This is an evolving story. Look for a related story later today about the new acting CDC director.
By Gina Shaw
The week has been dominated by a literal and figural firestorm at the CDC with Health and Human Services Secretary Robert F. Kennedy Jr. trying to force out the CDC director, other officials resigning in protest and a walkout; all of this followed a campus shooting that occurred earlier this month.
Former CDC Director Susan Monarez, MD, was fired by the White House late in the day on Aug. 27, after refusing to resign under pressure from Mr. Kennedy. Dr. Monarez was confirmed by the Senate with a 51-47 vote as CDC director less than one month ago. Her departure initially was announced on a 5:30 p.m. post from HHS on X, stating that Dr. Monarez was no longer director of the agency. “We thank her for her dedicated service to the American people. @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,” the post said.
In response, over the next few hours, at least four leading CDC officials announced their resignations, including Debra Houry, MD, MPH, the chief medical officer; Demetre Daskalakis, MD, the director of the National Center for Immunization and Respiratory Diseases; Daniel Jernigan, MD, the director of the National Center for Emerging and Zoonotic Infectious Diseases; and Jen Layden, MD, PhD, the director of the Office of Public Health Data, Surveillance, and Technology.
Dr. Monarez refused to resign, noting that she held a Senate-confirmed post and could only be removed at the direction of the White House. In a public statement, her attorneys, Mark Zaid and Abbe Lowell, excoriated the HHS move.
“First it was independent advisory committees and career experts. Then it was the dismissal of seasoned scientists. Now, Secretary Kennedy and HHS have set their sights on weaponizing public health for political gain and putting millions of American lives at risk,” the attorneys said. “When CDC Director Susan Monarez refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts she chose protecting the public over serving a political agenda.
“For that, she has been targeted. Dr. 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.”
Repeated requests for comment from HHS and the White House went unanswered.
Pressured to Resign
According to reporting from Politico, Mr. Kennedy had summoned Dr. Monarez to a meeting on Monday, Aug. 25, where she was pressured to resign and fire several CDC staff, which she refused. On Wednesday night, White House spokesperson Kush Desai confirmed that she had been fired, stating “Susan Monarez is not aligned with the President’s agenda of Making America Healthy Again.”
White House Press Secretary Karoline Leavitt repeated that statement during a press briefing on Thursday, also saying, “This woman has never received a vote in her life, and the president has the authority to fire those who are not aligned with his mission.” Ms. Leavitt added: “A new replacement will be announced by the president or Secretary Kennedy very soon.”
In his resignation letter, Dr. Daskalakis noted that, seven months into the new administration, no expert from his center had yet been given the opportunity to brief Mr. Kennedy. “I am not sure who the Secretary is listening to, but it is quite certainly not to us. Unvetted and conflicted outside organizations seem to be the sources HHS use over the gold standard science of CDC and other reputable sources,” he wrote.
“I am unable to serve in an environment that treats CDC as a tool to generate policies and materials that do not reflect scientific reality and are designed to hurt rather than to improve the public’s health,” Dr. Daskalakis asserted. “The recent change in the adult and children’s immunization schedule threaten[s] the lives of the youngest Americans and pregnant people,” he warned, describing the newly reconstituted Advisory Committee on Immunization Practices (ACIP) as “people of dubious intent and more dubious scientific rigor in charge of recommending vaccine policy to a director hamstrung and sidelined by an authoritarian leader. Their desire to please a political base will result in death and disability of vulnerable children and adults.”
In her resignation email, Dr. Houry stressed the dangers of scientific misinformation. “For the good of the nation and the world, the science at CDC should never be censored or subject to political pauses or interpretations. Vaccines save lives—this is an indisputable, well-established, scientific fact,” she wrote. “Recently, the overstating of risks and the rise of misinformation have cost lives, as demonstrated by the highest number of U.S. measles cases in 30 years and the violent attack on our agency.”
On Aug. 8, a gunman reportedly motivated by vaccine misinformation attacked the CDC’s main campus in Atlanta, striking six buildings as staff barricaded themselves in offices, and ultimately killed a responding police officer, David Rose, before killing himself. Two weeks later, more than 750 CDC employees signed an open letter declaring Mr. Kennedy “complicit in dismantling America’s public health infrastructure and endangering the nation’s health by repeatedly spreading inaccurate health information.”
CDC Staff Stage Walkout; IDSA, SHEA, Other Health Leaders Respond
On Aug. 28, hundreds of CDC staffers staged a walkout and protest in support of the officials, as they were escorted out of the building around 10 a.m. “We need Congress to intervene,” said Dr.Houry, who warned that many others would leave or lose their jobs at the CDC soon.
Leading infectious disease and public health organizations and experts responded to Dr. Monarez’s firing with alarm and demanded action. “Susan Monarez has a history of being a credible scientist, who both publishes and reviews science in a rigorous manner,” said Paul Offit, MD, the director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, in an interview with Infectious Disease Special Edition. “We have dedicated scientists and civil servants who are trying to do the right thing, being forced out by an anti-vaccine propagandist and science denialist.”
“What we’re watching right now is the ever-increasing destruction of public health as we know it in this country,” said Michael Osterholm, PhD, MPH, the Regents Professor, McKnight Presidential Endowed Chair in Public Health, and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, in Minneapolis. “It is, without a doubt, the most dangerous time in my 50 years in public health. We are taking down the very base of what the CDC represents in terms of public health. We’re completely abdicating our role as a global public health force, which will come back to hurt us greatly because there are far too many microbes that emerge on distant shores that have not arrived here because of public health action, which will not be the case in the future.”
