 I ask unanimous consent that the Chair be authorized to declare a recess at any time without objection so ordered and I ask unanimous consent that members may have five legislative days to revise and extend the remarks without objection so ordered. I want to welcome everyone to this hearing of the Military Personnel Subcommittee. Today we convene to address a matter of paramount importance how the Department of Defense monitoring of COVID-19 has impacted our military ranks and the implications of the COVID-19 vaccine on the health and well-being of our servicemen and women. Over the past four years the COVID-19 pandemic has presented unprecedented challenges to our nation and its armed forces. As the virus has become just another part of the yearly flu season we need to look with clear eyes and healthy skepticism at how the Department handled the pandemic, the effects of the virus and vaccines on our servicemembers' health, and if the Department's policies and practices actually mitigated any risk to servicemembers and their families. Many servicemembers and their families are concerned with the safety and value of the COVID-19 mRNA vaccine prompting questions about adverse reactions and unforeseen circumstances most concerningly related to heart conditions and hypertension in a young military population. And the data is worrying. In 2022 we saw heart-rated conditions like hypertension and cardiomyopathy among servicemembers increased by 47 percent and 94 percent respectively over DOD averages. In addressing this pandemic there is no doubt that the Department has made mistakes and that some decisions were made for political gain rather than based on science in fact. So today we seek clarity for the servicemembers who took the COVID-19 vaccine for their families and for everyone's future health and well-being. We seek to understand the extent to which the Department of Defense has monitored the impact of COVID-19 on our military personnel including any potential correlation between the virus itself and the development of medical conditions. Moreover, we aim to examine the data surrounding the administration of the COVID-19 vaccine within our ranks evaluating its safety profile and any observed trends in adverse reactions and health outcomes. As stewards of our nation's defense it is incumbent upon us to ensure the well-being of those who wear the uniform. We owe it to our servicemembers to provide them with the best possible care and support especially in times of crisis. By convening this hearing we demonstrate our commitment to transparency, accountability and above all the health and safety of our military community. I would like to welcome our witnesses Dr. Lester Martinez Lopez the Assistant Secretary of Defense for Health Affairs at the Department of Defense and Dr. Shauna Stallman, Senior Epidemiologist of the Armed Forces Health Surveillance Division at the Defense Health Agency Public Health. Thank you for being here today. I hope this hearing provides us an opportunity for our members to have a productive exchange. Before hearing from our witnesses let me offer ranking member Takuta an opportunity to make any opening remarks. Thank you Mr. Chair. Thank you to our witnesses for being here today and providing testimony regarding the Department of Defense's Health Surveillance efforts which includes monitoring health threats and emerging infections, biosurveillance and epidemiological analysis to include the impacts of infections and vaccines. As a member of the House Select Subcommittee on the Coronavirus Pandemic I am not unfamiliar with whether it's to politicize science behind vaccines to the detriment of public health and national security. I cannot emphasize enough the importance of using a fact-driven science-based approach to this conversation today. Let's focus on the facts. Safe and effective COVID-19 vaccine options have been readily available since 2021. According to the CDC in the first 10 months that COVID-19 vaccines were available they saved over 200,000 lives and prevented over 1.5 million hospitalizations in the United States. This is the purpose of these vaccines to save lives and prevent severe illness. While the military COVID-19 vaccine requirement was rescinded in January 2023 96% of the active and reserve force over 1.9 million people safely received one or more doses of a COVID-19 vaccine. Vaccine requirements have longstanding precedent in our armed forces. Since the founding of the U.S. military vaccine requirements have been necessary to preserve military readiness and personnel safety from General George Washington's smallpox vaccination of the Continental Army in 1777 to the flu vaccine requirement in the mid-20th century. Today the Department administers as many as 17 different vaccinations and while it was in effect the COVID-19 vaccination requirement helped ensure that our armed forces remained healthy and medically ready. Service members that have received COVID-19 vaccines have done so under the most intense safety monitoring program in United States history. The CDC, the FDA and other federal partners