
COVID-19 vaccine was the deadliest month for COVID-19-related 
deaths in the United States. That month, our nation experienced 
more than 65,000 confirmed and probable COVID-19-related 
deaths, raising our total count to over 334,000 deaths since 
the start of the pandemic. It was also that month that the 
Center for Disease Control and Prevention initiated new travel 
restrictions to and from the United Kingdom where we have a 
significant force presence to contain a new variant that was 70 
percent more transmissible.
    When Secretary of Defense Austin mandated immunization for 
service members on August 24th, 2021, our national death toll 
had risen to over 634,000. Those circumstances drove the 
Department of the Air Force's decision to implement the 
earliest vaccination deadline amongst the military departments. 
The decision to immunize was the right decision at the time 
and, in fact, the only choice given the criticality of our 
mission.
    I will never forget those dire summer months when I would 
receive a notification, sometimes as many as two a day about a 
DAF teammate who died due to COVID-19-related complications 
only to read they were unvaccinated. Vaccination was essential 
in allowing us to deploy, rotate our forces to countries that 
mandated vaccination, and most importantly, keep the men, 
women, and dependents of the DAF healthy. As they have for 
decades, the vast majority of our Airmen and Guardians complied 
with the lawful order to vaccinate.
    Of the over 500,000 total force Airmen and Guardians, 
approximately 98 percent followed the Secretary of Defense's 
lawful order. As a result, our force was able to focus on the 
mission. While vaccination has received the overwhelming 
majority of public attention, I want to reinforce the 
Department did not rely solely on immunization to protect the 
force.
    The DAF in concert with the Office of the Secretary of 
Defense and the other services took a holistic approach to 
combat COVID-19. Through a series of prophylactic measures such 
as masking, physical distancing, telework, remote work, travel 
and deployment restrictions and control, we maintained 
readiness while much of industry in the commercial ground to a 
standstill. The DAF continued our flying mission, operating 
from austere locations, conducting worldwide operations, 
executing strike and mobility operations and support of the 
joint force, maintaining our nuclear deterrent, and ensuring we 
continue to induct and train our force.
    Our collective safety measures kept our depots running, 
facilities maintained, bases operating, and missions executed. 
The DAF simultaneously supported national efforts to augment 
civilian emergency response, mass testing, immunization, and 
healthcare infrastructure, notably hospitals operating beyond 
capacity. The Air Force Medical Service deployed 2,700 total 
force airmen in support of COVID-19 response operations during 
the pandemic.
    We deployed ten vaccination teams to ten cities and nine 
States to deliver 1.6 million vaccinations. And we deployed 612 
medical personnel to support 33 locations in 18 States, many of 
which are represented on this committee today, to provide in-
patient critical care at hospitals that experienced significant 
personnel shortages. We would only be able to do this because 
of the vaccination rates within our force.
    On January 10, Secretary Austin rescinded the vaccination 
mandate for military personnel at the direction of Congress. 
Accordingly, on January 23rd, Secretary Kendall formally 
rescinded his order to vaccinate as well as the force 
implementation guidance associated with the mandate. We are 
actively working with OSD and the other services to 
expeditiously implement Secretary Austin's guidance. We also 
have ceased ongoing reviews of current service members 
religious, administrative, or medical accommodation requests 
for exemption from the vaccine to include accommodation denial 
appeals.
    Additionally, we have taken steps to ensure that no bars to 
enlistment or to include those commissions that were held in 
abeyance. Let me close by expressing my profound respect for 
the men and women of the DAF, for their tenacity, resolve, hard 
work, and resilience and indomitable spirit in the face of this 
pandemic. Thank you again for the opportunity to appear before 
the committee, and I look forward to your questions.
    [The prepared statement of Ms. Jones can be found in the 
Appendix on page 61.]
    The Chairman. Thank you to each of you. I will begin with 
questions. Mr. Cisneros, last night OSD replied to a February 
12th letter from me and Chairman Rogers regarding DOD's COVID 
policies. I am going to quote a few lines from the response. 
Military services officials are determining, quote, 
``appropriate action for service members who did not submit an 
exemption of accommodation request remained unvaccinated and 
refused a lawful order to take the vaccine,'' end quote. My 
first question is, why are officials in the services still 
reviewing these cases if the COVID-19 vaccine mandate was 
rescinded?
    Mr. Cisneros. Thank you for the question there, Mr. 
Chairman. This is a situation we've never really been in before 
where we've actually had to go through a process of repealing a 
vaccine that we mandated and Congress initiating a statue to 
make us take it back. This is a new process for us.
    It's something that we're trying to figure out, and we've 
been working on it. The situation that you just described was 
members who refuse the vaccine who disobeyed a lawful order. 
The Services are going through a process to look at that and 
evaluate what needs to be done in those situations. And for 
more information, I can turn it over to the services to kind of 
have them reflect----
    The Chairman. So your answer is that the reason that we are 
still reviewing cases after the vaccine mandate was rescinded 
is because they disobeyed a lawful order. Is that what I heard 
you say?
    Mr. Cisneros. Those who refused the vaccine and did not put 
in a request for accommodation refused a lawful order. That is 
correct.
    The Chairman. But expand for a minute. What is the point? 
If we rescinded the mandate, what is the point of continuing to 
review the cases?
    Mr. Cisneros. Well, they're reviewing the case because, as 
I said, they disobeyed a lawful order. And in order to maintain 
good order and discipline, it's very important that our service 
members go and follow orders when they are lawful. And there 
were several or thousands that did not. And so the services are 
going through a process to review those cases to make a 
determination of what needs to be done.
    The Chairman. All right. Then there was this statement, 
quote, ``no service members currently serving will be separated 
based solely on their refusal to receive the COVID-19 
vaccination if they sought an accommodation based on religious, 
administrative, or medical grounds,'' end quote. So if service 
members did not receive or seek an accommodation for the COVID-
19 vaccination, are you still planning to separate those 
service members?
    Mr. Cisneros. That is up to the services. But as the 
statement said, no individual is being separated for refusing 
the COVID-19 vaccine. If an individual has been separated, they 
were separated because they disobeyed a lawful order.
    The Chairman. Any of you able to respond to that? Mr. 
Camarillo.
    Mr. Camarillo. Mr. Chairman, there are a number of cases 
that we still have yet to review for individual Soldiers that, 
as Secretary Cisneros said, chose to not comply with a lawful 
order. I would just add that each of these cases has to be 
evaluated on its own individual merits because they're highly 
fact-specific. There may be in any instance numerous violations 
of the Uniform Code of Military Justice [UCMJ] or other areas 
in which there might be circumstances which look at 
disciplinary procedures. So we have to look at them all 
individually on a case-by-case basis.
    The Chairman. Mr. Raven.
    Mr. Raven. That's exactly right. We are determined to look 
at each of these cases on the merits--the facts of each case. 
And we will conduct an individualized review of each one of 
these cases.
    The Chairman. Ms. Jones.
    Ms. Jones. Let me just say we have implemented guidance to 
rescind the mandate. We're not reviewing any further 
exemptions. Those have been referred to--returned to the 
service members without action. As captioned by my colleagues, 
we're doing this expeditiously and look forward to working 
toward the 17 March deadline that Personnel and Readiness [P&R] 
has put in place to make sure all these things are fully 
rescinded.
    The Chairman. Yeah, I know you are going to hear from a lot 
of my colleagues today who are infuriated about the double 
standard and message that you are sending to our troops, 
rescinding a policy and then still punishing them for not 
taking the vaccine. But I am going to move on and leave that up 
to some of my colleagues. In his opening statement Under 
Secretary Cisneros said that many vaccines are, quote, 
``required for all military personnel who do not already have 
immunity,'' end quote.
    Last week, The Lancet, a medical journal, published a study 
showing that natural immunity is as effective as two doses of 
the COVID-19 vaccine at preventing severe illness and death. 
Thousands of service members were discharged and tens of 
thousands of potential recruits were barred from enlisting 
because they had not been vaccinated against COVID-19. However, 
a significant portion of them did have immunity due to a prior 
COVID infection. Secretary Cisneros, does the DOD acknowledge 
The Lancet's conclusion that natural immunity is as effective 
as a vaccination?
    Mr. Cisneros. Mr. Chairman, I believe we're still kind of 
evaluating the results of the COVID and the research that's 
gone through. It's not like chickenpox where if you get it once 
and you're good. There have been people who have gotten COVID 
numerous times.
    And so we don't know about natural immunity there as far as 
how it works and how effective it is. And so we are going based 
on the research that we have. And we've continued to update and 
change our policies as the research has progressed and we've 
gone through this process. But right now, there is no more 
COVID-19 vaccine mandate, although we do still encourage our 
members to get the vaccination as well as the boosters when 
they come out.
    The Chairman. So recruits can be exempt from chickenpox and 
measles vaccines if they have natural immunity. Is the DOD 
considering natural immunity while reviewing cases as service 
members refuse the COVID-19 vaccine? Or is that off the table?
    Mr. Cisneros. Again, Mr. Chairman, as the research gets 
better and we learn more about this disease, it's still 
relatively young. It's only been since 2020 that this has been 
around. There's no good evidence, and the research is still 
going on as to how we need to progress with this.
    But as of right now, natural immunity is not something that 
we believe in for this. And so we are still moving forward. But 
again, right now, there is not COVID-19 mandate. There is no 
COVID-19 requirement for service members that enter the 
military or to be in the military.
    The Chairman. All right. I will yield to the ranking 
member.
    Mr. Kim. Thank you, Mr. Chair. I just want to take a step 
back here because the four of you have done an exhaustive 
amount of just review and looking through the last couple 
years. And I guess I just want to kind of tease out from you 
just what are some of the top lessons that you learned about 
how the Department as a whole approach this as well as the 
different services. But if you don't mind, I will start with 
Under Secretary Cisneros. Given the scope of the DOD response 
for the whole of government effort in support of the pandemic, 
but what are some of the key lessons learned for the Department 
that you think will serve us better going forward?
    Mr. Cisneros. You know, one thing I will say is that I 
think the Department has shown through this over two 
administrations of what it can do and what it can accomplish 
when it has the resources and how quickly it can act. Over the 
previous administration, Operation Warp Speed was put into 
effect. The development of a vaccine was initiated.
    That was done in record time. The previous administration 
during a memo signed by the former Deputy Secretary Norquist 
was that as soon as it was the vaccine would be licensed that 
they planned to put it into effect and to make it a 
requirement. So what we did was we just kind of pretty much 
followed on what the previous administration was doing.
    And that's why Secretary Austin signed the mandate right 
after--the day after the first license of the vaccine came out. 
But I think what we've done and what we've showed is that we 
can really go out and accomplish things. We were able to move 
supplies around. We were able to respond on a national basis to 
support hospitals around the nation in order to--when they were 
overworked, we were able to build medical hospitals in place of 
those places that were overcrowded.
