Susan Monarez, the CDC director, appears during her Senate confirmation hearing on Capitol Hill in Washington, on June 25. Monarez, who just weeks ago became director of the Centres for Disease Control and Prevention, has been ousted from her job after a tumultuous month. Photo / Tierney L. Cross, The New York Times)
The White House said that it had fired Susan Monarez, the new director of the Centres for Disease Control and Prevention, after a tense confrontation in which Health Secretary Robert F. Kennedy jnr tried to remove her from her position and she refused to resign.
Monarez, an infectious disease researcher, was sworn in just a month ago by Kennedy, but had clashed with the secretary over vaccine policy, people familiar with the events said.
Four other high-profile CDC officials quit en masse, apparently in frustration over vaccine policy and Kennedy’s leadership.
Because Monarez had been confirmed by the United States Senate — previous CDC directors were not subject to such confirmation — she served at the pleasure of the president.
Kennedy likely did not have the authority to dismiss her.
Her lawyers insisted she was staying put. But a spokesperson for President Donald Trump, Kush Desai, said in an email message that Monarez had been terminated.
“As her attorney’s statement makes abundantly clear, Susan Monarez is not aligned with the President’s agenda of Making America Healthy Again,” Desai wrote.
“Since Susan Monarez refused to resign despite informing HHS leadership of her intent to do so, the White House has terminated Monarez from her position with the CDC.”
Monarez’s firing, along with the resignations of four of the CDC’s top leaders, will undoubtedly throw the nation’s public health agency into further turmoil after a tumultuous month in which agency employees were laid off and a gunman fired a barrage of bullets at the Atlanta headquarters, killing a police officer and terrifying employees.
Her lawyers, Mark S. Zaid and Abbe Lowell, asserted in a statement earlier today that Monarez’s situation was symbolic of larger issues.
“It is about the systematic dismantling of public health institutions, the silencing of experts, and the dangerous politicisation of science,” Zaid and Lowell wrote.
“The attack on Dr Monarez is a warning to every American: Our evidence-based systems are being undermined from within.”
The clash between Kennedy and Monarez, which had been brewing for days, burst into public view.
The Department of Health and Human Services announced on the social platform X that Monarez was “no longer” director of the CDC.
Without elaborating, the agency thanked her for “her dedicated service to the American people,” adding, “@SecKennedy has full confidence in his team at @CDCgov who will continue to be vigilant in protecting Americans against infectious diseases at home and abroad.”
Hours later, Lowell and Zaid disputed the department’s account, saying Monarez “has neither resigned nor received notification from the White House that she has been fired, and as a person of integrity and devoted to science, she will not resign”.
Kennedy and his department, they said, “have set their sights on weaponising public health for political gain and putting millions of American lives at risk.”
Neither Monarez nor the HHS responded to requests for comment.
Monarez and Kennedy were at odds over vaccine policy, according to an Administration official who is familiar with the events.
The official, who spoke on condition of anonymity for fear of retribution, said Kennedy summoned Monarez to his office on Tuesday and demanded that she resign. When she refused, Kennedy demanded that she remove the agency’s top leadership by the end of the week.
Monarez then called Senator Bill Cassidy, the Republican chairman of the Senate health committee, who in turn called Kennedy, according to the official.
Kennedy, furious, summoned Monarez to a second meeting yesterday and accused her of “being a leaker”, according to the official, and told her she would be fired.
The official said Monarez spoke to other senators as well. Today, a White House official told Monarez that if she did not resign by the end of the day, Trump would terminate her.
The four high-ranking agency officials who did resign are Dr Debra Houry, the CDC’s chief medical officer; Dr Demetre Daskalakis, who ran the centre that issues vaccine recommendations; Dr Daniel Jernigan, who oversaw the centre that oversees vaccine safety; and Dr Jennifer Layden, who led the office of public health data.
Some cited an increasingly tense environment within the Administration that had become intolerable.
“I am not able to serve in this role any longer because of the ongoing weaponisation of public health,” Daskalakis wrote in an email to colleagues, adding that they “continue to shine despite this dark cloud over the agency and our profession”.
Jernigan was deeply involved in the agency’s response to anthrax, swine flu and Covid; Daskalakis helped the nation cope with an mpox outbreak; Layden established the Covid strategic science unit; and Houry built the agency’s opioid response programme.
