
FDA commissioner floats ideas on how to better handle the pandemic
FDA Commissioner Rob Califf joined the heads of the CDC and NIH in the hot seat today before a key House subcommittee, explaining that there needs to be a much faster, more coordinated way to oversee vaccine safety, and that foreign biopharma inspections, halted for years due to the pandemic, are slowly ramping up again.
Califf, who stressed to the House Energy and Commerce’s Subcommittee on Health that the CDC also needs better data, made clear that the FDA’s ability to monitor the safety of vaccines “would also benefit greatly by a coordinated federal public health data reporting authority.”
FDA currently uses its Biologics Effectiveness and Safety (BEST) Initiative, to analyze health insurance claims or electronic health records (EHRs) from large data systems. But Califf made clear there are still limits to these uses.
“While the BEST Initiative has been essential for our work and provided us with a robust picture of safety data, our ability to analyze claims information is limited by the fact that some vaccinations are not recorded in health insurance claims data,” Califf’s written testimony says, adding:
Further, when insurance claims databases or EHRs detect an adverse event, FDA often needs to quickly verify information or access additional information to evaluate the adverse events of interest. When we request records to verify adverse events detected by the BEST Initiative databases it has taken FDA around 8-12 weeks in some cases to receive voluntary access to these records. Additionally, coordinated federal public health data reporting authority would help the Agency to more swiftly identify adverse event patterns and trends associated with the use of vaccines or other MCMs, and swiftly be able to communicate with health care providers and patients about safety signals.
Committee Chair Cathy McMorris Rodgers (R-WA) questioned Califf on why there aren’t more FDA staffers coming into the agency’s campus in White Oak, MD, and Califf defended his team, and in his written testimony, adding:
Our staff have had to be pulled off other work and have been working relentlessly on pandemic issues for the past three years, leading to a significant backlog and fatigue.
But he also called for the creation of a specialized program within CBER to defend against emerging pathogens to better position FDA to deal with these kinds of threats.
“In consultation with HHS partners, the program could: provide recommendations and guidance to developers of vaccines and other medical products and relevant federal partners; use real-world data or real-world evidence to study the safety and effectiveness of products for addressing biological incidents and identify which products may be best suited for specific pathogens or for use in different populations; and facilitate product development including advances in manufacturing,” Califf wrote.
Rep. Gus Bilirakis (R-FL) questioned Califf on FDA’s foreign inspections, which have rapidly declined during the pandemic. Between April and September 2021, the FDA said it completed just 37 foreign drug inspections, which compares with more than 1,200 in 2019.
Califf acknowledged there’s more work to do on supply chains, but it should be an interaction between FDA and industry. He noted that FDA now has additional hiring authority to ramp up the number of inspectors,”and we’re catching up, particularly in China due to lack of access until very recently. We’ll have a lot to discuss on how to make this better. It’s fragile,” Califf said.
As far as thoughts on the manufacturing boom in China and India over the last decade or so, Califf said, “We’ve got to be there … and I hope we can fix that and bring it back to the US.”
In his written testimony, Califf called on Congress to do more to align federal and state officials on the supply chain too.
“Allowing for disclosure of non-public information to these agencies with complementary functions related to FDA-regulated products could achieve faster and more effective action to protect the public health during national public health emergencies, other state/local disaster declarations, outbreaks or other public health events, and for routine regulatory oversight,” he wrote.