Kennedy
Sought to Fire C.D.C. Director Over Vaccine Policy
The
director, Susan Monarez, declined to fire agency leaders or to accept all
recommendations from a vaccine advisory panel made over by Mr. Kennedy,
according to people with knowledge of the events.
Health
Secretary Robert F. Kennedy; C.D.C. director Susan Monarez.
Sheryl
Gay Stolberg Apoorva Mandavilli Christina Jewett
By Sheryl
Gay StolbergApoorva Mandavilli and Christina Jewett
Aug. 28,
2025
https://www.nytimes.com/2025/08/28/health/rfk-jr-susan-monarez-cdc-vaccines.html
Health
Secretary Robert F. Kennedy Jr. summoned Susan Monarez, the director of the
Centers for Disease Control and Prevention, to his office in Washington earlier
this week to deliver an ultimatum.
She
needed to fire career agency officials and commit to backing his advisers if
they recommended restricting access to proven vaccines — or risk being fired
herself, according to people familiar with the events.
Dr.
Monarez’s refusal to do so led to an extraordinary standoff on Thursday that
paralyzed the nation’s health agency, which is still reeling from mass layoffs
and a shooting this month that killed a police officer and terrified employees.
Top
officials have quit, Dr. Monarez’s future is in doubt and President Trump has
yet to publicly back his health secretary. But late Thursday night, Mr. Kennedy
sent an email to C.D.C. employees saying he had installed his deputy, Jim
O’Neill, a former biotechnology executive, as the agency’s acting director.
The White
House press secretary, Karoline Leavitt, said earlier in the day that Mr. Trump
had fired Dr. Monarez. “The secretary asked her to resign,” Ms. Leavitt said.
“She said she would, and then she said she wouldn’t, so the president fired
her, which he has every right to do.”
Lawyers
for Dr. Monarez insisted that, because she had been confirmed by the Senate and
served at the pleasure of the president, she would leave only if Mr. Trump
personally instructed her to do so. They said she had chosen “protecting the
public over serving a political agenda.”
The
president — who previously praised Dr. Monarez as “an incredible mother and
public servant” — was silent.
Dr.
Monarez, who had been sworn in just one month earlier, had lost access to her
agency email. Three other high-ranking officials, who had resigned in support
of the director on Wednesday, were escorted out of the agency’s Atlanta
headquarters. A new chief operating officer was installed.
And Mr.
Kennedy, who had tried unsuccessfully to fire Dr. Monarez himself, fumed at a
news briefing in Texas that the C.D.C. — an agency he has previously described
as “a cesspool of corruption” — needed an overhaul.
“There’s
a lot of trouble at C.D.C., and it’s going to require getting rid of some
people over the long term in order for us to change the institutional culture,”
he said.
Public
health leaders said the health of all Americans was at stake.
With Dr.
Monarez facing an uncertain future, and the agency’s top ranks depleted,
leading public health experts wondered aloud on Thursday whether the C.D.C.
could recover — and what might happen should a pandemic or other health crisis
arise.
They said
they fear the United States will be unable to handle a future pandemic or other
health crisis.
“I think
this is quite a negative and potentially catastrophic step for the country,”
said Adm. Brett Giroir, a pediatrician who helped lead the response to the
coronavirus pandemic during Mr. Trump’s first term and advised Mr. Kennedy
during the latest transition.
“I don’t
know who’s in charge, honestly, and that’s frightening because the No. 1 thing
you need is somebody in charge,” he added.
The
Monday meeting was just the beginning of a tense back-and-forth between Dr.
Monarez and her boss, the health secretary, according to people familiar with
the events.
In
addition to firing top C.D.C. leaders, Mr. Kennedy insisted that Dr. Monarez
agree to accept whatever recommendations were made by the Advisory Committee on
Immunization Policy, they said. The expert panel was recently reconstituted by
Mr. Kennedy with new members who have questioned the safety of vaccines.
The
committee is scheduled to meet again on Sept. 18 and 19, and may consider
recommendations for a wide array of vaccines, including those for hepatitis B,
Covid and respiratory syncytial virus, as well as a combination vaccine for
measles, mumps, rubella and varicella, according to an agenda posted on the
Federal Register.
After Dr.
Monarez refused Mr. Kennedy’s demands, she called Senator Bill Cassidy,
Republican of Louisiana and chairman of the Senate health committee. He called
Mr. Kennedy, which angered the health secretary, according to an administration
official familiar with the events.
Mr.
Kennedy summoned her back on Tuesday and reiterated his demands. On Wednesday,
Dr. Monarez received a phone call from the White House personnel office telling
her that she was being fired.
Dr.
Richard Besser, chief executive of the Robert Wood Johnson Foundation and a
former acting director of the C.D.C., said that he called Dr. Monarez on
Wednesday, just by chance, to see how they could cooperate on public health
matters.
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He said
she told him she did not expect to be long in her job — and that there were two
things she would never do to keep it.
“One was
anything that was deemed illegal, and the second was anything that she felt
flew in the face of science,” he said. Dr. Monarez said she had been asked to
do both, he continued — to fire agency leadership and “to rubber stamp A.C.I.P.
recommendations that flew in the face of science.”
In
Washington, senators from both parties expressed dismay at the events unfolding
at the C.D.C. Mr. Cassidy, a physician who voted for Mr. Kennedy’s confirmation
as health secretary after publicly agonizing over it, said on social media late
Wednesday that the “high-profile departures will require oversight” by his
panel.
On
Thursday, Mr. Cassidy called for a delay in the upcoming vaccine advisory
committee meeting. Mr. Cassidy said that said if the meeting proceeds, “any
recommendations made should be rejected as lacking legitimacy” given concerns
about the panel “and the current turmoil in C.D.C. leadership.”