Former CDC leaders said the departures would harm the agency and the nation.
Dr Mandy Cohen, who ran the agency during the second half of the Biden Administration, called the officials “exceptional leaders who have served over many decades and many administrations”, and warned that “the weakening of the CDC leaves us less safe and more vulnerable as a country”.
Dr Anne Schuchat, the CDC’s principal deputy director until her retirement in May 2021, called them “the best of the best”.
“These individuals are physician-scientist public health superstars,” she said. “I think we should all be scared about the nation’s health security.”
The resignations, which coincided with a decision by the Food and Drug Administration to put new restrictions on updated Covid vaccines for the northern autumn-winter season, occurred at a difficult time for the nation’s public health agency.
This month, a gunman angry about Covid vaccines opened fire on CDC headquarters in Atlanta, killing a police officer, shattering bullet-resistant windows and traumatising employees.
After the attack, Houry and Daskalakis pushed for Monarez to reassure CDC employees that the matter would be given the attention it deserved.
“We’re mad this has happened,” Houry said in a large group call the day after the shooting.
Daskalakis, whose office was among those hit by bullets, told Monarez that employees wanted to see a plan for their safety and an acknowledgment that the attack was not just “a shooting that just happened across the street with some stray bullets”.
It seemed to many employees on the call that Monarez had not spoken to Kennedy directly after the attack.
Kennedy did not address the shooting until the day afterward, when he posted condolences on his official X accounts. Trump still has not spoken about the assault.
CDC employees issued an open letter pleading with Kennedy, who has repeatedly cast doubt on Covid shots and other vaccines, to stop spreading “inaccurate information”.
Monarez, while not pointing a finger at the health secretary, echoed their concerns about misinformation in a note to employees.
In interviews and opinion articles, many current and former employees — including one of the agency’s most renowned directors, Dr William Foege — also blamed Kennedy’s rhetoric for playing a part in the shooting.
Foege, 89, who helped eradicate smallpox in the 1970s, recently wrote that Kennedy’s “words can be as lethal as the smallpox virus”.
In an email to colleagues, Jernigan said he was grateful for the opportunity to serve the American public for more than 30 years but “given the current context in the department, I think it is best for me to offer my resignation”.
Houry, in her own email, said she, too, felt unable to continue, given the circumstances at the agency: “This is a heartbreaking decision that I make with a heavy heart”.
Monarez was the first non-physician to lead the CDC in more than 50 years.
She had been acting director of the agency since Trump took office, and she was nominated to the top post after the President withdrew his first choice, Dr David Weldon.
Morale has plummeted at the agency as Kennedy severely reduced the workforce, sharply cut back CDC funding and eliminated some core functions of the agency.
Monarez was expected to run her plans by Matt Buckham, the new chief of staff at HHS, and by Matt Buzzelli, the chief of staff at CDC, according to a person familiar with the unusual arrangement.
Her brief leadership included dealing with the fallout from decisions by Kennedy, who had unseated members of an influential vaccine advisory committee and replaced them with some staunch opponents of existing immunisation policies.
Late last week, HHS confirmed that a vocal Covid vaccine opponent had been appointed to lead a subcommittee reviewing safety of the shots, upsetting public health experts.
In addition, Kennedy has gone against the consensus of many scientists and public health experts by announcing new efforts and funding for research into whether there is a link between vaccines and autism, despite years of studies that have not found evidence to support his belief.
In recent weeks, the CDC has been under pressure from Kennedy’s allies to grant access to a large database called the Vaccine Safety Datalink that is managed in part by large health systems around the US.
Kennedy brought in David Geier, a widely discredited researcher who has published studies using the database and purporting to show a link between vaccines and autism.
Geier’s team has been seeking the data from the CDC and other corners of the federal health bureaucracy for the work seeking a tie between vaccines and autism.
Kennedy previously complained that officials were blocking his access to federal data. But in a presidential Cabinet meeting yesterday, he suggested that his staff was likely to have a preliminary answer to the cause of autism soon.
“We’re finding interventions, certain interventions now that are clearly, almost certainly causing autism and we’re going to be able to address those in September,” Kennedy said.
This article originally appeared in The New York Times.
Written by: Sheryl Gay Stolberg, Apoorva Mandavilli and Christina Jewett
Photographs by: Tierney L. Cross, Getty Images
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