use multiple passive and active surveillance systems and data sources to conduct comprehensive safety monitoring of COVID-19 vaccines and the Department of Defense conducts near real-time monitoring and research on the impacts of COVID-19 vaccinations and infections through the military health system. Studies continue to show that the benefits of COVID-19 vaccines outweigh the risk yet concern and apprehension regarding the safety of COVID-19 vaccinations do still exist. This may be in due in large part to a fundamental misunderstanding of the Department's COVID-19 vaccine surveillance data which has unfortunately been the subject of misleading news stories over the past year. The Department of Defense's monitoring efforts of COVID-19 have reported a small number of increases in adverse health effects following the COVID-19 vaccine requirement but correlation does not imply causation. The legitimate questions remain as to the root cause of these identified adverse health effects. The overarching question for today's panel is one of paramount importance. Are there long-term effects from COVID-19 on our service members? And if so how do we discern whether any increase in reported adverse health effects are attributable to the virus itself or to the vaccine? To address this question comprehensively we must approach today's discussion with scientific rigor ensuring that we prioritize the health and safety of our all-volunteer force as a whole above all else. As we navigate the complexities of this issue we must acknowledge the profound impact that the COVID-19 pandemic has had on the operational readiness of our armed forces. First and foremost the pandemic resulted in thousands of hospitalizations across the department and the tragic loss of hundreds of lives. It also had far-reaching second and third order effects on our military including disruptions in training exercises and deployments, the mobilization of military medical personnel to support civilian pandemic response efforts and negative impacts to military family quality of life issues like delays and move, child care and health care access. At the heart of today's discussion regarding the department's monitoring of COVID-19 lies the fundamental commitment to the health and well-being of our service members that must ultimately include a shared dedication to transparency and facts grounded in scientific evidence. Mr. Chairman I'd like to request that the Department of Defense's report on cardiac and kidney issues and service members prior to and following the COVID vaccine requirement be included in the record for today's hearing. Thank you Mr. Chair. Congress required this report in fiscal year 23 NDA and it serves as an example of the careful and thoughtful monitoring the department is doing. Thank you again Mr. Chair for this hearing and I look forward to our witness testimony and the responses to questions that will be posed today. I yield the balance of my time. Thank you. I understand that you have one consolidated opening statement. We respectfully request that you summarize your testimony in five minutes or less. Your written comments and statements will be made part of the hearing record. Following opening statements each member will have an opportunity to question the witnesses for a very liberal five minutes. With that Dr. Martinez Lopez you may make your opening statement. Chairman Banks, ranking member Takuta, distinguished members of the subcommittee. We are pleased to represent the Office of the Secretary of Defense to discuss the department's ongoing health surveillance of the force related to COVID-19 in the aftermath of the global pandemic. This testimony provides the committee with information on some of the key data used to track the health of service members and provides updates on some past and future studies related to the impact of COVID-19 on the health of the service members. Service members like all members of our nation experience the effects of the global COVID-19 pandemic. However, unlike the civilian population when service members particularly those deployed or on operational units became sick with COVID-19 it impacts national security. This is an unacceptable risk for the military and our nation. As part of force health protection the Department of Defense took actions to blunt the impact of the pandemic on the force and to maintain operational readiness. This was achieved primarily through force health protection measures like vaccinations, testing, masking, symptom monitoring and remote work. These actions saved lives and resulted in less severe disease and fewer hospitalization among those service members that were infected. Nevertheless, the impact of COVID-19 lingers with some service members and veterans like just like many other Americans are experiencing the long-term effect of COVID-19 infections including long COVID and heart-related conditions. As we seek to keep the total force healthy and on mission the department monitors for infectious diseases and a range of other health threats. We do this through the dedicated staff with public health