Senator
Bernie Sanders, the Vermont independent and ranking member of the health panel,
said the attempt to fire Dr. Monarez was “outrageous” and called for a hearing.
His colleague on the committee, Senator Patty Murray, Democrat of Washington,
demanded Mr. Kennedy’s “immediate termination.”
Ms.
Murray, who voted against Dr. Monarez’s confirmation, said in a statement that
she once had “serious doubts about Director Monarez’s willingness to stand up
against R.F.K. Jr.’s personal mission to destroy public health in America.”
She
added: “I’m glad to say that I was wrong.”
The three
officials who were ushered out the door by security on Thursday had coordinated
their resignations. C.D.C. employees planned a “clap-out” send-off at agency
headquarters to honor them, but the officials were forced to leave earlier.
Still, hundreds of C.D.C. employees, including many in service uniforms,
gathered at the agency to celebrate them.
The
C.D.C. officials had decades of government experience, and all influenced
vaccine policy.
Dr. Debra
Houry, the C.D.C.’s chief medical officer, coordinated the various arms of the
agency. Dr. Demetre Daskalakis ran the center that oversees respiratory
illnesses and issues vaccine recommendations. Dr. Daniel Jernigan supervised
the center that oversees emerging diseases and vaccine safety.
A fourth
official, Dr. Jennifer Layden, who resigned a day earlier, led the office of
public health data.
Dr.
Jernigan said he had heard from Dr. Monarez that Mr. Kennedy’s office felt his
position “was not needed anymore.” He decided to resign before his job could be
eliminated, he said, in part hoping that would allow Dr. Monarez to continue as
the director.
“If we
were the problem, and she had the opportunity to actually stay, removing us as
a problem I think was something that we were willing to do,” he said, adding
that it was “important to have a strong, scientifically driven director.”
Dr.
Jernigan said he was also increasingly uncomfortable with the things he was
being asked to do, including providing data for a new analysis of vaccine
safety data for potential links to autism, even though dozens of studies have
already examined that claim and not found a connection.
Mr.
Kennedy has hired David Geier, a discredited vaccine skeptic, to reanalyze the
data, but Mr. Geier seemed to already have a conclusion in mind, Dr. Jernigan
said.
“That
approach to having a desire of what you want out of the data, and then looking
at the data in order to find it — that, to me, is not the right way to ask
scientific questions,” he added.
In an
interview on Thursday morning, Dr. Houry and Dr. Daskalakis said there was no
single move that pushed them to resign.
Rather,
it was “death by a thousand paper cuts,” Dr. Houry said. “We had so many of
these instances where we just couldn’t take it.”
The three
had been contemplating leaving the agency for weeks, they said. But their
distress escalated sharply after the new members of the vaccine advisory panel
said that they would revisit the childhood and adolescent immunization
schedules when they met again in the fall.
One
vaccine that protects against hepatitis B was added to the committee’s agenda
for its next meeting in September. Mr. Kennedy has long been critical of the
vaccine.
Hepatitis
B is a highly transmissible and dangerous pathogen that can be spread through
sexual contact, needle stick injuries or from an infected mother to child, said
Dr. Sean O’Leary, chair of the infectious disease committee for the American
Academy of Pediatrics.
The
vaccine has been shown to be safe and is given at birth to ensure that no cases
are missed, he said. Any attempt to remove it from the immunization schedule
would most likely face opposition, including from Senator Cassidy, he added.
Other
recent moves also influenced the resignations.
Last
week, Mr. Kennedy named Retsef Levi, a health analytics expert at the
Massachusetts Institute of Technology, to lead the Covid vaccine working group,
which was given a broad mandate.
Dr. Levi
has called for the Covid vaccines to be pulled from the market. Last week, a
spokesman for the Department of Health and Human Services defended the choice,
saying the group’s members would work with federal experts and be receptive to
diverse perspectives.
Dr.
Daskalakis criticized the selection of Dr. Levi, saying he had no expertise in
vaccines, “is frankly riddled with bias” and was assigned specifically to
prevent the C.D.C.’s input to the discussion.
“That
was, for me, one of the brightest red lines,” he said.
Mr.
Kennedy signaled his intention to transform immunization policies when he fired
all 17 independent scientific advisers to the C.D.C. and replaced them with
eight people of his own choosing. (One later dropped out because of financial
conflicts of interest.)
This
week’s high-profile resignations are only the latest in a series of exits at
the agency since Mr. Kennedy took office. In April, as the C.D.C. and other
agencies were sharply pared down, some C.D.C. leaders were placed on
administrative leave and a few took early retirement.
Two
experts in vaccine policy left the agency in June, saying they feared for the
lives of Americans if Mr. Kennedy were to continue unchecked.
Dr.
Lakshmi Panagiotakopoulos oversaw the Covid vaccine working group before she
resigned in June.
“It’s
heartbreaking to witness such important, nuanced work being led by someone who
has shown publicly at the A.C.I.P. meeting that he not only doesn’t understand
the data, but is also dedicated to baseless conspiracy theories,” she said of
Dr. Levi on Thursday.
The
newest resignations are a sign of “how dire things are at the agency,” she
said.
Maggie
Haberman contributed reporting.
Sheryl
Gay Stolberg covers health policy for The Times from Washington. A former
congressional and White House correspondent, she focuses on the intersection of
health policy and politics.
Apoorva
Mandavilli reports on science and global health for The Times, with a focus on
infectious diseases and pandemics and the public health agencies that try to
manage them.
Christina
Jewett covers the Food and Drug Administration, which means keeping a close eye
on drugs, medical devices, food safety and tobacco policy.



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