    The reaction that we were able to kind of shows, I think, 
again, how effective the United States military can be. What we 
do have in place right now is we do have a biodefense review or 
biodefense posture review going on right now where we should 
hopefully kind of be in the process, kind of wrapping this up, 
which will kind of lay out some of the things that we've 
learned over the pandemic. And that'll help us prepare in the 
future in case this ever happens again.
    Mr. Kim. Thank you. Under Secretary Camarillo, anything you 
would like to add here?
    Mr. Camarillo. Congressman Kim, just a couple of points I 
would add. The first is understanding the Army's role in an 
interagency response to a national pandemic like this in the 
future, whether it's contracting to help acquire vaccines and 
personal protective equipment and other similar items or 
certainly the construction through the Corps of Engineers of 
emergency medical treatment facilities, other areas in which we 
surged, first responder response operations across the country. 
Certainly our ability to do that as part of an interagency team 
is something we'll take forward. Secondly, the value of an 
education campaign, as we explained, the value and benefit of 
vaccination across the force and how it has been said by my 
colleagues enabled us to maintain a high level of readiness to 
ensure that our force protected----
    Mr. Kim. Was there a particular----
    Mr. Camarillo [continuing]. And be able to meet----
    Mr. Kim [continuing]. Method of that education campaign 
that was most successful or kind of stood out to you?
    Mr. Camarillo. Well, Congressman, to achieve 94 percent of 
the force is something we're very proud of. And I give a lot of 
credit to our team, Commanders at every level, our Surgeon 
General, our medics, and others to make sure that they 
adequately explained the value of these requirements.
    Mr. Kim. Okay, great. Under Secretary Raven, anything you 
would like to add?
    Mr. Raven. Yes, Mr. Kim. Thank you for the question. I 
think there's two key lessons that we take forward. First of 
all is our experience working in a whole of government team, 
not only with our sister services and OSD but other interagency 
partners to tackle a global pandemic that impacted life in 
unimaginable number of ways.
    We have a lot of lessons learned about how to increase our 
participation with these key partners. The second I would say 
is much more tactical, and that's about resiliency and supply 
chain. We learned about--a lot about shortage of mass.
    We need to be ahead of the next pandemic. And in terms of 
resiliency, we've also learned lessons about the challenges of 
just simply moving people around the globe, not only service 
members but their families. And we will keep those lessons in 
mind as we move forward.
    Mr. Kim. Great, thank you. Under Secretary Jones, if you 
would like to close us out here.
    Ms. Jones. Yes, Representative Kim, thank you for the 
question. So first lesson learned, I mean, when your military 
is vaccinated, your military can step up when many local 
communities health infrastructure is unfortunately failing 
under the crushing burden of the pandemic as we saw. So if I 
may, just to get very specific, we were able again to put 1.6 
million shots into the arms of our fellow Americans.
    Some of those communities, Gary, Indiana; Minneapolis, 
Minnesota by Representative Finstad; Tampa, Florida; Newark, 
New Jersey; Brooklyn, New York, I mean, we actually even sent 
medical personnel into the Hennepin Health Care System in 
Minneapolis, the Center of Care at St. Cloud Hospital in 
Minnesota. Again, we showed up when the country needed us. We 
are proud of what we have done. Again, we were only able to do 
that because we were vaccinated at the rate that we were: 99 
percent in the Department of the Air Force Active Duty, 98 
percent across the total force. Thanks for the question.
    Mr. Kim. Thank you. I yield back.
    The Chairman. Mr. Gaetz.
    Mr. Gaetz. Under Secretary Cisneros, is there a plan to 
reinstate the roughly 8,600 service members across Active Duty, 
Reserves, and the Guard back to their point of service?
    Mr. Cisneros. Thanks for the question there, Representative 
Gaetz. Service members that have been separated, there is a 
policy procedure for that. They can apply to the Board of 
Corrections if they have a--they think there's a discrepancy in 
their discharge. They can go do that process.
    Mr. Gaetz. No, I didn't ask about their options.
    Mr. Cisneros. As far as the----
    Mr. Gaetz. I am asking about your specific--like, do you 
have a plan to go get these folks back into service in our 
military?
    Mr. Cisneros. Well, the policy is the same it has always 
been, right? If service members are discharged and they want to 
come back into the service, they can apply.
    Mr. Gaetz. Am I to understand the DOD----
    Mr. Cisneros. They can go talk to recruiters.
    Mr. Gaetz [continuing]. Has no active plan to do proactive 
outreach to these individuals to get them back in the military.
    Mr. Cisneros. Our plan is the same as it's always been.
    Mr. Gaetz. Okay. But it doesn't include that active 
outreach to get people back it seems like. I wanted to ask 
Under Secretary Raven, did the Navy send out form letters in 
response to people's requests for religious exemptions?
    Mr. Raven. Sir, I'd have to get back to you on that.
    Mr. Gaetz. Really important, though, because the law 
requires an individualized assessment of people's request for a 
religious exemption, right?
    Mr. Raven. Yes, sir. Whatever initial outreach, maybe I'll 
get back to you on that. But in terms of the process we 
followed, it was individualized review at multiple levels.
    Mr. Gaetz. You believe there was that individualized 
review?
    Mr. Raven. Yes, sir.
    Mr. Gaetz. Well, I mean, the Inspector General [IG] 
disagrees with you. The Inspector General issued a report in 
June of 2022. I am quoting directly from it. ``The denial 
memorandum we reviewed generally did not reflect an 
individualized analysis.'' And the IG's report goes on to say 
that the average amount of time that each package was 
considered was 12 minutes. Does 12 minutes seem like a 
sufficient amount of time to make an individual review on 
someone's deeply held religious basis for an exemption?
    Mr. Raven. Sir, the process that was followed included 
multiple reviews at the medical, chaplaincy, and legal reviews, 
Senior Commanders, going all the way up to headquarters. The 
Marine Corps established a board with senior level reviews 
outside the chain of command for each one of these reviews that 
amounted to, in many cases, more than ten hours review of each 
case.
    Mr. Gaetz. That is not what the Inspector General says. 
That seems like a self-assessment, not a reflection on the 
assessment. To hear you say that is concerning because it would 
seem to suggest that you guys haven't really taken to the 
advice into the findings of IG. And it also doesn't really 
comport with what I saw with my own two eyes because I went to 
naval installations and met with service members who could 
point to a memorandum they received that were exactly 
identical. You could have held them up to a lamp back to back.
    And it was these people had poured out their faith basis to 
seek an exemption, then they got a form letter back. And it 
sort of goes back to my question to Mr. Cisneros. Are we 
stronger or weaker as a country because there are 8,600 people 
that used to wear the uniform but because of the vax mandate, 
now they don't?
    Mr. Cisneros. Congressman, I would say we're strong as 
ever. We're still a lethal force. We are ready. Our retention 
has been at record high levels, and we're ready to defend the 
nation today.
    Mr. Gaetz. I think that you will find in a lot of military 
communities, they feel like they are not as strong because they 
see instructor pilots that have been separated, people involved 
in critical test mission that now are not part of the fighting 
force. Ms. Jones, how many pilots did we lose because of the 
vax mandate?
    Ms. Jones. Representative, I have to follow up with you on 
that.
    Mr. Gaetz. I have got a report here from the Epic Times. I 
don't know if it's true or not. But it talks about over 700. 
Does that number sound about right?
    Ms. Jones. That does not sound right, but I'd have to 
follow up with you. I'm not familiar with the publication----
    Mr. Gaetz. It strikes me----
    Ms. Jones. That you're----
    Mr. Gaetz [continuing]. As something we should really know, 
Mr. Chairman. I mean, right now, we have got an Air Force that 
faces a pilot shortage. And we should know at this hearing and 
I am hopeful we will get for the record how many pilots we lost 
because I think that if you lost hundreds of pilots, it would 
be really hard to make the argument that you made that we are a 
stronger country because of it.
    How about special operators? I know how much money we put 
in to special operators? Did we lose any of them because of the 
vax mandate?
    Mr. Cisneros. I'm sorry. I didn't hear the last part of 
your question.
    Mr. Gaetz. Did we lose any special operators because of the 
vax mandate?
    Mr. Cisneros. You would have to ask the services to that 
for their specific--the amount of----
    Mr. Gaetz. Mr. Camarillo, did we lose any Green Berets?
    Mr. Camarillo. I'd have to take that for the record. I 
don't have the breakout.
    Mr. Gaetz. Gosh, Mr. Chairman----
    Ms. Jones. Representative Gaetz, may I follow up with you?
    Mr. Gaetz. Please.
    Ms. Jones. We actually did not discharge any officers as a 
result of them--Department of the Air Force officers as a 
result of them failing to obey the lawful order. For those that 
opted to voluntarily separate or retire in lieu of, then that 
was--they voluntarily did that. And----
    Mr. Gaetz. Do we know that number? Because I think----
    Ms. Jones. I do actually. Would you like it?
    Mr. Gaetz. Okay. Yes, please.
    Ms. Jones. Yes. So those folks that opted to--it's on the 
other chart. But let me--there were 610 folks that were 
separated and just a small amount of those folks that were----
    Mr. Gaetz. I sure how we can get--I would hope----
    Ms. Jones [continuing]. For the record.
    Mr. Gaetz. Great. And Mr. Chairman, I yield back my time to 
you. I think the breakdown of some of these folks who we invest 
so much time into training and to see how many of those we lost 
and to be able to assess readiness would be important work for 
our committee going forward. I appreciate your indulgence, and 
I yield back.
    Ms. Jones. It was 40 Air Force officers separated in lieu 
of, 14 retired in lieu. I can provide that----
    The Chairman. Ms. Houlahan.
    Ms. Houlahan. Thank you, Mr. Chair. And thank you very much 
for your testimony today. And also just a point of order, 
having served and having been asked lawfully to have 
vaccinations for the good of the service, for the good of the 
nation, the people who are now currently in the military I 
believe are in a better position because they have obeyed and 
followed lawful orders.
    And so good honor and discipline has been upheld and 
maintained. And so I would argue that we are in a stronger 
position now that we were before. I will turn, though, to the 
subject of the hearing at large which is COVID-19's impact on 
DOD and its service members and want to talk about specifically 
child care and family issues.
    We all know throughout the pandemic that access to child 
care was an issue, a huge problem for millions of families, 
and, of course, for those in military as well. As someone who 
separated myself personally from the Air Force due to child 
care issues among others, I am particularly concerned about the 
impact that closures of those centers, both on military bases 
as well as off of them, might have had on military retention 
and recruitment during COVID. Would you be able, each of you, 
to provide a brief update on the reopening of those child care 
centers in your branches and how did a lack of sustained access 
to child care potentially impact our military families in terms 
of retention and otherwise.