commands collocated with military units around the world. In addition, we have a team of analysts evaluating the data for trends and investigating any signal that are identified. One of the primary tools this health threats analyst used to answer complex epidemiological questions is a relational database called the Defense Medical Surveillance System or DMSS. As the central repository of medical surveillance data for the U.S. Armed Forces, DMSS contain up-to-date and historical data on diseases and medical events including inpatient and ambulatory medical encounters, immunizations, prescriptions, laboratory data and deployment health assessment and casualty data. To enhance our ability to identify signals in the noise of infectious disease data, we have related capability to a DMSS called the Defense Medical Epidemiology Database or DMSS. DMSS using its proper context is a useful tool for DOD medical and public health professionals to monitor health trends among their local populations and identify potential issues that require further inquiry or research. The DOD's data is compelling. In looking at the impact of vaccine, the department's data show that unvaccinated individuals with a reported COVID-19 infection were at significantly higher risk of developing three cardiac conditions, myocarditis, pericarditis and acute myocardial infarction, compared to individuals who receive a COVID vaccine. Further, the DOD data show that among the 31 active duty service members who died from COVID-19, none of them were fully vaccinated. Now, today, four years after the emergence of SARS-CoV-2 virus, it continues to circulate in our military communities and evolve into new variants, presenting an ongoing health threat capable of harming service members and affecting operations. The department remains committed to protecting the health of the force and to better understand these impacts as we prepare for future health threats. Our ongoing studies will support the development of therapeutics and medical countermeasures. We will also continue to evaluate the relationship between COVID-19 infection or COVID-19 vaccinations and cardiac conditions through surveillance and research. Our ongoing data surveillance will help inform future DOD policy on force health protection, improve readiness, and help prepare for and mitigate against future health threats. Thank you for inviting us here today to speak with you about the department's health data, which enables our ongoing surveillance of the impact of the COVID-19 and the force and the health of the force. We look forward to answering your questions. Thank you for your opening statement. I'll begin with questions and yield myself five minutes. Dr. Martinez Lopez, I find it convenient that in the report to Congress you cited in your testimony and the same report that the minority just entered into the record, that the researchers chose to use 45 days as the at-risk period following a COVID-19 infection, but only 21 days for the at-risk period following the COVID-19 vaccination, especially when the administration and the Biden administration, the CDC, told everyone that you weren't considered immune immediately after the shot. Seems to me like you were skewing the data to make it fit what you wanted the conclusion to be by doing that. And to justify your use of the vaccine, you also admitted that the sample sizes are inaccurate due to underreporting. So how are we to trust the department and the Biden administration that you all are being honest when it reaches a conclusion that all of these medical problems were due to the infection and not the vaccine? Mr. Chairman, as a retired soldier and now giving the opportunity to serve the safety, the health, and the readiness of the force and the service members is the most important to me. The data is very clear, you know, that you have higher risk of developing these conditions if you just got the disease without the vaccine. The vaccine doesn't exempt you from getting some of these complications, but it really does decrease the risk to the service members. I would defer to Dr. Stallman on the 45 versus the timeline differential. Sure, thank you. As an epidemiologist with the DHA, I am concerned as well with the health and wellness of our service members and we take reports of any increase in medical conditions that are potentially due to the vaccine or to the virus seriously. In that report, we worked with cardiologists, specialists within DHA to determine the best risk window to use when looking at an adverse event in relation to the vaccine or to the virus. If you're looking at an event due to a vaccine, say five years later, it becomes less likely that that event is actually due to the vaccine because you've accumulated much more exposures over time. So in talking with cardiologists and SMEs and in the work that the immunizations healthcare division has done in clinically following the myocarditis and pericarditis cases within DOD, we knew that most myocarditis and pericarditis cases when they occur due to result of vaccine will occur within 21 days after the