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Tensions rise between CDC and Biden’s health team over boosters

The new approach has blinded senior health officials in the federal government, further straining the tenuous relationship between the White House and the CDC.

Seven senior administration officials working on the federal response to the pandemic, and three others familiar with the subject, described the growing tension in interviews with POLITICO. All spoke on condition of anonymity to discuss the sensitive issue more openly.

The internal struggles come as the administration seeks new approaches to quash the Delta variant and regain the confidence of Americans after two months of setbacks and missteps. And it raises questions about the administration’s ability to make clear policy recommendations to protect Americans as the pandemic continues. This will require close collaboration between health agencies and the White House to distil rapid and unpredictable discoveries about virus behavior and vaccine performance into practical advice.

“We have made so much progress in the past seven months of this pandemic,” Biden said in a speech Thursday outlining sweeping new policies to tackle the virus. “Now we just have to finish the job with truth, with science, with confidence, and together as one nation.”

Neither the White House nor the CDC responded to a request for comment.

At the agency, which is still recovering from the crushing workloads and political pressures it has endured in the last year of the Trump administration, the extra trips have lowered morale further.

Walensky has fiercely defended the CDC in recent weeks, telling White House officials who have pledged for months to follow science that the end-September recall target was likely too ambitious and his agency had failed. studies that would help provide justification for the shots have not yet been completed. The CDC and FDA were also still awaiting recall data from vaccine makers Moderna and Johnson & Johnson.

Other CDC officials working on the pandemic response are also enraged by the situation and what they see as unrealistic expectations from the White House as it tries to bolster public opinion.

“Science takes time,” said a CDC official. “I don’t know how many times we have to say this. “

A senior administration official said the Biden administration’s public commitment to letting science rule was wavering behind the scenes. “The CDC is putting out what it can when it can,” the official said.

But a second senior health official in the administration objected to the idea that the Sept. 20 recall target had been imposed on Walensky. The person said senior federal health officials agreed to the language and date of September before the White House announced the plan in August. The timeline was established based on the FDA’s projections of when it might look at company-specific data as well as manufacturer data, the official said.

Some at the CDC say the agency must change its approach, working quickly with the White House Covid team to develop policy recommendations during what they describe as one of the pandemic’s most chaotic and critical times . In addition to the planned booster rollout, the CDC and the FDA are set to consider the use of Covid-19 vaccines for children under 12, a group that has seen more infections and deaths then that the country has returned to in-person schooling.

But it is the nascent stimulus package that has generated the most friction lately. Three senior officials said they were surprised by the September White House deadline, saying it imposed a tight timeline on the CDC and FDA to analyze data, publish vaccine efficacy studies and approve or authorize injections.

White House officials and Anthony Fauci, the president’s chief medical adviser, were eager to start distributing reminders later this month, citing data from Israel and other countries suggesting that the effectiveness of vaccines were dwindling and revolutionary infections were on the increase. These officials pushed the CDC to publicly share data from its ongoing studies of vaccine performance and breakthrough cases.

Walensky and other senior CDC officials, who agreed that the vaccine’s effectiveness was waning and that Americans would eventually need boosters, noted in their conversations with the larger Biden Covid team that the CDC did not have still enough data from his studies on the issue. Its scans, which looked at infection rates among frontline health workers and residents of specific cities such as New York and Los Angeles, would take weeks.

The White House and leaders of the FDA and CDC “are trying to align the two agencies further,” an official said, particularly amid the departure of two of the FDA’s top vaccine regulators, Marion Gruber and Philip Krause. The couple announced their retirement this month, in a decision a former official attributed to frustrations over the CDC’s role in the stimulus package.

The FDA’s frustrations with the CDC are long-standing and predate the pandemic. The agencies clashed over data regarding perennial issues such as foodborne illness and issues related to other epidemics and emerging conditions, such as the lung injury called EVALI which has been linked to the use of the electronic cigarette. The FDA has long argued that the CDC is moving too slowly, two former officials said.

That the White House Biden “start to exert a little more pressure [on CDC] is long overdue, ”said a former Trump health official. “[President Donald] Trump’s mistake was not to understand that the way to fix it was not to publicly reprimand them … but to lead and reform.

The FDA said in a statement that its “long-standing collaboration with the CDC continues to have a positive impact on the public health of our country.” He added, “Particularly for vaccines, our agencies have always had and continue to have shared responsibilities when the FDA makes regulatory decisions and the CDC’s Immunization Advisory Committee provides clinical recommendations.”

Whatever the motivation, the episode of the CDC advisory committee in late August only reinforced perceptions in the White House that the agency is the weakest link in a collaborative Covid-19 response. narrow and extremely competent.

In the aftermath, some officials outside the CDC working on the Covid-19 response blamed Walensky for the turmoil around the boosters, who they said struggled to instill a sense of urgency in top scientists in the world. ‘agency. Others took a more sympathetic view, attributing the problems to the institutional problems within the CDC that Walensky is trying to address.

As a sign that even the CDC director herself acknowledges the agency has repeatedly failed messaging, several people familiar with the matter said Walensky had recently considered hiring new communications staff. The agency’s main spokespersons are career employees who predate Walensky’s arrival in January.

She also tried to streamline the CDC’s pandemic response team, calling on respected agency veteran Henry Walke to lead the way. Three former health officials applauded Walensky’s restructuring earlier this year, saying it could fix some of those issues, though many felt the move sidelined CDC veteran Nancy Messonnier, who resigned earlier this year after decades at the agency working on respiratory illnesses.

The reorganization began in the spring, before the Delta variant became the dominant Covid strain in the United States, causing a massive increase in cases and hospitalizations. With the rise of Delta, officials of the CDC’s pandemic team told POLITICO, they are increasingly overwhelmed. In the past two weeks, Walensky has decided to strengthen this team again.

Since the start of the Biden administration in January, the CDC chief has worked to address inefficiencies within the agency, streamlining its Covid-19 response and ensuring his office coordinates more closely with the White House, two senior CDC officials said. One of his main goals, these officials said, has been to put the agency back on the map after the Trump administration ousted its scientists throughout 2020. Biden also pledged to leave science and agencies behind. scientists leading political conversations around Covid.

Senior administration officials working on the pandemic response have become frustrated with messages from the CDC on Covid policies, including masks, in recent months – and what they see as a slow response to crises such as the emergence of the Delta variant. Much of the criticism leveled at the CDC centers on its data collection and analysis, officials said.

The agency has struggled for years to get accurate disease data from state health services, and the pandemic has strained the country’s public health infrastructure, causing massive delays in case reports and investigations. This made it difficult for the CDC to gather information on breakthrough infections to inform administration policies regarding boosters.

The CDC also often publishes its studies in medical journals, but this approach can delay the release of critical information to the public. Walensky recently took steps to address the issue, telling CNN this month that the CDC was working with the New England Journal of Medicine to publish data on pregnant women and vaccines on its website before publishing the results in the newspaper.

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