    And finally for Mr. Cisneros, what lessons have we learned 
about how to maintain and reopen child care operations because 
we hopefully will never see COVID again but might? I would 
start with--it's hard to say. I am trying not to say Gina, the 
Honorable Under Secretary Jones.
    Ms. Jones. Understood. Thank you for the question. And if I 
may, I applaud your and Representative Bice's bipartisan 
efforts on the family leave program.
    On the child care piece, you're absolutely correct in terms 
of there was no aspect of our military installations that was 
not impacted by the pandemic. And certainly our CDCs [Child 
Development Centers] are within that. And honestly, we are 
still continuing to recover from that.
    Many of our Child Development Centers understaffed. The 
staffing shortage across the country again is similarly 
impacting our own. And so we are working very hard to get those 
staffed to ensure that, again, our folks can focus on mission 
and not focus on long, long wait times at CDCs.
    Very proud of the fact that Secretary Austin is taking care 
of people initiative as part of that. We actually went above 
and beyond what was asked for. And for those folks that come 
and work for the Department of the Air Force as a direct child 
care provider, their first child would be covered 100 percent, 
right?
    Again, we know how important child care is, even to the 
child care providers. And so going above, we want to make sure 
we can look our airmen and guardians in the eye and say, we are 
doing absolutely everything we can do to get those CDCs staffed 
so you can focus again on mission. Thank you for the question, 
though, and continue to look forward to working with the 
committee on that in particular.
    Ms. Houlahan. Secretary Raven, please.
    Mr. Raven. Thank you for that question. Absolutely, the 
women and men who work at both CDCs and in our schools are 
vital to readiness because they provide the support to military 
families that allow service members to do their job. It's an 
incredibly important mission, and we value that at the 
Department of the Navy. We like the rest of the country 
continue to experience the same shortfalls that exist in the 
private sector. We are looking at innovative ways to get after 
those issues.
    Just a couple of examples, we have partnered with the 
Coronado School District to make use of a facility that was no 
longer being used for a public school and are now working to 
transition that into a child development center. We've also 
initiated outreach with some colleges to essentially uplift the 
program in terms of a pipeline of talented professionals into 
this very important career area. And we continue to work with 
P&R and Under Secretary Cisneros on really cross-cutting 
initiatives to make sure that this important service is as 
robust as we need it to be.
    Ms. Houlahan. Secretary Camarillo, please.
    Mr. Camarillo. Congresswoman, just to expand on what my 
colleagues have said, absolutely critical issue. I think in 
direct response to your question, during the pandemic, we saw 
the urgent need to make sure that we kept our CDC workers on 
staff and paid even as the CDCs were closed down. But as 
everybody knows, it exacerbated the larger problem we have 
regarding access to child care.
    And it's for these reasons that we've all said. Secretary 
Wormuth has established a very ambitious goal to make sure that 
in the Army we have to place children in child care within 30 
days of the need, whether it's on or off installations, whether 
it's in a CDC, through Army fee assistance, or in-home 
providers that are appropriately licensed to do that. And we're 
taking all the efforts at our disposal to make sure that we can 
grant access to child care.
    Ms. Houlahan. Thank you. I have run out of time, and I 
yield back.
    The Chairman. Mr. Alford.
    Mr. Alford. Thank you, Mr. Chairman, Ranking Member Kim. I 
appreciate you having these witnesses here before us. Thank you 
for being here, taking your time out.
    I am honored to represent two vital military installations 
in the Fourth Congressional District of the great State of 
Missouri, that being Fort Leonard Wood and Whiteman Air Force 
Base, home of the B-2 stealth bomber. Fort Leonard Wood, of 
course, is a critical asset to our military. We train more than 
80,000 personnel each year there.
    Our military has incredible capabilities, and we are all 
very proud of that. But readiness is an issue. I think that's 
one of the things we are really going to concentrate in this 
subcommittee, the readiness for our personnel.
    And this vaccine mandate which ended up kicking out 8,400 
service members, I don't think it did much for the morale for 
the military, the morale for America. The Army has really 
missed its recruitment goals, 25 percent last year, 15,000 
soldiers. And we live in an increasingly dangerous world where 
Communist Chinese government is the number one threat to our 
national security. We have got to be ready.
    We cannot afford the loss of anymore Soldiers. So I want to 
start with Under Secretary Cisneros. Your response to 
Congressman Gaetz earlier, I was a little bit shocked when he 
asked you, are we stronger? And you think we are stronger. How 
are we stronger after losing 8,400 service members?
    Mr. Cisneros. Congressman, thanks for the question. We've 
had over 2 million service members who received the vaccine. 
That's allowed us to remain operational.
    It's allowed us to deploy forces. It's allowed us to 
continue training. It has allowed us to do the mission and 
carry out the national defense strategy. Our retention is at 
record levels. So I would argue that the vaccine has been an 
instrumental part of keeping the force ready and played a big 
part in ensuring readiness of our force.
    Mr. Alford. But we now know that the vaccine does not 
completely prohibit the spread of COVID-19. So looking back, it 
is a little bit easier to do that. But how are we stronger by 
losing 8,400 people when----
    Mr. Cisneros. I want to say----
    Mr. Alford [continuing]. This vaccine may not have 
prevented the spread of it in the first place?
    Mr. Cisneros. Congressman, we do know the vaccine has been 
effective is keeping people alive and keeping them out of the 
hospital. And there's been good data and research on that.
    Mr. Alford. All right. Next question for Under Secretary 
Jones. The Department of Air Force recently issued guidelines 
on removal of adverse actions related to refusal of COVID-19 
vaccinations. Can you explain exactly what the Air Force is 
doing now to remove adverse service records?
    Ms. Jones. Representative, thank you for the question. 
Thanks for your support for Whiteman Air Force Base. I was able 
to visit last year, and it's a great mission--total force 
mission support out of the base. So in terms of adverse action, 
we are doing a couple of things based on the bucket that you 
are in. So if you are currently serving and you followed the--
excuse me--you submitted an accommodation request and if the 
adverse action is tied solely to your refusal of the vaccine, 
then the Air Force Personnel Center is taking steps now to 
remove that adverse paperwork from your file.
    Mr. Alford. And there will be nothing left on that file? It 
will be totally expunged?
    Ms. Jones. Well, so I want to be clear about the caveat. If 
the only reason is the refusal to vaccinate, then AFPC, the Air 
Force Personnel Center, is going to remove that. If there are 
aggravating factors----
    Mr. Alford. Such as?
    Ms. Jones. Other misconduct----
    Mr. Alford. Okay.
    Ms. Jones. Right? Other misconduct. Then that'll have to be 
reviewed for what may be appropriate, right? So for those that 
are currently serving that did not submit a religious 
accommodation request or availed themselves of any of the 
exemption processes, they will have to initiate the process 
with the Air Force Board for a correction of military records. 
For those that have already separated and would still like to, 
for example, update their file, they would have to go through 
the discharge review board.
    Mr. Alford. Gotcha.
    Ms. Jones. And so this has been well laid out in the memo 
that Secretary Kendall put out.
    Mr. Alford. I have got 30 seconds left. Let's go to Under 
Secretary Camarillo. Maybe you can answer this. Will there be 
any tags, markers, codes associated with any service personnel 
that has been dismissed that will be recognizable by anyone 
bringing these service members back? Will anyone know that 
these people left because and then brought back because of the 
mandate?
    Mr. Camarillo. Their discharge, Congressman, will be 
consistent with the NDAA. And as Secretary Jones just 
explained, the Army is following a very similar process. If 
it's only related to refusal to comply with the COVID vaccine 
mandate, those will be removed.
    Mr. Alford. Thank you again, witnesses. I yield back.
    The Chairman. Mr. Horsford.
    Mr. Horsford. Thank you. I didn't expect to go so early. I 
am way down here at the end. I would like to thank Chairman 
Banks and Ranking Member Kim for holding this hearing today.
    And I am really pleased to be a part of this important 
subcommittee which really focuses on military health and 
families. And I am really glad that we are having this 
conversation about COVID-19's impact on our service members and 
their families. Since the start of COVID-19 pandemic, thousands 
of Active Duty service members have been deployed to civilian 
hospitals across the United States as you indicated to help 
take pressure off our medical staffs as they battle the effects 
of COVID-19.
    And I want to commend all of our service members, 
especially those from the 99th Medical Group stationed at 
Nellis Air Force Base in my district who were deployed to 
places in California during the Omicron wave to provide medical 
support at overrun hospitals. Service members stepped up to the 
plate when this country needed them most. And I would hope that 
if nothing else we can agree that our service members performed 
remarkably and should be commended.
    Under Secretary Cisneros, it is good to see you on that 
side of the dais. Miss you on this side, but we are glad to 
have you there. How did the services support the whole of 
government response to COVID-19, including sending military 
personnel to civilian hospitals to support COVID-19-related 
missions?
    Mr. Cisneros. Congressman, thank you for the question. And 
I think you described it very well. We had service members both 
in the Active Duty and the Reserve who deployed all over the 
country.
    They went to hospitals. We had service members that went 
and built hospitals and then served there as well. They 
administered the COVID-19 test.
    They administered the vaccinations to individuals. They 
played an integral part in working through this vaccine, not 
only for the Department of Defense but for the entire nation. 
And as well as I say in my opening remarks is we also played an 
integral part in ensuring the logistics of getting supplies 
where they needed to be and ensuring that the vaccines were 
getting to different parts of the country where they needed.
    We were able to bring in supplies from all over the world 
where there was mask or surgical suits that were needed. We 
were able to go out and do lots of things, the logistics, the 
purchasing power of the Department of Defense to go out and buy 
supplies that hospitals needed, buying tests, buying, as I 
said, surgical gear, being able to go out and procure 
ventilators for hospitals that needed them. This was all done 
through the Department of Defense. And it played an integral 
part in helping us get through this pandemic.
    Mr. Horsford. Well, if no one else has said it today, I 
want to thank our service members who played a critical role. 
Under Secretary Cisneros, I also want to talk about DOD's long-
term strategy to mitigate risk from COVID-19 and future 
pandemics. We have heard a lot of talk today regarding 
recruitment and retention.
    But as several of my colleagues on our side have indicated, 
if we want to talk about recruitment and retention and you talk 
to any service member and their family, ask them about the need 
for higher military pay. Ask them about more adequate on base 
and off base housing that supports the needs of their family. 
Talk about the long waiting list to get into child care 
services and some of the facilities.
    I know under the last Congress, we expanded a number of 
those opportunities. But I just really hope that this 
subcommittee would use our time in a bipartisan way to bring 
the voices of the service members and their families into the 
readiness discussion. Readiness is about the quality of life of 
our service members and their families.
    So I want to encourage my colleagues to work with us to 
help make the military more attractive to young men and women 
who are interested in serving and to not politicize the health 
and well being of those men and women. We are coming out of 
this pandemic. We are stronger, and it is because of the 
Department of Defense that we are in the position--the good 
position that we are to protect both our national defense and 
our international security around the world. Thank you, and I 
yield back.