vaccine. We also know in working with cardiologists, experts within DOD that if you're going to have myocarditis or pericarditis event following COVID-19 infection, it's most likely to show up within that 45-day period. So we chose that period because we're using administrative data. We were not able to go in to confirm that the event was clinically ruled out due to some other conditions. So using administrative data, you have to use a risk window period so that it's likely you're looking at an event that's due to your exposure. Okay, so on that point, either one of you, can you tell me how many new cases of myocarditis there were among active duty service members in 2020? Thank you. There are around 100 to 200 cases of new myocarditis among active component service members each year. What about 2020? Obviously you tracked this. We do, but I do not have that exact number in front of me. Okay, so according to DOD data obtained by Senator Ron Johnson, there were 275 new myocarditis cases among active service members in 2021, which is a 151% more than average over the five years prior. And the reason I bring that up is because I asked your office before this hearing to give me that specific number, and you gave me the 20... Instead of giving me the 2020 numbers, you gave me the 2021 numbers. So it's very suspicious why you wouldn't have that data available when you had an exact answer for me for 2021. Thank you. We do have the number. I do not have it in front of me. It takes our analysts time to write programming code to pull the data. It then has to be reviewed by an epidemiologist to ensure that the code is accurate, that the output is accurate, and we will get you those numbers. Can you at least remember if there were fewer cases of myocarditis in 2020 than what there were in 2021? I mean... I believe they were higher in 2021 than in 2022. As the report, the DOD report on cardiac and kidney issues shows, there was more than a 10 times increase rate in myocarditis among active component service members who had a recent COVID-19 infection compared to a 2.6 increase rate among active component service members who had recently received the COVID-19 vaccine. I'm going to yield five minutes to Ms. Takuta. Thank you, Mr. Chair. Just some basic questions, perhaps, so that we get a better understanding of the research and the data that you folks have been doing. What does DOD currently use the DMSS, the Defense Medical Surveillance System in D-Med, Defense Medical Epidemiological Database, data form? I'm just trying to get an understanding of the regular practical uses of the data beyond research. Congresswoman, we take very seriously... I mean, data to formulate policy is critical to us, especially when it comes to clinical policy. So I'm not the expert, I would defer, but I'll open up saying we have two systems. We have multiple systems. The two key systems is the DMSS, the Defense Medical Surveillance System. That's a relational database that encompasses pretty much all the many of the healthcare points of every service member since 1990. And then we have another system, it's called D-Med, the Defense Medical Epidemiological Database. That's not a database, that's a web-based tool that actually can perform queries into the DMSS. But it's really for the field that that information is not identifiable for a particular patient. So it gives the people in the field an idea that something may be happening and that's what we want. But then if you have a question about something happening, then we have to do further studies using the other system, the DMSS. But I'll defer to Dr. Almans if she wants to expand. Yes, thank you. D-Med is used more as hypothesis generating. It allows users to do certain limited canned queries of the data. The default output, if you do a query on D-Med looking at a certain ICD diagnostic code from a drop-down list that you can choose, the default output that it will give you include numbers of outpatient encounters with diagnoses made in the first diagnostic position. So it's a useful tool to get a quick idea of how commonly we're seeing encounters for certain conditions. It can also do very basic population level queries. It does not contain any information about a vaccine. The Defense Medical Surveillance System is used by health analysts at the Armed Forces Health Surveillance Division to do comprehensive health surveillance for service members. It's the data source that feeds the D-Med. So D-Med is refreshed on an approximately monthly basis with data from the DMSS, but just a limited amount of those data. Thank you. That differentiation is very helpful. I think part of it is while D-Med seems to be more of that open source that you have it is also very limited. And if people do not understand that in fact it is an aggregated data set, it's not disaggregated. Obviously because you have privacy issues, although you could potentially de-identify some of that, but because it is not disaggregated out, you really can't differentiate between new encounters, follow-up encounters. I believe that's something that you've referenced