Committee hearing is about two and a half hours. This hearing will come to order and without objection the chair is authorized to declare recess at any time. The worlds population killing approximately 300 Million People in the 20th century alone. Smallpox is the only human disease to be eradicated thanks to the development of the vaccine. Another devastating disease, polio just started a third case worldwide in 2018 compared to 350,000 cases in 1988. Everyday vaccines are saving lives. There is no such thing as healthy skepticism when it comes to vaccines. There is a wellfunded Disinformation Campaign targeting the public and weakening the publichealth law. School vaccination requirements have been commonplace in the u. S. Generations and exemptions were granted for legitimate political reasons. However in my home state of texas, the number of unvaccinated children who spiked since 2003 when they expanded the exemptions to include non medical reasons. The 57,000 last year we are seeing this played out across the country and innocent children are falling ill. Health officials have confirmed 21 cases in texas this year and 1261 nationwide. 61 of which lead to serious complications. The Science Committee may not have jurisdiction over the agencies but we have long had a role in supporting Public Health through good science and we would explore the integration challenges for Vaccine Development through the lens of influenza for the healthiest among us it leaves us out for several days with no lasting side effects. However, for the young and the elderly, it can be dead late. The center for Disease Control estimated 48. 8 melian illnesses and 79,000 deaths during the 2017, 2018 flu season. The each year influenza vaccine production begins with a collection analysis of data many months before the beginning of the season. The challenge with influenza is that the viruses change constantly and by the time the season begins, the vaccine may not match the circulating viruses. Scientists are working to develop alternatives as well as a vaccine that will not require annual updates. Another many are incomplete. Incomplete data in the system through modernization of the systems the data analytical tools across the federal and state levels we will be able to accelerate the Vaccine Research and development for many diseases. We have two expert panels that will help us understand from basic research to Vaccine Development, production and deployment and surveillance. The witnesses will also describe the role of federal agents and the private sector including the part worships among all of the stakeholders. I want to extend a warm welcome to all of you this morning and think the vice chair for his leadership on this issue. I look forward to todays discussion and i might say i have a mark upon another committee so i will have to leave before we get through all of the deliberations. The chair will now recognize you for an opening statement. Id like to thank you for holding this hearing especially given that we are in the middle of flu season. Nearly a million individuals are hospitalized every year including more than 48,000 children. In oklahoma since the 2019 flu season beyond, theres been one death and 73 hospitalizations. However, these numbers would be worse if we didnt have vaccines. Vaccination is by far the best measure we can have today to. Its easy to forget a little over 100 years ago the world faced one of the deadliest pandemics and history the 1918 h. One and one epidemic that has thasthe spanish flu that killedn estimated medical technologies at the time were limited to isolation and. The influenza vaccines did not exist and antibiotics havent been fully developed yet. Thankfully due to basic research, advancements were made in treatment and prevention. The development played an Important Role in reducing and eliminating deadly disease. I can still recall my fathers stories about how late summer and fall are terrifying times as a child because of the threat of polio. Luckily for me i didnt have to experience this fear because of the first polio vaccine available in the United States in 1955. And thanks to widespread vaccinations its been nearly eradicated in the United States with just 33 cases reported in 2018. However, it remains a threat in some countries with the world becoming more attractive for moderconnected throughmodern try takes one traveler with polio to bring the disease into the United States. And as im sure we will hear this morning from the witnesses, the best way to keep the United States polio free is to maintain high immunity for vaccinations. Considerable advancements have been made in the technology disease surveillance, medical care, medicines, drugs, vaccines and pandemic planning. While significant progress has been made i, the gaps remain in the severe pandemic could still be devastating to the global population. If the population has grown, so has the livestock and poultry population to feed them. This expanded number of host provides increasing opportunities for the viruses from birds, cattle and pigs to spread and infect people and as a member i supported the creation of the National Animal vaccination and veterinarian countermeasures which was included in the last farm bill. For a Rapid Response to an animal disease outbreak. An outbreak if it were to occur and we were not prepared on the entire sector suffer immense losses causing longterm harm to the economic viability of the United States livestock in swine production come not to mention the damage to human health. I look forward to hearing from Witnesses Today about the current state of the stockpile of the Human Vaccines to provide the capacity for Rapid Response to emergency