    The Chairman. Thank you. I will remind the gentleman there 
is a readiness subcommittee. And Chairman Rogers is setting up 
a quality of life task force within the Armed Services 
Committee. I'm sure he will be glad to hear about your interest 
in that task force as well. Mr. Mills.
    Mr. Mills. Thank you, Mr. Chairman. Thank you to this team. 
I would ask that you keep it very brief because I want to get 
through this and I have a lot of questions. First, Mr. 
Chairman, I would like to be entered into the record DD Form 
3176, DD Form 3177 for qualifications. Mr. Chairman?
    The Chairman. Without objection.
    Mr. Mills. Thank you so much. With that, also I just want 
to note something that my colleague, Mr. Gaetz, had followed 
through on was the idea that these packages that were actually 
being submitted for a request of medical exemption or delay was 
being reviewed in a time span of about 12 minutes per to vet 
these to ensure the actual qualifications of whether they are 
qualified or not qualified. Now have you seen these forms by 
chance, the DD 3176 or DD 3177?
    Mr. Cisneros. I'm not familiar with that form that you're 
referring to. But I have looked at some of the packets that 
have gone through the process of being evaluated.
    Mr. Mills. Okay. Well, let me go ahead and explain really 
quickly some of the questions on here which are quite lengthy. 
But I will talk about the ideas of medical conditions and 
circumstances. It talks about your circumstance for being 
vaccinated, why you would feel that you would need to be exempt 
from it. It talks about your religious liberties, things like 
that. Do you think that--anyone on this panel can answer--that 
you have the qualifications and/or the vetting process to be 
able to do this within 12 minutes which is exactly what the DOD 
IG said the average time is?
    Mr. Cisneros. Representative, I would agree with my 
colleague here, Mr. Camarillo, when he stated earlier that 
these packages were given----
    Mr. Mills. That is not what I asked. I asked, do you think 
they can be done in 12 minutes?
    Mr. Cisneros. And my response is that they were given over 
a lengthy view and looked over----
    Mr. Mills. Twelve minutes is a lengthy view in your 
opinion?
    Mr. Cisneros [continuing]. I don't think it was done in 12 
minutes. I think they were done----
    Mr. Mills. So the DOD IG is wrong is what you are saying. 
Then you are on the record for saying that the DOD Inspector 
General is incorrect in this?
    Mr. Cisneros. I think the DOD Inspector General looked at 
some kind of numbers and kind of did it and did some math and 
wrote a letter to the Secretary of his opinion. It's my 
understanding there's still an IG report on this topic that is 
coming out later this year.
    Mr. Mills. So staying with you, Under Secretary Cisneros, 
you said in your statement just a moment ago that the United 
States military is as strong now as ever, even with the 8,400 
purged out our military and the 25,000 shortage in our 
recruitment. So you are saying that we don't need those 
additional 30-plus thousand troops is what you are saying to 
maintain strength?
    Mr. Cisneros. What my statement was, Congressman, is that 
the vaccine--the COVID-19 vaccine allowed us to go out and to 
train. It allowed us to operate. It allowed us to deploy around 
the world and keep up our mission and carry out the national 
defense strategy and defend the nation.
    Mr. Mills. By increase battle fatigue, sir, because I can 
tell you I spent over 7 years in Iraq, over 3 years in 
Afghanistan, Kosovo, Pakistan, was blown up twice in 2006. 
There is such a thing as battle fatigue. Maybe you haven't 
experienced it because there wasn't recruitment shortages to 
the level they are right now. But they do exist. Let me move on 
to my next question which is simply this. Are you familiar with 
the DOD Defense Casualty Analysis System?
    Mr. Cisneros. I'm sorry. Can you repeat that? The----
    Mr. Mills. The Department of Defense has a Defense Casualty 
Analysis System. Are you aware of it?
    Mr. Cisneros. Yes, sir.
    Mr. Mills. So then you should be aware that from the time 
period of 2000 to 2021 that the actual number of deaths due to 
illness has not changed. And in fact, the highest year was in 
2009 with 277. And meanwhile, it says as a result of due to 
illnesses, you have--and I will read these off quickly.
    But from 2010 through 2021, you had 238, 252, 246, 214, 
195, 196, 173, 171. It actually starts coming down, 2019, 174; 
2020, 154; 2021, 190. Relatively unchanged in the last 22 
years. Can you tell me again how the COVID vaccine contributed 
to that?
    Mr. Cisneros. What I will tell you, sir, is the COVID 
vaccine allowed us to operate and to be able to deploy our 
forces around the world and make sure that we continued 
training and that we're able to carry out the national defense 
strategy and defend the nation.
    Mr. Mills. Okay. And just a quick question. I noted that it 
was very simple that it said administrative exemptions were 
typically granted for service members who were within 6 months 
of separation or retirement. This is almost like the arbitrary 
thing where COVID only exists when you stand up, you have to 
wear your mask. But when you sit down, it magically goes away. 
So are you saying then that members who had 6 months or less 
had less risk of actually spreading the virus as those who have 
a year or more? This is your policy by the way, sir.
    Mr. Cisneros. That is what we are saying is when that was 
carried out when people were allowed to go, they were still 
required to meet the force health protection guidance that was 
put out by the Department of Defense where they were still 
serving. And that was at times wearing their mask and doing 
what needed to be done in order to protect themselves and 
others from the COVID-19. What was granted and with the 
services did--and I'll let them explain it further. But if a 
member was getting out and they had made the decision to get 
out and they were within 6 months of separation, they were 
given the administrative----
    Mr. Mills. And last question, what actually reentry code 
was everyone given who was separated?
    Mr. Cisneros. You'd have to ask the services that. But I 
know there wasn't one specific. Each service has a different 
culture, and they did it on their own depending on their 
service and their culture as to what they did.
    Mr. Mills. Well, I can tell you this, sir. As a military 
combat veteran and a proud service member, I will be pushing as 
well I am sure that our chairman as well as for the Armed 
Services chairman to allow these individuals who are unlawfully 
purged in my opinion to be reentered into the military with 
their full benefits, their back pay, and be granted what they 
should have been given which is a chance to serve our United 
States military. With that, I yield back.
    The Chairman. Mr. Davis.
    Mr. Davis. Thank you so much, Mr. Chair and to the ranking 
member. I want to start today, for me having served our 
country, I realize that we lost over a million here in the 
nation. I would also highlight any service member too that 
loses their life. It raises concern for me.
    So my first line of questioning, looking at those who we 
know died that we can look at the particular members, 96, the 
whole column of 690. What do we know about these cases that 
perhaps moving forward in the future, similar circumstances, we 
might be able to prevent? Also, do we see any trends in 
particular branches that these were accounted for, in 
particular installations, Continental United States [CONUS] 
versus overseas? What do we understand about these cases?
    Mr. Cisneros. Congressman, thanks for the question. And I 
don't have a breakdown by service. And I think each service 
could explain to you how many or it could tell you how many 
service members in their service died.
    But the one thing I will tell you that we do know is, as 
you stated, 96 service members had passed away. There was also 
36 family members, 417 DOD civilian employees, and 141 DOD 
contractors that also passed away from COVID-19. But I will 
tell you out of the 96 service members, what we do know is that 
93 of them were not vaccinated.
    Mr. Davis. My next question, I understand that there were 
efforts to go out to hospitals. But what was taking place on 
the ground, hospitals on our installations? Did we see that 
they had been overwhelmed with these hospitalization cases?
    Mr. Cisneros. I think as we were--and thank you for that 
question because it really, I think, kind of allows us to kind 
of explain really how our military is stretched but yet how 
they're still able to carry out the mission. While we were 
going around deploying around hospitals around the nation 
supporting overworked physicians and communities and setting up 
hospitals for communities that were overwhelmed by COVID-19, we 
still had to run our hospitals as well within the medical 
treatment facilities throughout our Department of Defense, 
throughout Defense Health Agency [DHA]. And we continue to do 
that. And so again, I think that just shows another aspect of 
the resiliency of our military force and what they're capable 
of doing.
    Mr. Davis. And another question when we look at the number 
of cases, not just the hospitalizations or the deaths but the 
cases are we able to understand how we are able to mitigate 
moving forward. I pray to God that circumstances do not occur. 
But what do we understand from those cases?
    Mr. Cisneros. Well, I think we just like any other hospital 
or hospitals experience the same things as hospitals across the 
nation. There were communities, especially some of our 
veterans, that were at risk because of their age and maybe some 
other preexisting conditions that they may have had. We had to 
deal with those in our hospitals.
    The thing that we learned--I will say again the most 
important thing that we learned was that the vaccine does work. 
The vaccine kept people out of the hospitals and it kept people 
alive. And for us, that's a win.
    Mr. Davis. But again, yes, vaccinations work. But in some 
cases, it went beyond as we can see, hospitalizations and 
deaths. I am just making a note there.
    But moving back now to a person that wants to reenter, we 
talked a little bit about that process. But I guess my question 
would be, do we know not necessarily how many have reentered, 
but how many are actually now going through that process?
    Mr. Cisneros. I'll yield to the services on that if they 
know how many have actually asked to come back into the 
service. But as I stated earlier, we already have a procedure 
for this for those that have left the military and want to come 
back in. We have a procedure for those that think there's a 
discrepancy in their discharge and want to have it corrected 
that they can go forward and do, and that's at the Board of 
Corrections. But we're going to continue to follow the 
procedures that we already have in place.
    Mr. Davis. I would love to hear from the----
    Mr. Cisneros. I'll defer to the services.
    Mr. Davis [continuing]. Services.
    Mr. Camarillo. Congressman, just to be clear, there are two 
paths by which anybody who was separated can come back. One is 
to talk to a recruiter and just reenlist. The second as 
Secretary Cisneros said to go through the Board of Correction 
of Military Records. I don't have data on how many people were 
prior separations related to this. But we can get that for the 
record.
    Mr. Raven. Sir, for the Department of the Navy, exactly the 
same process. An individual can talk to a recruiter or the 
Board for correction of naval records. We've had single digits 
in terms of numbers of individuals who've explored the option 
of returning to service.
    Ms. Jones. Representative, thanks for the question. For 
those Department of the Air Force veterans that received a 
general discharge, if they are interested in being reinstated, 
they'd have to first meet the discharge review board to have 
their discharge characterization upgraded. And once they were 
able to do that, if they do that successfully, then they can 
talk to a recruiter assuming they met accession standards would 
be able to apply to----
    The Chairman. The gentleman's time----
    Mr. Davis. Thank you. I yield back.
    The Chairman. Is expired. Ms. Tokuda.