in your testimony that this D-Med is very much limited, potentially open to misinterpretation of results for those that are using it in the field to try to figure out if something is happening. So my question would be given that it's subject to misinterpretation and it's very limited in its scope because it is aggregated, has there been conversations about perhaps making D-Med more of a disaggregated type of system so that you can get truer results if you are actually using it? I mean, if not, it's always going to be subject to potential misinterpretation by the users or limited by user understanding of the data that's within it. Congresswoman Vanityen, the intent of the D-Med is to have it available across the force as a first trigger. In other words, you have a question, you have a query. But I guess my concern is you have it as a first trigger, but if the user is unsophisticated to understand that it is limited, what you're going to have out there is misinformation and false assumptions. So I do feel that we have to make sure when we do have these data sets that it gives the most accurate information possible and is this user-friendly as possible. I think right now the way D-Med is, you know, it is great that it's there, but I think it is going to be subject to more misinformation and false assumptions being made if users are unaware of its limitations and misinterpreting the data that they're getting from it. I know, Chair, I'm almost out of my time, so I'll just yield back to you. Thank you. Yield five minutes to Mr. Gates. Dr. Martinez Lopez, is the Department of Defense covering up vaccine injuries? Congressman, no. So who is Lieutenant Ted Macy? Congressman, I don't know the Lieutenant. Well, it's sort of the reason we're here. On November 27, 2023, Navy Medical Corps Officer Lieutenant Ted Macy shared a video on X where he expressed grave concern for his patients suffering after receiving the COVID-19 vaccine. And according to Lieutenant Macy, he tried reporting the DoD data from the D-Med system to his superiors, and he was subsequently silenced and punished. He lost access to the D-Med system. He's been removed from seeing his patients and has been relegated to some broom closet somewhere to continue his service. It seems to me that Lieutenant Macy has suffered more than the people who screwed up the D-Med system. So why is this person being punished for trying to showcase data that was alarming? Congressman, I'm not prepared to talk about specifics on the Lieutenant because I really don't know. But I'll be glad to answer any questions regarding the system of the vaccines and our findings. Well, right. But part of the system and the vaccines and how we conduct oversight is that if there are whistleblowers who say that you're not doing your job right, if there are whistleblowers concerned about a cover-up, there's a process by which that has to get to the Inspector General and be reviewed. And in the case of Lieutenant Macy's concerns, those languished for like more than five months. Do you have any reason why a request made through the chain of command to view this data that could illuminate concerns over vaccine injuries was smothered? Again, Congressman, I'm not prepared to talk details. Okay, let's maybe let's get to what you're prepared to talk about. Let's get to the actual data that's so concerning since the people who raise concerns about the data, they get punished and we don't seem to remember them. The hyper-tensive diseases up 23 percent when you compare the 2016 to 2020 averages to cases in 2021. Does that sound right? That sounds right. Okay, so hyper-tensive diseases up 23 percent. Then ovarian dysfunction up 35 percent. Does that sound right? I'm not specific. Can we... Does that sound right, Dr. Stallman? I think you're referencing something from an older document, but it could be. I'm referencing data from the Defense Medical Surveillance System. Is that a system that you're both familiar with? Yes. Okay, so that system says that hyper-tensive diseases up 23 percent. Ovarian dysfunction up 35 percent. Pulmonary embolisms, witches, we all know can kill you up 43 percent. Myocarditis as Chairman Banks was describing, up 151 percent. Is it really your testimony that these massive spikes in these serious ailments are a consequence of contracting COVID? Is that your best medical opinion? Congressman, not all, but I mean many of them obviously ovarian dysfunction. There are other reasons, emboli, there are other reasons, but yes, there's an influence, there's a correlation not only from our data for the data of CDC that yes, correlate COVID with having higher likelihood of having some of these... Yeah, just pardon me for not treating the CDC assessment. Not the ovarian one, but the other... The vaccine or the virus? Both. The virus, and you know like the cardiomyopathy is a little bit higher. The risk is much higher if you just get the disease, but you have an enhanced risk, not as big as when you get the infection, but you do get some risk from getting the vaccine. It's minimal, but yes. So there is vaccine risk associated