situations. I particularly look forward to hearing how the influenza vaccine managing infrastructure is supporting the Public Private partnerships with domestic manufacturers to increase preparedness levels and response capacities for potential events in the United States. Last i would like to say how pleased i am to see the recent executive order to address modernizing flu vaccines. The order recognizes it as a Public Health and National Security priority with the potential to inflict harm on the United States and largescale illness and death. Most importantly it establishes a National Task force to explore alternative vaccine production methods and technologies including a plan to accelerate the development of universal flu vaccines. I look forward to seeing what recommendations come from the task force and i would like to thank the chairman for holding this hearing and also both witness panels for taking the time to share your expertise, insight with us this morning and i will yield back the balance of my time. Thank you very much. If there are members who wish to submit additional statements at this time i will introduce the witnesses. First is doctor Daniel Jernigan for the National Center for immunization and respiratory disease at the cdc. Responsible for oversight and direction of a broad Scientific Program to include the detection, prevention, treatment and response to the pandemic of influenza. They are responsible for national and global surveillance as the World Health Organization corroborated center for the surveillance epidemiology control. Doctor jernigan entered the cdc and 94 and is a retired captain of the Public Health service and was the recipient of the 29 Teams Service 2019 service. The next witness on the panel is doctor anthony of the institute of allergy and Infectious Diseases, a position he has held since 1984. He oversees Extensive Research and applied research to prevent, diagnose and treat established Infectious Diseases such as hiv, respiratory infections, tuberculosis and ball area as well as emerging diseases. He also supports research on the transportation transplantation and related illnesses including antiindian disorders asthma and allergies. He has advised six president s on hiv aids and many other domestic and Global Health issues. He was one of the principal architects of the emergency plan for aids relief, a program that has saved millions of lives throughout the developing world. As our witnesses should no, you will each have five minutes for your spoken testimony. Your written testimony will be included for the hearing. When you have completed your testimony, we will begin with the question. Each member will have five minutes to question the panel. Well start with doctor jernigan. Thank you very much and good morning chairman lucas and distinguished members of the committee. I am the directors of the influenza position at the center of Disease Control and prevention i want to thank the committee for the opportunity to discuss the work supporting vaccine innovations to improve the prevention of influenza. Each year influenza causes a Significant Health burden with many millions of americans becoming ill, hundreds of thousands requiring hospitalization and tens of thousands dying. They are constantly changing requiring us to update the components every year. Sometimes these changes can be sudden and significant resulting in those that can lead to devastating pandemics. Hospitalization deaths can happen in any season and each year the vaccination prevents millions of illnesses and thousands of severe sometimes tragic outcomes. Influenza vaccines are very safe and remained the single best way for people to fight the flu. Despite the significant benefits, the effectiveness of those are not optimal. We are working with nih and other federal and State Government partners and private sector to use cuttingedge science to make vaccines that are. The longlasting broadly protected universal vaccine will talk about are the ultimate goal for the flu prevention. However, vaccines are still years away. In the near term we can save millions of americans by making incremental improvements to the vaccines that can be produced using already available production platforms and getting more americans vaccinated each flu season. The cdc has a central role in every part of the development and administration cycle including continuous virus tracking around the globe, preparation of the vaccine viruses, purchasing 10 of the vaccines used in the United States and monitoring the safety and effectiveness. To improve, theyve implemented innovations throughout the vaccine lifecycle. The cdc has invested in and collaborated with every state Publichealth Department on surveillance. This has resulted in automated realtime Electronic Laboratory reporting of test results using cloudbased messaging. To characterize all of the specimens received this means we can identify and track the virus is much more quickly and accurately leading to more timely connection and earlier detection of the viruses with pandemic potential. The genomic sequencing equipment at once filled a room now fits in the palm of your hand. We now have a mobile mini lab that can be taken on the plane as they carry on and can be set up anywhere in the world including resource constrained settings. The cdc has implemented innovations for supporting vaccines by developing vaccine viruses for the cellbased vaccine and by providing genomic sequences used to make the protein vaccine. Both of these have the potential to be manufactured more quickly and may be more effective than those that are grown in neighbors. They also now routinely generate a vaccine viruses using a technique called