    Ms. Tokuda. Thank you, Chair. Under Secretary Raven, you 
noted in your testimony there was a critical moment in the 
early days of the pandemic where there was an outbreak as we 
all know very well, the USS Theodore Roosevelt which led to a 
prolonged docking in Guam. We had over 1,300 confirmed cases 
and sadly and tragically the death of Chief Petty Officer 
Charles Thacker, Jr. We saw in that case the significant impact 
that infectious disease outbreaks can have not just on our 
readiness and our ability to execute mission but also training, 
maintenance, repair needs.
    Now looking beyond COVID and what we have learned from 
COVID and infectious disease however, they may also be 
implications where our medical response and our ability to 
respond in any mass casualty event at sea that affects large 
numbers of our Sailors at once. You know better than I do. 
Readiness is key in order to execute mission.
    What are the lessons we learned from the Navy responding 
effectively to infectious disease outbreaks or any mass 
casualty event as a result of the COVID-19 pandemic? And what 
steps have been taken to improve its future response, whether 
it is equipment, whether it is medical and operational chain of 
command, policies and procedures? We know a lot of these things 
unfortunately fell short and led to what we saw on the USS 
Theodore Roosevelt.
    Mr. Raven. Absolutely, and thank you for that question. 
First of all, a key part of military readiness is medical 
readiness. And we believe that vaccines have helped preserve 
medical readiness to preserve military readiness.
    As you stated, the incident regarding the Theodore 
Roosevelt was incredibly important, not only for what happened 
on the ship but what it meant for out in the world. You 
mentioned 1,300 Sailors fell ill. About two dozen had to go to 
the hospital for intensive care, and the one service member who 
unfortunately passed.
    This is a reminder that throughout history the number of 
service member deaths from disease exceeds that from direct 
enemy action. And so in the Department of the Navy, we continue 
to be committed to maintaining medical readiness and 
preparedness. That's not only making sure we have medical 
facilities that are ready and medical personnel who are trained 
but supplies on hand to be ready for the next major event, 
whatever it may be.
    Ms. Tokuda. Okay. Well, I definitely just hope that we have 
learned from this experience and that we are preparing for 
sadly what will inevitably be next, whether it is mass 
casualties or outbreak. Speaking to the entire panel, we know 
that the pandemic caused unprecedented amounts of stress on the 
American people but also for many of our service members and 
their families as well. And the Government Accountability 
Office [GAO] found that telehealth mental health visits surged 
dramatically in the early days of the pandemic before declining 
a bit and tabling off to a stable level, still above the pre-
pandemic levels.
    And I think all of us in this room know that in terms of 
mental health, this has always been an area of soreness, if you 
ask me, for the military, making sure that we really provide 
the care and support to our military men and women. Ensuring 
our service members get easy access to mental health healthcare 
is essential to force readiness in my humble opinion. And as we 
adapt to now life with COVID and quite frankly long COVID in 
many cases, I am concerned that we will lose some of the 
momentum and progress we made during the pandemic to provide 
access to mental healthcare services but also to encourage 
folks to actually get the help and support that they need. And 
so to all of you here today that is willing to answer, what 
steps has your organizations taken to make sure that we build 
on the improvements in mental health and behavioral health 
access from during the pandemic and how we are going to promote 
its continued usage going forward?
    Mr. Cisneros. Thank you for the question. As Secretary 
Austin always says, mental health is health. And the health of 
our service members is definitely one of his big concerns. It's 
one of my major concerns.
    As you stated, telehealth was something that really 
expanded during the pandemic. The ability to do mental health 
through telehealth is something that was a tremendous help to 
our service members. We did over 65,000 and have that ability 
to do 65,000 mental telehealth calls a year.
    But it is something that we continue to work on that we 
want to continue to grow and improve. Mental health is--the 
lack of behavioral health specialists is not only a concern 
throughout the military but a concern throughout the whole 
nation. There's just a lack of providers that are out there.
    So we are doing what we can to increase that. And one of 
the ways is through telehealth. But we are also taking a public 
health approach. Our family centers are there.
    If somebody just needs somebody to talk to, there's a 
variety of counselors that we have. I know all the services and 
I'll let them kind of explain more, how they're expanding 
services. Our schools are making counselors available to our 
students when they need them. I'm talking specifically our 
Department of Defense Education Activity [DODEA] schools. But 
I'll let the services----
    The Chairman. The gentlewoman's time has expired. Ms. 
Sewell.
    Ms. Tokuda. Thank you. I look forward to the continued 
conversation.
    Ms. Sewell. Thank you, Mr. Chairman. Before I begin, I 
would like to say that I am indeed thrilled to be a new member 
of the House Armed Services Committee and of course this 
subcommittee on military personnel. I would like to really 
thank you, Mr. Chairman and Ranking Member Kim, for allowing us 
to have this conversation today.
    I look forward to advocating for all of the military 
personnel in my district, including those serving at Maxwell 
Air Force Base, the 187th Fighter Wing as well as 117th 
Refueling Wing that are located in my district. I am glad that 
we are having this conversation today about COVID-19 and having 
it with senior leadership in our military. The COVID pandemic 
posed a unique threat to our military, not just because it 
endangered our service men and women health but also it posed a 
threat to the readiness.
    I am proud that the DOD took the necessary steps to 
vaccinate our men and women in uniform. Moreover, I would like 
to thank everyone of our service men and women who played a 
role in developing, deploying an administration of the COVID-19 
vaccination. To date, almost 9 million total doses of vaccine 
has been administered to our service members.
    And as Secretary Cisneros pointed out, we lost 96 service 
members. One loss is too many. But when you focus in on the 
fact that 93 of the 96 that we lost were not vaccinated, I have 
to tell you the fact that we now do not make it mandatory gives 
me great pause for thought.
    And I wanted to ask you, Secretary Ortiz Jones. I know that 
Maxwell Air Force Base is home of Air University. We are very 
proud of that.
    But during the pandemic, how did the COVID-19 affect 
military installation and your personnel, moving personnel in 
and out? And what lessons were learned in terms of that? And I 
also wanted to ask your thoughts about what the reversal of 
policy not requiring a vaccination has done with respect to the 
morale culture of the service.
    Ms. Jones. Representative, thank you for your support for 
Maxwell Air Force Base. So your immediate question about how 
did we deal with that, I mean, as you know, we have many 
international students. And so one of the things I'm really 
proud that the team did early on is as soon as those 
international students arrived on base in that first week, if 
they were not already vaccinated, we offered them the vaccine.
    We also followed all of the practices as recommended by the 
CDC to ensure that we could continue functioning, so masking, 
social distancing, increasing awareness, contact tracing. And 
then when folks were identified as being symptomatic, 
quarantining and taking all the measures again that could 
ensure those classes could continue and the base could function 
as intended. So again, lots of lessons learned about when you 
vaccinate and follow the CDC guidance, you can continue to 
execute mission as was done at Maxwell Air Force Base, as was 
done throughout the Department of the Air Force enterprise.
    Ms. Sewell. I know that my time is drawing near, and I 
really am curious to know if there has been any increase in 
military personnel refusal to receive other mandatory 
vaccinations like hepatitis, like measles, tetanus. Have you 
seen that happen? And if so, how are you addressing it?
    Ms. Jones. Representative, what we have seen at this point 
are there are four cases where individuals submitted a 
religious accommodation request for COVID and other vaccines. 
And so it's not a significant uptake. That is a manageable 
number.
    And again, there is a process in place to ensure that folks 
are, one, aware of that process, provide the sufficient 
information so those can be reviewed accordingly. If I may say, 
readiness has been addressed here a number of times. And one 
thing I would offer for the committee's consideration is we 
talk about medical readiness.
    One of those things is our family members, our service 
member's ability to access healthcare. And a lot of that is 
tied to medical providers that don't take TRICARE. So I would 
recommend for this committee if you really focus on medical 
care, you would look at steps to encourage medical providers to 
accept TRICARE.
    And that's directly related to the future readiness of the 
force. We know a lot of the service members of the future are 
dependents of today. And when they have better access to 
healthcare through more TRICARE providers, there will be a 
healthier pipeline into our service. So----
    Ms. Sewell. Thank you.
    Ms. Jones. A request to please encourage your medical 
providers to accept TRICARE.
    Ms. Sewell. Thank you.
    The Chairman. The gentlewoman's time has expired. I want to 
thank all of our witnesses for being with us today. We are off 
to a great start with the Military Personnel Subcommittee.
    I intend for this subcommittee to be the most active of all 
of the subcommittees with the help of the ranking member. And 
we are off to a good start today on an important topic. So with 
there being no further business, this subcommittee stands 
adjourned.
    [Whereupon, at 3:32 p.m., the subcommittee was adjourned.]



      
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                            A P P E N D I X

                           February 28, 2023

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              PREPARED STATEMENTS SUBMITTED FOR THE RECORD

                           February 28, 2023

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              QUESTIONS SUBMITTED BY MEMBERS POST HEARING

                           February 28, 2023

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                   QUESTIONS SUBMITTED BY MR. BERGMAN

    Mr. Bergman. Of those discharged, how many were afforded the 
opportunity to come back into service?
    Mr. Cisneros. Former Service members may seek to re-enter the 
military under established processes. Such decisions are considered on 
a case-by-case process based on the needs of the Military Service 
concerned. Former Service members can start this process by contacting 
a recruiter. Each Military Service already has an accessions process 
for individuals with a break in their service.
    Mr. Bergman. Of those discharged, how many were afforded the 
opportunity to come back into service?
    Mr. Camarillo. We want to retain every quality soldier we can, 
especially in this challenging recruiting environment. Therefore, we 
put a lot of effort into educating our force about the vaccine choices 
and had a process for Soldiers to seek religious and medical 
exemptions. Some soldiers were granted exemptions, some who were denied 
ultimately chose to get vaccinated.
    Ultimately, good order and discipline is important. It's important 
for unit cohesion and the principle of following lawful orders, which 
is a bedrock principle in the U.S. Army. Soldiers who chose to disobey 
a lawful order, who didn't seek an exemption were in some cases 
separated.
    Any soldier who was separated for refusal to follow the lawful 
order to receive the COVID-19 vaccine may request re-entry into the 
Army. Any former soldier who desires to return to Service may contact a 
recruiter to evaluate their specific circumstances on a case-by-case 
basis or seek a review of their status through the Army Board of 
Correction of Military Records.
    Mr. Bergman. Of those discharged, how many were afforded the 
opportunity to come back into service?
    Mr. Raven. Any former member may work through existing processes to 
potentially access back into the Navy or Marine Corps. Any former 
member seeking a records correction may seek relief from either the 
Naval Discharge Review Board (NDRB) (for requests to upgrade 
discharges) or the Board for Correction of Naval Records (to address 
all other adverse actions). The process for applying to the Boards is 
well documented and readily available through the Boards' website.
    Mr. Bergman. Of those discharged, how many were afforded the 
opportunity to come back into service?