with hypertensive diseases, right? Hypertension, help me out. Not that I'm aware of, but... Okay, well how about ovarian dysfunction? Not that I'm aware of. And how about pulmonary embolisms? Yes. Okay, so you're here giving us testimony that the vaccine increases someone's risk of pulmonary... No, pulmonary the COVID virus doesn't... I'm asking about the vaccine. No, the vaccine. Not that I know of. No, and myocarditis, you think there is a risk? Yes, a slightly higher risk, but it's much higher that when you get the virus itself, when you get infected. And to tease out those data distinctions, wouldn't it be responsible to assess these conditions in people who got the disease and were unvaccinated versus the people who got the disease and were vaccinated? Has that type of an analysis been done? We did look at this in the DOD report on cardiac and kidney conditions. The information stratified by all the different ways vaccinated not vaccinated, those are not all included in the report. I do have the data on that. When we reported the 10 times increase rate due to recent infection that is adjusting for vaccination status, it's also adjusting for demographic risk factors, including age, sex, and BMI. Right, so did that analyze ovarian dysfunction? It did not. Did it analyze pulmonary embolisms? It did not. And did it analyze hypertensive diseases? It did not. Well, I mean, we got thousands more people than the average in 2021 getting hypertensive diseases, thousands more people getting ovarian dysfunction, thousands more people, or I'm sorry, hundreds more people getting these pulmonary embolisms. What's the case against analyzing those conditions that have seen these increases in the vaccinated versus the unvaccinated? We are continuing to do surveillance on these conditions, and we are open to doing additional work on this. With chronic conditions, it is tricky to look at that in relation to a vaccine. Is a pulmonary embolism a chronic condition, or is it an acute condition? We can look at acute conditions. Yeah. Your medical knowledge goes far beyond mine, but I would consider a pulmonary embolism acute, not chronic. With hypertension, it could be difficult to get causal evidence to link that to the vaccine, but yes, we can look at acute outcomes. Right, but see, that's how you get the causal evidence. The reason there are people concerned that the DOD is engaging in a cover up here is because you seem to be willfully and purposefully ignorant to those comparisons on these ailments that are skyrocketing now for pregnant women, for people who get pulmonary embolisms, for people with hypertension. And in the one area you've looked, myocarditis, you're here giving testimony that that actually causes this increased risk factor. And so, Mr. Chairman, I hope we continue to follow up on this because my deep concern is that there is a cover up here and that they're playing games with the data so that we can't actually assess whether it's the vaccine or the ailment that is causing these acute conditions. And wouldn't it be a tragic thing to have to discover that we hurt people with the vaccine more so than the virus did with the ailment, particularly in a condition where now the CDC, whose opinion, I guess, we treat like the gospel, is saying that you just should quarantine for 24 hours after you're done with your fever. So they have evolving sensibilities on this. And the only way we get to the bottom of it is that data comparison. I thank the Chair's indulgence and I yield back. Thank you. I agreed. It's why we asked for the 2020 figures. And I didn't ask you on the record before, but will you please, will you submit the 2020 figures to the committee? Can we take that for the record? Yes, sir. Okay. Mr. Moylan. Thank you, Mr. Chairman. Dr. Martinez-Lopez. And by the way, thank you for your service and military. I appreciate that. And our guard unit back in Guam, Air and Army, were also very responsive to the COVID-19 situation. They played a big role in supporting our island. And our adjutant general, he has a lot of medical background too. He's a surgeon as well. He's really concerned now we need to be ready for the next public health emergency on Guam. After all, we're Indo-Pacon region. We're the most western territory. We need to protect our community and our troops. So what I need to know is your interest in the Indo-Pacon area specifically in Guam to support our National Guard and Air Force out there because they need to be properly staffed. So I need to know your interest in that and making sure their training is up to date and equipped as well so we can have, we'll be ready for the next pandemic health emergency. Congressman, we are actually, I'm intimately involved with the issues of Guam. I'm very concerned about that. My concern is that we have the systems, not only for reserve and guard for the many active duties that we have in Guam and family members. We are concerned about biosurveillance, making sure it's not just about COVID. Not only about the things we know, but the things that we may not know coming about. And we want to