WASHINGTON, D.C. – Today, during a hearing of the Senate Committee on Health, Education, Labor and Pensions (HELP), U.S. Senator Jacky Rosen (D-NV) questioned Francis Collins, MD, PhD, Director of the National Institutes of Health (NIH) and Vice Admiral Jerome M. Adams, MD, MPH, Surgeon General of the United States on planning and strategy related to vaccine deployment in rural communities in Nevada and across our nation. A transcript of the Senator’s full exchange can be found below, and a video of the Senator’s full exchange can be found here.

ROSEN:  Thank you for holding this hearing. Thank you to both doctors for being here today. I really appreciate your work and your testimony. But to begin with, I really want to raise again the importance of ensuring that we have robust longitudinal studies on how the virus impacts a wide range of patients in the short and the long term, including what treatments are most effective. So, I've introduced the bipartisan Ensuring Understanding of COVID 19 to Protect Public Health Act to make sure that this critical research happens and that it includes a very diverse set of patients. This bill was included in the House-passed HEROES Act, and I ask support from my colleagues, and especially on this committee, to ensure it's included in the next COVID package passed by the Senate. That's going to help us determine future cures. But I'd like to move on now to rural access to vaccines and information. 

The CDC has asked states to draft and be ready to follow vaccine distribution plans in less than two months. Our health departments are doing the work of heroes, but they are stretched thin and they still lack the robust federal support that they need. Last month, I was on a statewide virtual tour, I heard how the need for basic health care services remains a huge issue, particularly in rural towns. In Beatty, Nevada, they still lack access to regular primary health care. Rural areas across the country are continuing to struggle as the pandemic exacerbates existing problems with access to adequate medical care.

So, with this in mind, Dr. Collins, what recommendations do you have for making sure that rural areas are not left out of the critical vaccine distribution—both the actual delivery of vaccines, information about who should receive a vaccine? I have communities that have no hospital, no physician offices, and no pharmacies, and closest medical services potentially a hundred miles away. What is the national plan to deploy this vaccine across our states? Mobile clinics perhaps? Can you tell us what’s going to happen, or will we have to figure it out on our own?

COLLINS: Well, I'll start. But I'm sure the Surgeon General might want to add something because that's even more in his domain. But certainly, the distribution issues are critically important and are under intense planning processes right now, recognizing that [Operation] Warp Speed has not just the role of trying to encourage the clinical trials, but also the manufacturing and then the distribution… [unintelligible]… And how do you actually get these doses to the places where they need to be? Recognizing that we're going to need to do this in a priority way so that the most vulnerable people get the doses first. That means thinking about rural communities and all the ways that can happen, but it's going to be working with the states, and CDC is already deeply engaged in that. I think they've got a little misunderstood when they said to the states, you know, we need to be ready by November 1st just in case. I think they were trying to say, let's be prepared here and not wait until the last minute. And that is very much the conversation that's going on. But the Surgeon General may want to say a little bit more about rural areas in particular.

ROSEN: Yes. I want to make sure that Congress is your partner and being sure that we leave no rural communities behind.

ADAMS: I'll be very brief. I grew up in a rural community in southern Maryland where the nearest hospital was quite far away. And I ran the State Department of Health in Indiana, which is a mostly rural state for three years. We've utilized the Vaccines for Children's Program (VSC). We've utilized the Section 317 immunization program. We have infrastructures in place to get vaccines out to those territories. But you're right, we have to acknowledge that we still have done a poor job of making sure we have equitable distribution of vaccines -- before there is a COVID vaccine -- in those communities and we need to double up on those efforts. We're working with state and local health departments to make sure that occurs. And I stand ready to work with you to make sure people know vaccines are safe and effective and that we're addressing the practical issue, the availability, convenience, cost, service, quality, and satisfaction; making sure that not just it's there, but the people can get it easily and are happy with the way they received it. These are all issues that are on my radar and that we're working with local partners to try to figure out before we get a vaccine.

ROSEN: Thank you, and I only have a moment left, but I'm going to submit this for the record. But, we have seen a troubling decline in vaccination rates overall during the pandemic. It was reported that in May this year, vaccinations generally were down by approximately 64 percent [in Nevada]. This is extremely concerning not just to me, but to everyone across our state. And I'm sure other states have similar statistics. And so, Dr. Collins, how do you think that the current drop in vaccinations impact getting a COVID-19 vaccination out? Should we pair up giving existing vaccinations to people along with the COVID-19 vaccination? Would you recommend that? Or how do you think that we can bring our general vaccination rate back to where it should be as well?

COLLINS: Well, the general vaccination rate is a crisis right now that ought to be attended to right now. There's no reason to have to wait until we see what happens with the current COVID-19 vaccines that are in clinical trials. So all of those folks who might be listening to this, who fell behind on childhood immunizations because of concerns about going to the doctor's office, those doctors' offices have figured out how to make themselves about the safest place you can be. It's time to catch up. And I know your physicians will be very willing and interested to help you do so. And then that ought to be happening this fall, as well as everybody getting their flu shot, which is another vaccine whose appropriateness and urgency is going to be even more the case than ever.

ROSEN: Thank you. My time expired. I really appreciate your service. Thank you, Mr. Chairman.

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