    Ms. Ortiz Jones. Former members who sought an exemption on 
religious, administrative, or medical grounds and who received adverse 
actions solely due to their refusal to obey a lawful order to vaccinate 
may petition the Air Force Discharge Review Board and Board for 
Correction of Military records to individually request a correction to 
their personnel records, including records regarding the 
characterization of their discharge, if they believe there was an error 
or injustice.
    Should those records be corrected, former Service members may work 
with a local recruiter to request re-entry. The DAF has placed a banner 
on the landing page of the Air Force Review Boards Agency website with 
a link (https://afrba-portal.cce.af.mil/#covid) to all of the 
information regarding the COVID immunization mandate recission. It also 
includes information on how to apply to the Discharge Review Board and/
or the AFBCMR depending on applicants situation. Additionally, we have 
been coordinating with DAF Public Affairs on press releases to ensure 
the agency website URL is provided.).
                                 ______
                                 
                    QUESTIONS SUBMITTED BY MR. WALTZ
    Mr. Waltz. Can you tell the committee how much the Department has 
spent thus far on the COVID vaccine for the force?
    Mr. Cisneros. The Department of Defense (DOD) did not pay for 
COVID-19 vaccines. Until vaccine commercialization, DOD does not expect 
to pay for COVID-19 vaccines.
    Mr. Waltz. Does DOD have the existing authority to reinstate 
service members separated due to the COVID vaccine mandate?
    Mr. Cisneros. Yes. Former Service members may seek to re-enter the 
military under established processes. Such decisions are considered on 
a case-by-case process based on the needs of the Military Service 
concerned. Former Service members can start this process by contacting 
a recruiter. Each Military Service already has an accessions process 
for individuals with a break in their service.
    Mr. Waltz. Secretary Austin's recission memo tells the Services 
that ``no individuals will be separated solely on the basis of their 
refusal to receive the covid 19 vaccination if they sought an 
accommodation based on religious, administrative or medical grounds.'' 
The memo goes on to say ``The Military Departments will update the 
records of each individuals to remove any adverse actions solely 
associated with the denials of such requests, including letters of 
reprimand.'' Is your Service extending those same accommodations to 
those members of your Service that were already eliminated/removed from 
serving our nation? If not why not? What are your services doing to 
help these men and women return to the Service of our nation as 
expeditiously as possible?
    Mr. Cisneros. The information requested is Service-specific, and I 
would defer to the Service Assistant Secretaries for Manpower & Reserve 
Affairs to provide a fulsome response.
    Mr. Waltz. According to DOD's data, over 8100 service members have 
been discharged. What impact has the loss of those military members, 
that talent, that experience had on your service?
    Mr. Cisneros. While the Department was impacted by the loss of the 
talent and expertise represented by those 8,100 Service members, there 
was and is no direct or substantive impact to the Department's ability 
to execute our overall mission of defending the nation. In fact, 
throughout the COVID-19 pandemic, our forces were able to maintain a 
high level of readiness, meeting global security challenges and 
maintaining our commitments to exercises and deployments, while helping 
staff and operate testing and vaccination centers here at home. The 
Nation is stronger thanks to the Department's swift and effective 
actions, which helped save the lives of many Americans, both in and out 
of uniform.
    Mr. Waltz. Did the DOD or your service perform any studies or 
analyses of the number of service members who would refuse to take the 
mRNA products based on religious or medical objections? Were any 
studies or analyses performed on the likely number of service members 
who would be discharged, separated, transferred to the IRR, barred from 
drilling etc. as a result of non-compliance? Did your service attempt 
to quantify the costs of the mandate (e.g., lost/discharged/
nondeployable service members) and compare it to the expected benefits 
from the mandate? o If so, what were the results? If not, why not?
    Mr. Cisneros. I am not aware of any studies performed by the 
Department, as you described. The Armed Forces have long recognized the 
military value of vaccines against biological threats; Service member 
vaccination requirements are not new and are important to maintain 
medical readiness and reduce the risk of mission failure, especially 
against the growing future threat of bioweapons.
    The Department followed the direction of senior civilian and 
military leadership, across two administrations, responding to a 
rapidly unfolding global pandemic event and following the guidance of 
the Centers for Disease Control and Prevention. The health and welfare 
of the Force is the highest priority for DOD leadership. The swift 
development of the COVID-19 vaccine, wide distribution/utilization, and 
rapid rollout were instrumental to curb hospitalization and deaths 
related to the pandemic, including within the Total Force.
    Mr. Waltz. Despite SecDef Austin's Aug. 24, 2021, order that the 
mandate would use only FDA products with ``full licensure'', just a few 
weeks later, on Sep. 9, 2021, Under Secretary of Defense for Health 
Affairs, Miss Terry Adirim, published an ``Interchangeability 
Memorandum'' declaring that military medical authorities could 
substitute an unlicensed mRNA product--Pfizer's BNT162b2--in the place 
of the ``fully licensed'' COMIRNATY. Where did the Under Secretary of 
Defense for Health Affairs get the authority to declare FDA regulated 
drugs as interchangeable? Interchangeability is a regulatory term of 
scientific and legal significance, regulated by Congress under the 
Public Health Service Act--42 USC Sec. 262. There has been no 
application for interchangeability filed by the companies involved and 
the FDA's compendium of interchangeable drugs doesn't contain any mRNA 
vaccines at all. Why can DOD officials make regulatory declarations and 
instantly force service members to have to accept an unlicensed product 
in direct contradiction to the SecDef's Memorandum? Given the close 
coordination between the DOD and FDA, what conversations did you have 
with the FDA about DOD officials making these kinds of drug regulatory 
decisions in place of the proper officials from the FDA?
    Mr. Cisneros. The authority to declare U.S. Food and Drug 
Administration (FDA) regulated drugs as interchangeable resides with 
the Secretary of the Department of Health and Human Services (HHS) as 
per section 262 of Title 42, United States Code, Regulation of 
Biological Products, which also contains the definition of 
interchangeability and the standards to meet the definition of 
interchangeability. The FDA determined the interchangeability of the 
FDA-approved Comirnaty (COVID-19 Vaccine, mRNA) and the FDA-emergency 
use authorized Pfizer-BioNTech COVID-19 Vaccine. The DOD accessed this 
FDA determination on September 10, 2021, prior to the DOD memorandum on 
interchangeability.
    The Assistant Secretary of Defense for Health Affairs (ASD(HA)), 
under the authority, direction, and control of the Under Secretary of 
Defense for Personnel and Readiness (USD(P&R)), and in accordance with 
the Department of Defense Directive (DODD) 5136.01, serves as the 
principal advisor to the Secretary of Defense and the USD(P&R) for all 
DOD health policies, programs, and force health protection activities. 
The DOD complies with FDA regulatory determinations, to include those 
related to the interchangeability of drugs and biologics, and generally 
follows the Centers for Disease Control and Prevention (CDC) 
recommendations for immunization practices.
    The FDA, not the DOD, made regulatory decisions regarding 
interchangeability of FDA-approved Comirnaty (COVID-19 Vaccine, mRNA) 
and the FDA-emergency use authorized Pfizer-BioNTech COVID-19 Vaccine. 
The FDA publicly published its decision on the interchangeability of 
FDA-approved Comirnaty and the FDA-emergency use authorized Pfizer-
BioNTech COVID-19 Vaccine at (https://www.fda.gov/vaccines-blood-
biologics/qa-comirnaty-covid-19-vaccine-mrna), which states:
    ``The FDA-approved Comirnaty (COVID-19 Vaccine, mRNA) and the FDA-
emergency use authorized Pfizer-BioNTech COVID-19 Vaccine for 
individuals 12 years of age and older, when prepared according to their 
respective instructions for use, can be used interchangeably to provide 
the COVID-19 vaccination series without presenting any safety or 
effectiveness concerns. Therefore, providers can use doses distributed 
under EUA to administer the vaccination series as if the doses were the 
licensed vaccine. For purposes of administration, doses distributed 
under the EUA are interchangeable with the licensed doses. The Vaccine 
Information Fact Sheet for Recipients and Caregivers provides 
additional information about both the approved and authorized 
vaccines.'' The Department followed the FDA's decision on the 
interchangeability of FDA-approved Comirnaty (COVID-19 Vaccine, mRNA) 
and the FDA-emergency use authorized Pfizer-BioNTech COVID-19 Vaccine, 
which was consistent with Secretary of Defense's memorandum on 
mandatory COVID-19 vaccination. DOD health care providers continue to 
comply with the applicable FDA-approved labeling and guidance when 
administering COVID-19 vaccines.
    Although the DOD closely coordinates with the FDA on many issues to 
ensure DOD continues to comply with all applicable FDA regulations, DOD 
held no conversations with, nor made requests of, FDA officials 
regarding making autonomous regulatory decisions related the 
interchangeability of COVID-19 vaccines. The DOD aligns all policy 
decisions to regulations and other guidance published by the CDC, FDA, 
and HHS. DOD works collaboratively within the interagency space where 
necessary exceptions are driven by unique mission needs of the 
department.
    Mr. Waltz. 10 U.S.C. 1107a prohibits the mandate of an unlicensed 
emergency use authorization (``EUA'') product, unless there is an 
express written authorization by the President finding that it is 
necessary for national security to do so. There was no such finding by 
President Biden. Yet the DOD and each Armed Service mandated EUA 
products from the issuance of their respective mandates in August 2021 
through the rescission of the mandates in January 2023. Why did your 
service consistently and systematically ignore and violate 10 USC 
1107a? What policies or procedures have been put in place to ensure 
that 10 USC 1107a is not violated in the future? Did your service treat 
the EUA product as ``legally'' interchangeable with the FDA-licensed 
version, i.e., so that the EUA version could be mandated? Were there 
any policies or procedures in place to ensure that only FDA-licensed 
products were mandated and that no EUA products were mandated? How many 
doses of properly labeled and licensed doses of COMIRNATY were given to 
U.S. service members? How many doses with EUA on the label were given?
    Mr. Cisneros. Section 1107a of Title 10, United States Code 
addresses information that must be provided to recipients of EUA 
products. The President of the United States did not waive the 
requirement to provide vaccine information to patients, and the DOD 
made information regarding COVID-19 vaccinations available to patients 
in accordance with all applicable laws for voluntary and involuntary 
immunizations.
    DOD follows the requirements of section 1107a of Title 10, United 
States Code and provides the necessary product information to all 
patients at the time of vaccine administration.
    The FDA, not the DOD, made regulatory decisions regarding 
interchangeability of FDA-approved Comirnaty (COVID-19 Vaccine, mRNA) 
and the FDA-emergency use authorized Pfizer-BioNTech COVID-19 Vaccine. 