make sure that, A, we detect them early. And number two, we have a response mechanism to ameliorate whatever threat comes in Guam way or any other way. I appreciate your concern and your continuous interest in the Indo-Pacon specifically, thank you for that. Another question, doctor, what do you and Admiral Valdez need to safeguard the Defense Health Agency's ability to support the military readiness if we were enter a conflict in Indo-Pacific? While ensuring patients do not experience a lap and care, what steps are you taking with stakeholders or doctors, hospitals in on Guam to prepare for future conflicts? We're way out there. We have no support from the mainland. Time is of the essence, please. Congressman Lutheran General Crossland just came from the theater, went to visit Guam and visited with many of the civilian and military leadership on the island to address the medical. She's the director of the Defense Health Agency. And she came back with a report, you know, trying to understand, she understood what the issues are. Now we're working through how we're going to counter whatever gaps she found on her trip. This has to be a two-way conversation not only the military leadership, it has to be with the civilian leadership of the island, medical in the medical aspects. So we make sure that at least that we do our best to be in a good position to respond to any needs that in particular our service members and family members need. Very good. And final question, doctor. Currently the U.S. Army Reserve on Guam carries innovative readiness training mission in one of the villages, Jigo, to provide medical care to my community. Efforts like this are important for building good will between the people of Guam and the military, especially as the department plans to station increasing numbers of personnel on island. What can be done to expand efforts like this? This is very good for our community as well. Congressman, is in our interest to aid to, you know, have our troops ready and prepared to do the care they're going to be asked to do in combat. The way we achieve that is by seeing patients and taking care of patients. If there's an opportunity, you know, a mutual opportunity by providing care to the local communities, we also enhance our skill sets as clinicians. That's a win-win for the department and our neighbors. So we are pursuing this, not only in Guam, we're pursuing this across the country. In those places where we can have a mutually agreeable and acceptable benefit, then we're going to exactly go in that direction. And I hope that there will be many opportunities in Guam just to do that. I appreciate that. And I look forward to working with you closely on how we can assist as well. So thank you for your efforts. Thank you, Mr. Chairman. Thank you, Mr. Chairman. I appreciate you both being here. Although I must say there's a growing trend within the DOD that my colleagues recognize as well where people come here unprepared to be able to have the substantiated data that we require and that we've requested to make sure that we're able to get the answers and follow up. This is not the first time, so I hope that in future hearings you'll actually make sure that we have the subsequent data that we're trying to ask for and all the algorithms and all the other data planning has actually gone forth. I want to start out with the fact that kind of following along one of my colleagues, Mr. Gates' testimony, where he talks about how many people have been impacted negatively, whether it be by myocarditis, whether it be by ovarian issues, whatever the case may be, in addition to those who are unconstitutionally purged out of our military for religious and medical freedoms that they should have been afforded. So I just want to say for the record, do either one of you have an opinion, an objective opinion, on whether or not you feel that medical and religious freedoms should be a key element for all members of our armed forces? Congressman, DOD is committed to protect religious liberties. As you know, there's a process to request. Actually, I do know that process by the way, and I got to say if it was actually to be true would be impressive because on average they were able to adjudicate through six individual layers per the Under Secretary of Readiness who is here in less than five minutes. Imagine the ability to reach out to a minister, to a priest, to other religious figures who they actually are trying to get this counsel from or looking at their individual medical background from historical medical data from their families and being able to determine that in five minutes. I can tell you, as a person who now works for the federal government, we are not that efficient. If anything, it would take us about five weeks to be able to do so. But they were adjudicating these in less than five minutes. Do you think that they could adequately adjudicate a medical or religious exemption within five minutes or less? Congressman, I'll have to defer to the services that executed that for us. You know, there has been an admission to the significant errors in the