Nominee for head of NIH probed by U.S. Senate panel on vaccine-autism research

WASHINGTON — President Donald Trump’s pick to lead the National Institutes of Health appeared poised for Senate confirmation following a Wednesday hearing, though he still has several hurdles to overcome before taking over the agency. 

Jayanta Bhattacharya laid out five goals for the NIH — including focusing the agency’s research on chronic diseases and funding the “most innovative biomedical research agenda possible” — during the two-hour hearing in the Health, Education, Labor and Pensions Committee.

“The NIH is the crown jewel of American biomedical sciences, with a long and illustrious history of supporting breakthroughs in biology and medicine,” Bhattacharya said. “I have the utmost respect for the NIH scientists and staff over the decades who have contributed to this success.”

But, he said, “American biomedical sciences are at a crossroads” following the coronavirus pandemic.

If confirmed by the committee and then the full Senate, Bhattacharya said he would ensure NIH’s scientific research is replicable, that it has a culture that respects “free speech in science and scientific dissent” and that it regulates “risky research that has the possibility of causing a pandemic.”

“While the vast majority of biomedical research poses no risk of harm to research subjects or the public, the NIH must ensure that it never supports work that might cause harm,” he said. 

Vaccine safety and autism research

HELP Committee Chairman Bill Cassidy, R-La., repeatedly questioned Bhattacharya about how he would direct NIH’s research budget, specifically whether he would steer federal dollars toward researching vaccines that already have a well-established safety record. 

“As far as research on autism and vaccines, I don't generally believe that there is a link, based on my reading of the literature,” Bhattacharya said.

“But what I have seen is that there's tremendous distrust in the medicine and science coming out of the pandemic. And we do have, as you know, senator, a sharp rise in autism rates in this country. And I don't know, and I don't think any scientist really knows the cause of it. So I would support an agenda, a broad agenda, a broad scientific agenda based on data to get an answer to that.”

Cassidy said he supported NIH researching causes of autism, but pressed Bhattacharya on whether he would spend the agency’s “limited resources” on “plowing over ground that has been plowed over, knowing you can never prove a negative.”

Their exchange went on for a few minutes before Bhattacharya said the reason he wouldn’t agree with Cassidy “is that there are people who might disagree with me.”

Cassidy responded by telling Bhattacharya “that’s life.”

“I mean, there's people who disagree that the world is round. And I say that not to minimize these concerns, but people still think Elvis is alive,” Cassidy said. “And so if you just say someone disagrees with me, so therefore I'm going to put precious, limited taxpayer dollars to this — and not to addressing issues of obesity, heart disease, cancer — we've lost. There's an opportunity cost there.”

New Hampshire Democratic Sen. Maggie Hassan said later in the hearing that a now-retracted study that was published in The Lancet in 1998 has been repeatedly refuted.

“So for parents out there who may think that vaccines have something to do with autism, there is no scientific evidence that it does,” Hassan said before telling Bhattacharya that his answers on the issue had missed the mark.

“It disappoints me greatly that neither you nor the secretary now of Health and Human Services are willing to say that declaratively and strongly,” Hassan said. “Because what you do when you hesitate — what the secretary does, quite cynically, in my view, when he hesitates about this — is you turn and sow doubt and worry at a time when we should be focused on actually finding the cure, the cause and the cure of autism.”

Health and Human Services Secretary Robert F. Kennedy Jr. got into heated exchanges during his confirmation hearings in the Finance and HELP Committees regarding past statements about vaccine safety that weren’t consistent with reputable medical research. The full Senate ultimately confirmed Kennedy in February following a 52-48 vote.

Cap on indirect costs

Influential Democrats and Republicans on the committee also pressed Bhattacharya to reverse a decision that would cap how much the NIH pays research universities and medical schools in “indirect costs” at 15%.

That figure is significantly lower than the percentage that many of those institutions have negotiated over the years with the NIH, leading to the potential loss of hundreds of millions of dollars in some places.

Maine Republican Sen. Susan Collins said the decision by the Trump administration to cap the costs, which is paused by a court order while three lawsuits move through the judicial system, was illegal.

“To impose this arbitrary cap makes no sense at all," Collins said. "Furthermore, and I really want to stress this; this is against the law. Since 2017 we have had language in the Labor-HHS appropriations bill that specifically prohibits the indirect cost formula from being changed. And yet, that is what has been done without congressional intent or agreement or consent."

Collins is chairwoman of the Senate Appropriations Committee, which is tasked with drafting and approving the dozen annual government funding bills.

Washington Democratic Sen. Patty Murray, ranking member on the Appropriations Committee, said the Trump administration’s “illegal plan” to cap indirect costs “amounts to a massive funding cut for research institutions, large and small, red and blue states, everyone. And brings a lot of life-saving research to a screeching halt.”

Those indirect costs, officially called Facilities and Administrative fees, go toward costs that support research, but aren’t directly tied to one specific project. Universities often use that money to cover the cost of construction, utilities or for administrative staff.

Bhattacharya committed to following the law, but didn’t say specifically if he’d seek to undo the across-the-board 15% cap on indirect costs. He did testify that he believes institutions spend a lot of the indirect costs money they receive on “things that are worthwhile.”

“But there's a lot of distrust about where the money goes, because the trust in the public health establishment collapsed in the pandemic,” he said. “I think transparency regarding indirect costs is absolutely worthwhile. And it's just something that the universities can fix by working together to make sure that where that money goes is made clear.”

Research on chronic and infectious diseases

Bhattacharya also answered more general questions during the hearing about where he views medical research moving under the Trump administration, specifically on how much funding the federal government directs toward finding solutions for chronic or infectious diseases.

"I think the chronic disease problem is something that the NIH ought to have done a better job at the last several decades," he said. "The mission of the NIH is to address the health needs the American people have and to expand life expectancy of the American people. And we have not achieved that. It's flatlined.”

Bhattacharya testified that he believes scientists and medical researchers need to have more humility in recognizing that they might sometimes be incorrect.

“If I'm confirmed as NIH director, I want to make sure that all the range of hypotheses are supported. That's how you make progress,” Bhattacharya said. “One of the reasons I think that we have not made progress in Alzheimer's as much as we ought to have is because the NIH has not supported a sufficiently wide range of hypotheses.”