The FDA publicly published its decision on the interchangeability of 
FDA-approved Comirnaty and the FDA-emergency use authorized Pfizer-
BioNTech COVID-19 Vaccine at (https://www.fda.gov/vaccines-blood-
biologics/qa-comirnaty-covid-19-vaccine-mrna), which states: ``The FDA-
approved Comirnaty (COVID-19 Vaccine, mRNA) and the FDA-emergency use 
authorized Pfizer-BioNTech COVID-19 Vaccine for individuals 12 years of 
age and older, when prepared according to their respective instructions 
for use, can be used interchangeably to provide the COVID-19 
vaccination series without presenting any safety or effectiveness 
concerns. Therefore, providers can use doses distributed under EUA to 
administer the vaccination series as if the doses were the licensed 
vaccine. For purposes of administration, doses distributed under the 
EUA are interchangeable with the licensed doses. The Vaccine 
Information Fact Sheet for Recipients and Caregivers provides 
additional information about both the approved and authorized 
vaccines.'' The Department followed the FDA's decision on the 
interchangeability of FDA-approved Comirnaty (COVID-19 Vaccine, mRNA) 
and the FDA-emergency use authorized Pfizer-BioNTech COVID-19 Vaccine, 
which was consistent with Secretary of Defense's memorandum on 
mandatory COVID-19 vaccination. DOD health care providers continue to 
comply with the applicable FDA-approved labeling and guidance when 
administering COVID-19 vaccines.
    Yes, DOD Instruction 6205.02--DOD Immunization Program--contains 
current policy for the DOD Immunization Program.
    Based on the Immunization Tracking Registry, which includes data 
from the Military Health System electronic health records, Military 
Service Individual Medical Readiness Systems, Pharmacy Data Transaction 
Service, and TRICARE claims data (network providers):
      12,519 doses of Comirnaty (Monovalent--CVX 208) have been 
received by U.S. Military Service Members.
      1,264,717 doses of Pfizer EUA (Monovalent--CVX 208) have 
been received by U.S. Military Service Members.
      459,058 doses of Pfizer EUA (Monovalent--CVX 208) were 
administered on or after 23 August 2021.
    Mr. Waltz. Secretary Austin's recission memo tells the Services 
that ``no individuals will be separated solely on the basis of their 
refusal to receive the covid 19 vaccination if they sought an 
accommodation based on religious, administrative or medical grounds. 
``The memo goes on to say ``The Military Departments will update the 
records of each individuals to remove any adverse actions solely 
associated with the denials of such requests, including letters of 
reprimand.'' Is your Service extending those same accommodations to 
those members of your Service that were already eliminated/removed from 
serving our nation? If not why not? What are your services doing to 
help these men and women return to the Service of our nation as 
expeditiously as possible?
    Mr. Camarillo. Former soldiers may apply to the Army Discharge 
Review Board or the Army Board for Correction of Military Records to 
request corrections to their personnel records, including records 
regarding the characterization of their discharge. Former service 
members seeking membership in the Active Army, Army Reserve, or Army 
National Guard may contact a recruiter specific to those respective 
Army components. Re-entry, to include service members separated for 
refusing the COVID-19 vaccination, is conducted in accordance with 
existing policies and regulations, and depends on the basis of 
separation.
    Mr. Waltz. According to DOD's data, over 8100 service members have 
been discharged. What impact has the loss of those military members, 
that talent, that experience had on your service?
    Mr. Camarillo. To protect the health and safety of the Army's 
people and ensure we remained the world's premier combat force, the 
Army took decisive action to protect our soldiers, Army civilians, and 
their families. At the outset of the pandemic, the Army reacted to the 
rapid spread of illness during the pandemic by adopting telework 
policies, following the Department-wide force protection health 
guidance, and instituting contact tracing and other protocols. On 
September 14, 2021, we implemented Secretary of Defense Lloyd Austin's 
requirement to vaccinate our service members. These measures broadly, 
and the vaccine mandate specifically, saved lives and allowed the Army 
to continue advancing its mission. Orders to receive the COVID-19 
vaccine were lawful, and failure to obey a lawful order violates the 
Uniform Code of Military Justice. Furthermore, discharge for refusal to 
obey a lawful order promotes good order and discipline and increases 
the readiness of the force. The Army separated 1,903 Active Component 
Soldiers for refusing the lawful order to receive the COVID-19 
vaccination, yet demonstrated the ability to provide ready forces to 
combatant commanders worldwide. For example, 50K of the 100K service 
members in Europe are Army Soldiers. This responsiveness and vigilance 
allowed us to institute and remove measures and protections as we 
followed Federal guidance informed by medical expertise. These measures 
enabled the Army to continue participating in training events, conduct 
operations worldwide and maintain a high level of readiness even as our 
nation navigated a global pandemic. The Army is confident that the 
impacts of the separations are relatively small.
    Mr. Waltz. Did the DOD or your service perform any studies or 
analyses of the number of service members who would refuse to take the 
mRNA products based on religious or medical objections? Were any 
studies or analyses performed on the likely number of service members 
who would be discharged, separated, transferred to the IRR, barred from 
drilling etc. as a result of non-compliance? Did your service attempt 
to quantify the costs of the mandate (e.g., lost/discharged/
nondeployable service members) and compare it to the expected benefits 
from the mandate? o If so, what were the results? If not, why not?
    Mr. Camarillo. Following Secretary of Defense Lloyd Austin's order 
on 24 August 2021 date, the Army required soldiers to receive the 
COVID-19 vaccination. This decision was based on the need to ensure a 
healthy, resilient, and ready force in the face of a global pandemic 
and CDC guidance at the time the mandate was issued. The Office of the 
Secretary of Defense can best speak to the analysis that informed the 
Secretary's decision.
    Mr. Waltz. 10 U.S.C. 1107a prohibits the mandate of an unlicensed 
emergency use authorization (``EUA'') product, unless there is an 
express written authorization by the President finding that it is 
necessary for national security to do so. There was no such finding by 
President Biden. Yet the DOD and each Armed Service mandated EUA 
products from the issuance of their respective mandates in August 2021 
through the rescission of the mandates in January 2023. Why did your 
service consistently and systematically ignore and violate 10 USC 
1107a? What policies or procedures have been put in place to ensure 
that 10 USC 1107a is not violated in the future? Did your service treat 
the EUA product as ``legally'' interchangeable with the FDA-licensed 
version, i.e., so that the EUA version could be mandated? Were there 
any policies or procedures in place to ensure that only FDA-licensed 
products were mandated and that no EUA products were mandated? How many 
doses of properly labeled and licensed doses of COMIRNATY were given to 
U.S. service members? How many doses with EUA on the label were given?
    Mr. Camarillo. The U.S. Army COVID-19 vaccine implementation plan 
complied with 10 USC Sec. 1107a. On 23 August 2021, the U.S. Food and 
Drug Administration (FDA) approved the Pfizer-BioNTech COVID-19 vaccine 
(COMIRNATY), subsequent to its Emergency Use Authorization (EUA) 
status. On 24 August 2021, the Secretary of Defense iterated that 
mandatory vaccination ``will only use COVID-19 vaccines that receive 
full licensure in accordance with FDA-approved labeling and guidance.'' 
All service members were provided the opportunity to receive an FDA-
approved vaccine. To provide maximum choice and flexibility, the DOD 
also recognized vaccines being administered under FDA-EUA or WHO-EUL as 
satisfying the requirement to be vaccinated against COVID-19, in the 
event a soldier wished to voluntarily receive one of those vaccines to 
comply with the mandate.
    Did your service treat the EUA product as ``legally'' 
interchangeable with the FDA-licensed version, i.e., so that the EUA 
version could be mandated? Answer: As described above, DOD's COVID-19 
vaccine mandate did not require any soldiers to receive an EUA vaccine. 
The Army always acted consistent with FDA guidance and Department-wide 
policy.
    Were there any policies or procedures in place to ensure that only 
FDA-licensed products were mandated and that no EUA products were 
mandated? Answer: As described above, DOD's COVID-19 vaccine mandate 
did not require any soldiers to receive an EUA vaccine. DOD Instruction 
6200.02 ``Application of Food and Drug Administration (FDA) Rules to 
Department of Defense Force Health Protection Programs'' stands as the 
Army's policy and procedure for ensuring only FDA-licensed products are 
mandated, absent a separate action by the President of the United 
States.
    How many doses of properly labeled and licensed doses of COMIRNATY 
were given to U.S. service members? Answer: The Army does not have 
access to this data across the Department of Defense. As noted above, 
COMIRNATY was one of several vaccines available to Soldiers.
    How many doses with EUA on the label were given? Answer: The Army 
does not have access to this data but referred the question to the DHA 
Immunization Healthcare Division. Of note, the EUA-labeled version of 
the vaccine was available for several months prior to the mandate; many 
soldiers received it at their election prior to being required to 
become vaccinated.
    Mr. Waltz. Secretary Austin's recission memo tells the Services 
that ``no individuals will be separated solely on the basis of their 
refusal to receive the covid 19 vaccination if they sought an 
accommodation based on religious, administrative or medical grounds. 
``The memo goes on to say ``The Military Departments will update the 
records of each individuals to remove any adverse actions solely 
associated with the denials of such requests, including letters of 
reprimand.'' Is your Service extending those same accommodations to 
those members of your Service that were already eliminated/removed from 
serving our nation? If not why not? What are your services doing to 
help these men and women return to the Service of our nation as 
expeditiously as possible?
    Mr. Raven. The DON separated 5,626 members (1,878 Sailors and 3,748 
Marines) for refusing to obey the lawful order to receive the COVID-19 
vaccine. Any former member seeking a records correction may seek relief 
from either the Naval Discharge Review Board (NDRB) (for requests to 
upgrade discharges) or the Board for Correction of Naval Records (to 
address all other adverse actions). The process for applying to the 
Boards is well documented and readily available through the Boards' 
website.
    Any former member may work through existing processes to 
potentially access back into the Navy or Marine Corps, but will need to 
meet all of the accession standards that would be required of any 
former member. The specific circumstances of each individual's 
discharge, as well as his or her ability to continue meeting all 
accession standards, means that the services cannot guarantee an 
expeditious return to service in all cases.
    Mr. Waltz. According to DOD's data, over 8100 service members have 
been discharged. What impact has the loss of those military members, 
that talent, that experience had on your service?
    Mr. Raven. We observed no significant impact to any specific career 
field within the Navy or Marine Corps. We tracked a number of critical 
ratings and occupations over the course of COVID-19 and did not observe 
any strong correlation among refusers in particular career fields.
    Mr. Waltz. Did the DOD or your service perform any studies or 
analyses of the number of service members who would refuse to take the 
mRNA products based on religious or medical objections? Were any 
studies or analyses performed on the likely number of service members 
who would be discharged, separated, transferred to the IRR, barred from 
drilling etc. as a result of non-compliance? Did your service attempt 
to quantify the costs of the mandate (e.g., lost/discharged/
nondeployable service members) and compare it to the expected benefits 
from the mandate? o If so, what were the results? If not, why not?