reverse genetics. This allows us to build the vaccine in a matter of days or weeks making the u. S. For quickly to respond. The cbc was the first to establish a National System for the protein monitoring the and thats effectiveness provides critical information for the manufacturers and researchers in developing enhanced vaccines by collecting more specific data about how low the vaccine works each season. Recently weve expanded the network and we are planning to add new testing and conduct more studies to better evaluate the effectiveness. Finally a major component of improving the vaccine impact is getting more people vaccinated. Fewer than half received their influenza vaccines and despite all of our success and leadership there is still more we need to be able to do. Each of the topics i mentioned today from working with domestic partners to tracking the viruses to the candidates into studying the vaccine effectiveness will benefit from investments in generating more precise and timely data. I believe we can harness this to make vaccines work better. I want to close today by reminding you all to make sure that you and your families are vaccinated before the Holiday Travel begins and thank you for the opportunity to talk about the work and i look forward to your questions. Thank you very much madam chair and members of the committee thank you for giving me the opportunity to testify before you today. I am the director of the National Institute of allergy and Infectious Diseases and im going to talk to you over the next couple of minutes about the efforts to improve the influenza vaccine and develop a universal flu vaccine. As shown on the slide although as it is mentioned its important to be vaccinated because even if it isnt 100 effective or even 50 effective, the benefit. We can do better because the influenza vaccines are not consistently optimally effective. We know through history that the pandemics occur but we are usually tothey areusually too le as we were in the 2009 and finally we spend considerable time chasing after these as we had with the significant investments we needed to do that, but they never occurred. My colleague and i gave the introduction emphasizing the point i just made a it would lead to a better capability to respond to the pandemic influenza but ultimately get us to the goal we will speak about in a minute or two and that is the development of the influenza vaccine. In the summer of 2017, we put a group together to develop a plan that we published in 2018 for the Strategic Planning and Research Agenda to mobilize scientists throughout the country into th and the world tp a universal flu vaccine. So let me explain what we mean by universal flu vaccine. This is somewhat of a complicated slide but it does make the point. We will not get a universal flu vaccine overnight. It will be a statewide process in which we go from improvement in the broad capability of responding to a particular type strain versus the ability to respond to all of the strains. Note on the lower lefthand part of the slide is divided into two major groups. Group one and group two. On the righthand part of the slide, the tip of the triangle is what we do today. We make the vaccine for this season that is highly specific to the strains circulating this season however, those change. So then until we have a universal vaccine that essentially covers all of these. We are going to do that with new technologies as you are well aware. Youre well aware. We currently have a technique of developing a vaccine although thats tried and true and timehonored its inefficient and has many areas of going wrong so we are using new platforms as it is shown here on the slide such as proteins, viral vectors, nanoparticles and others. This is a blowup of the influenza virus into to the right is an important protein called the keynote was nick. Its important to note it has two components. The head is the part that the body makes them immune response but it often changes leading to the ineffectiveness. However, the dark blue is the stem doesnt change much at all so the strategy now, one of several strategies is to develop a vaccine in which you cut that off and put it on a narrow particle that will ultimately serve as the vaccine so if i can show you this, this is a 4 million times a blowup of what the first universal flu vaccine would look like and these dark blue areas are the stems. We have slaughtered a phase one trial as it is shown here in the spring of this year. It will end at the end of this year and then next year we will do a group to universal flu vaccine. So as the president said in the executive order, the purpose of what we are doing is to go ahead and improve little by little until we get the vaccines to protect us in the most efficient way possible. Thank you. At this point we will begin the first round of questions and the chair will recognize herself for five minutes. The campaign has different populations with different systems and innocent children are falling ill today with diseases that we once thought were eradicated in the u. S. Young women are being put at increased risk for cancer and these task forces are creating the major challenges due to the vaccination efforts. How big of a role does the social media play in this resurgence and how can we overlook the need to overcome these tactics and what are they doing specifically to combat these efforts . One of the reasons why they dont get vaccinated is they are worried about the effectiveness of vaccines with regards to the discussion here, improving the effectiveness of the vaccine certainly would get more people vaccinated. The question is around the role of the misinformation and social media participat