In a joint briefing held by the Infectious Diseases Society of America and the American Public Health Association (APHA), Wendy Armstrong, MD, FIDSA, the vice president of IDSA, called the events of Aug. 27 “the worst day in what’s been a steady exodus of expert leaders at the CDC.
“With the resignation of four high-level leaders and the uncertain status of the CDC director, America is actually far less safe than we were at the beginning of yesterday. In any organization or company, if the senior leadership team walked out en masse, we would have to recognize and accept that there is an irrefutable problem at the top. In this case, that is Secretary Kennedy and his continuous attacks on public health.”
State and local public officials are operating in the dark, said Philip Huang, MD, MPH, the director of Dallas County Health and Human Services, who also attended the briefing. “There were two conference calls scheduled for today that I was supposed to be on, where there were supposed to be presentations from CDC staff,” he said. “But we were told they were no longer allowed to present on these sorts of information-sharing calls.”
He described the situation as “frightening” for those at the local health department level. “Over the last several months, we’ve been feeling the impacts of these budget cuts and funding freezes, as well as the loss of the infrastructure and support that we really depend on from the CDC,” he said.
“In Dallas County, we had to cancel over 50 of our community outreach vaccination clinics, including some targeted at schools with low vaccination and high opt-out rates. We’ve lost a lot of other epidemiologic and lab capacity that is essential for us to be prepared for so many public health events. It’s so disheartening how they’ve successfully dismantled so many programs, and everyone in public health has been affected.”
APHA President Georges R. Benjamin, MD, called for Mr. Kennedy’s removal from office. “Since taking office, his actions have sown confusion, demoralized staff and jeopardized the very foundation of our nation’s health security. Most critically, these missteps threaten lives—creating risks that could have been prevented if competent leadership were in place,” he said in a statement. “Legislators and officials at all levels of government who are interested in protecting their constituents should demand Kennedy’s removal. We urge people across the nation to contact their representative and call for change to protect our health.”
In the briefing, Dr. Benjamin and others said it would be difficult for a new CDC director with a commitment to evidence-based science to take the position under Mr. Kennedy’s leadership. “Why would you take a job that is one of the most important science-based jobs in the country, when you know that your boss doesn't support science or evidence?”
“It’s going to make us all question the credibility of what comes out from CDC in the future,” Dr. Huang agreed.
Dr. Armstrong warned that the damage done by the actions that have taken place over the past several months is likely to be generational. “The impact of what we are seeing will last for decades. I think a question for debate is will the CDC be able to be the worldwide gem that it always was, ever again in the future? It certainly won’t be for a long time.”
The Society for Healthcare Epidemiology of America (SHEA) called for a return to stability and evidence-based guidance at the agency. “SHEA is deeply disappointed by the sudden departure of the CDC Director so soon after her confirmation, at a time when the agency most needs stability and authority to carry out its vital mission of protecting the health and safety of all Americans,” a statement from the organization said. “The United States stands at a critical crossroads, where strong, trusted public health leadership is essential to restoring confidence through evidence-based practices and guidance. In an era marked by increasing assaults on science and public health, CDC must be empowered to rise above politics and remain focused on their core purpose: safeguarding and improving the health of communities.”
Senate Reactions
Even Sen. Bill Cassidy, MD (R-La.), a physician who co-chairs on the Senate Health, Education, Labor and Pensions (HELP) Committee and whose advocacy was crucial to Mr. Kennedy’s Senate confirmation as HHS secretary, expressed concern and called for the postponement of the Sept. 18 meeting of the ACIP. “Serious allegations have been made about the meeting agenda, membership, and lack of scientific process being followed for the now announced September ACIP meeting,” he said in a statement. “These decisions directly impact children’s health and the meeting should not occur until significant oversight has been conducted. If the meeting proceeds, any recommendations made should be rejected as lacking legitimacy given the seriousness of the allegations and the current turmoil in CDC leadership.”
Ranking member of the HELP committee, Bernie Sanders (D-Vt.), called for a bipartisan investigation into Dr. Monarez’s firing, condemning the move as “reckless and dangerous” in a letter to Mr. Cassidy. “As part of that investigation, Secretary Kennedy must testify at a hearing in the HELP Committee as soon as possible. We should also invite Dr. Monarez and the senior CDC officials who resigned to testify as well,” he wrote. “It is absolutely imperative that trust in vaccine science not be undermined. The well-being of millions of people are at stake. … We have got to make it clear to Secretary Kennedy that his actions to double down on his war on science and disinformation campaign must end. Too many lives are at stake.”
Dr. Offit warned that Mr. Kennedy is likely to next set his sights on the National Vaccine Injury Compensation Program, established by Congress in the mid-1980s after anti-vaccination claims led to a flood of litigation against vaccine manufacturers, who were going to stop making vaccines, putting Americans at risk. In a recent social media post, Mr. Kennedy called the program “broken” and accused the individuals who run it of “inefficiency, favoritism and outright corruption.”
“Now RFK Jr. says that he wants to modify the program, no doubt to make it much easier to sue the companies or to add things to the list of compensable injuries that aren’t actually injuries from vaccines,” Dr. Offit said, adding that the vaccine companies should stand up for America’s children and meet with President Donald Trump and explain what is at stake. Mr. Kennedy “is not making American children healthier; he’s making them less healthy,” Dr. Offit said.
In a press statement titled “The Sustained Attacks on Public Health in the U.S. Must End Now,” IDSA President Tina Tan, MD, FIDSA, FPIDS, FAA, said the mass resignations “present a clear and present danger to Americans of all ages and leave our nation extremely vulnerable to a wide range of public health threats from outbreaks to bioterror attacks.”