    Mr. Raven. The Secretary of Defense mandated vaccination against 
COVID-19 in August 2021. As such, I would defer any information on 
specific analysis leading to that decision to the Office of the 
Secretary of Defense. However, in general, we know that safeguarding 
the health of our force is critical to our mission success. The U.S. 
military has long required several vaccinations against infectious 
disease because we understand the spread of disease poses considerable 
risk to the ability of our Service Members to train, drill, and conduct 
their assigned missions. In addition, global shutdowns and travel 
restrictions had profound impact on our ability to maintain our global 
posture and train with our international allies.
    The Department of the Navy experienced some of the earliest 
incidents that highlighted these risks and potential impact to our 
readiness. An early outbreak on the USS Theodore Roosevelt operating in 
the INDOPACOM area of operations infected 1,331 crew members, among 
whom 23 were hospitalized, four received intensive care, and one 
tragically died. Marine Corps Recruit Depot Parris Island was forced to 
suspend shipping recruits after an outbreak of COVID-19 infected dozens 
of new recruits and staff members. In response to these incidents and 
the evolving global situation, we developed COVID-19 operation plans to 
mitigate gaps in readiness and ensure daily training and mission 
functions were met. A common benchmark of each of these plans was the 
development and widespread utilization of a vaccine.
    Mr. Waltz. 10 U.S.C. 1107a prohibits the mandate of an unlicensed 
emergency use authorization (``EUA'') product, unless there is an 
express written authorization by the President finding that it is 
necessary for national security to do so. There was no such finding by 
President Biden. Yet the DOD and each Armed Service mandated EUA 
products from the issuance of their respective mandates in August 2021 
through the rescission of the mandates in January 2023. Why did your 
service consistently and systematically ignore and violate 10 USC 
1107a? What policies or procedures have been put in place to ensure 
that 10 USC 1107a is not violated in the future? Did your service treat 
the EUA product as ``legally'' interchangeable with the FDA-licensed 
version, i.e., so that the EUA version could be mandated? Were there 
any policies or procedures in place to ensure that only FDA-licensed 
products were mandated and that no EUA products were mandated? How many 
doses of properly labeled and licensed doses of COMIRNATY were given to 
U.S. service members? How many doses with EUA on the label were given?
    Mr. Raven. Section 1107a of Title 10, United States Code addresses 
information that must be provided to recipients of EUA products. The 
President of the United States did not waive the requirement to provide 
vaccine information to patients, and the DOD made information regarding 
COVID-19 vaccinations available to patients in accordance with all 
applicable laws for voluntary and involuntary immunizations.
    DOD follows the requirements of section 1107a of Title 10, United 
States Code and provides the necessary product information to all 
patients at the time of vaccine administration.
    The FDA, not the DOD, determined the interchangeability of FDA-
approved Comirnaty (COVID-19 Vaccine, mRNA) and the FDA-emergency use 
authorized Pfizer-BioNTech COVID19 Vaccine. The FDA publicly published 
its statement regarding the interchangeability of FDA-approved 
Comirnaty and the FDA-emergency use authorized Pfizer-BioNTech COVID-19 
Vaccine at (https://www.fda.gov/vaccines-blood-biologics/qa-comirnaty-
covid-19-vaccinemrna), which states: ``The FDA-approved Comirnaty 
(COVID-19 Vaccine, mRNA) and the FDA-emergency use authorized Pfizer-
BioNTech COVID-19 Vaccine for individuals 12 years of age and older, 
when prepared according to their respective instructions for use, can 
be used interchangeably to provide the COVID-19 vaccination series 
without presenting any safety or effectiveness concerns. Therefore, 
providers can use doses distributed under EUA to administer the 
vaccination series as if the doses were the licensed vaccine. For 
purposes of administration, doses distributed under the EUA are 
interchangeable with the licensed doses. The Vaccine Information Fact 
Sheet for Recipients and Caregivers provides additional information 
about both the approved and authorized vaccines.'' The Department 
followed the FDA's statement regarding the interchangeability of FDA-
approved Comirnaty (COVID-19 Vaccine, mRNA) and the FDA-emergency use 
authorized Pfizer-BioNTech COVID-19 Vaccine, which was consistent with 
Secretary of Defense's memorandum on mandatory COVID-19 vaccination. 
DOD health care providers continue to comply with the applicable FDA-
approved labeling and guidance when administering COVID-19 vaccines.
    Yes, DOD Instruction 6205.02--DOD Immunization Program (https://
www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/
620502p.pdf?ver=z0y1F_Enh5ZAcMDq5hLz-Q%3d%3d)--contains current policy 
for the DOD Immunization Program.
    Based on the Immunization Tracking Registry, which includes data 
from the Military Health System electronic health records, Military 
Service Individual Medical Readiness Systems, Pharmacy Data Transaction 
Service, and TRICARE claims data (network providers):
      12,519 doses of Comirnaty (Monovalent--CVX 208) have been 
received by U.S. Military Service Members.
      1,264,717 doses of Pfizer EUA (Monovalent--CVX 208) have 
been received by U.S. Military Service Members.
      459,058 doses of Pfizer EUA (Monovalent--CVX 208) were 
administered on or after 23 August 2021.
    Mr. Waltz. Secretary Austin's recission memo tells the Services 
that ``no individuals will be separated solely on the basis of their 
refusal to receive the covid 19 vaccination if they sought an 
accommodation based on religious, administrative or medical grounds. 
``The memo goes on to say ``The Military Departments will update the 
records of each individuals to remove any adverse actions solely 
associated with the denials of such requests, including letters of 
reprimand.'' Is your Service extending those same accommodations to 
those members of your Service that were already eliminated/removed from 
serving our nation? If not why not? What are your services doing to 
help these men and women return to the Service of our nation as 
expeditiously as possible?
    Ms. Ortiz Jones. Service members who have already separated who 
believe there was an error or injustice in their specific situation may 
petition their Military Department's Discharge Review Board and Board 
for Correction of Military for consideration. Each case must be 
individually adjudicated based upon individual circumstances. If 
granted relief, eligible members may be allowed to re-join the force.
    Potential Follow Up: What is the DAF doing to get the word out? The 
DAF has placed a banner on the landing page of the Air Force Review 
Boards Agency website with a link to all of the information regarding 
the COVID immunization mandate recission. It also includes information 
on how to apply to the Discharge Review Board and/or the AFBCMR 
depending on applicants situation. Additionally, we have been 
coordinating with
    DAF Public Affairs on press releases to ensure the agency website 
URL is provided. Should those records be corrected, former Service 
members may work with a local recruiter to request re-entry.
    Mr. Waltz. According to DOD's data, over 8100 service members have 
been discharged. What impact has the loss of those military members, 
that talent, that experience had on your service?
    Ms. Ortiz Jones. The DAF involuntarily separated 610 Air Force 
members. However, for the 99% of the RegAF and the nearly 98% of the 
500,000 total force that followed the Secretary of Defense's lawful 
order, vaccination enabled us to maintain our readiness during the 
height of COVID-19, minimized hospitalization of our members and 
allowed the DAF to support our local communities in their COVID relief 
public health effort (e.g., local and Federal testing and vaccination 
programs).
    Mr. Waltz. Did the DOD or your service perform any studies or 
analyses of the number of service members who would refuse to take the 
mRNA products based on religious or medical objections? Were any 
studies or analyses performed on the likely number of service members 
who would be discharged, separated, transferred to the IRR, barred from 
drilling etc. as a result of non-compliance? Did your service attempt 
to quantify the costs of the mandate (e.g., lost/discharged/
nondeployable service members) and compare it to the expected benefits 
from the mandate? o If so, what were the results? If not, why not?
    Ms. Ortiz Jones. The DAF did not conduct studies on potential non-
compliance with a lawful order. The DAF acted quickly, and in 
accordance with the law, to implement the vaccine mandate to ensure the 
readiness of the force.
    Mr. Waltz. 10 U.S.C. 1107a prohibits the mandate of an unlicensed 
emergency use authorization (``EUA'') product, unless there is an 
express written authorization by the President finding that it is 
necessary for national security to do so. There was no such finding by 
President Biden. Yet the DOD and each Armed Service mandated EUA 
products from the issuance of their respective mandates in August 2021 
through the rescission of the mandates in January 2023. Why did your 
service consistently and systematically ignore and violate 10 USC 
1107a? What policies or procedures have been put in place to ensure 
that 10 USC 1107a is not violated in the future? Did your service treat 
the EUA product as ``legally'' interchangeable with the FDA-licensed 
version, i.e., so that the EUA version could be mandated? Were there 
any policies or procedures in place to ensure that only FDA-licensed 
products were mandated and that no EUA products were mandated? How many 
doses of properly labeled and licensed doses of COMIRNATY were given to 
U.S. service members? How many doses with EUA on the label were given?
    Ms. Ortiz Jones. Why did your service consistently and 
systematically ignore and violate 10 U.S.C. 1107a? DAF COVID 
vaccination processes were not in violation of 10 U.S.C. Sec. 1107a. 
Mandatory vaccination requirements of service members at Air Force 
Military Treatment Facilities were implemented consistent with FDA 
regulations, CDC recommendations, and Department of Defense guidance. 
As directed by ASD(HA), DAF used only fully licensed vaccines and EUA 
vaccines which were determined by the FDA to be ``interchangeable'' 
with the fully licensed vaccine.
    What policies or procedures have been put in place to ensure that 
10 U.S.C. 1107a is not violated in the future? As stated above, the DAF 
responses to mitigate the spread of COVID did not violate 10 U.S.C. 
Sec. 1107a. 10 U.S.C. Sec. 1107a does not apply to products that have 
been approved/licensed by the FDA (i.e., Biologics License Application 
(BLA) approval).
    Did your service treat the EUA product as ``legally'' 
interchangeable with the FDA-licensed version, i.e., so that the EUA 
version could be mandated? As directed by ASD(HA), DAF used only fully 
licensed vaccines and EUA vaccines which were determined by the FDA to 
be ``interchangeable'' with the fully licensed vaccine.
    Were there any policies or procedures in place to ensure that only 
FDA-licensed products were mandated and that no EUA products were 
mandated? The Secretary of Defense's guidance stated mandatory 
vaccination will only use vaccines ``that receive full licensure from 
the [FDA], in accordance with FDA-approved labeling and guidance.'' DAF 
complied with legal and policy guidance from DOD and DoJ to ensure 
actions taken to curb the COVID pandemic were lawful.
    How many doses of properly labeled and licensed doses of COMIRNATY 
were given to U.S. service members? DHA-IHD would be best positioned to 
provide a response. The service doesn't track at that level.
    How many doses with EUA on the label were given? DAF operated 
within the FDA and ASD(HA) guidance and all doses were properly 
labeled.