defense medical epidemiology database that disordered the true numbers of medical encounters faced by service members. How can you be certain this issue has been satisfactorily rectified as to not continue to mislead the American public? Thank you. I could take that. We do take data accuracy seriously. We know that data goes into making decisions about healthcare that's provided to service members. When we became aware of the programming error that was done in DMED, this was in January 2022, the error, by the way, was an analyst had used a count function instead of a sum function, which led to the data that existed between 2016 and 2020 to be corrupted. That error was immediately corrected. Since then, we've implemented both additional technical and functional controls. So on the technical side, they're doing additional QC steps. We've also implemented a functional team that's doing additional quality assurance checks on a periodic basis. So this is for both of you, and I'd really like to hear your thoughts on this. Uniform service members were expelled from the military and punished for standing up for their personal rights. How do we ensure that they are properly compensated for rightfully expressing these rights? How do we address the discrimination and mental drain that these individuals have faced and continue to face by things such as giving them a general discharge as opposed to honorable? Also the DOD forcing individuals to pay back their bonuses where they did not separate from the military at their free will. They were forced out of the military. What would be your recommendations and how we would adequately compensate these individuals unconstitutionally purged? By the way, almost 9,000 who was unconstitutionally purged, in addition to the 41,000 recruitment deficits, pretty significant for the largest volunteer force in the world. Congressman, as you probably know, all those service members had the right to appeal the discharge to the services. Dr. Martinez Lopez, we have seen where many of them had tried to appeal this and in many cases wasn't actually given any answer whatsoever. Again, we can adjudicate things in five minutes whenever we're denying people their medical and freedom religious rights, but we can't actually adjudicate something quickly where it should be a simple thing that if you did not exit the service for something which was disciplinary and reasoning, not medical and religious freedom, but disciplinary and U.C.M.J. Article 15 or above, court marshaling, then I don't understand how we can at least acknowledge the fact that this is unconstitutionally purged and at least given the opportunity on an honorable discharge as opposed to a general where in many cases this plagues them and follows on in their careers and in future jobs. But that still doesn't answer the bottom question, which is that these individuals, and my personal opinion, I know there's others on this committee that feel the same way, should be compensated. They should have their benefits restored. They should have their original rank reinstated for those who actually still want to serve our country, not a political agenda that is placed before us. And they should be given the rights that they were actually denied. Would you not at least admit to the fact that these people who are trying to serve as you have served and as I have served should be denied these rights or be given these rights? Congressman, we have processes and there are laws and processes in the system. I hope that the services who, you know, I'm confident the services are doing their best to exercise those procedures to look at the Arish case in particular. I'll have to defer to the services. I appreciate that you have the confidence. I wish that I had that and shared that same confidence levels. But under the direction of someone like Secretary Lloyd Austin, I have very little when you talk about the dereliction of duty that has been placed forth and the prioritization of things that are not to the military armed forces as benefits. With that, I yield back. Thank you. I want to thank Mr. Gates who just left the room for requesting this hearing. I think it's a really important conversation, the type of oversight that this committee should be doing more of. It's important that we work together to differentiate between the rise of medical conditions due to COVID-19, the infection, or the COVID-19 vaccination. This effort is vital for guiding public health responses, informing treatment and management strategies, monitoring vaccine safety, and maintaining the public trust and immunization programs. By systematically investigating and addressing these concerns, policymakers and healthcare professionals can effectively safeguard public health and the health of our men and women in uniform who put their lives on the line for this great country. I want to thank both of our witnesses again and thank you for providing your testimony and answering your questions this afternoon. I want to thank the members who participated. There being no further business, the subcommittee stands adjourned.