Wednesday afternoon, Centers for Disease Control and Prevention (CDC) Director Susan Monarez, Ph.D., was reported to be leaving her position less than a month after her confirmation, with a statement from the Department of Health and Human Services (HHS) confirming the change shortly after.
In the hours to follow, prominent leaders within the agency reportedly resigned from their roles in protest. What's more, it appears that Monarez has no interest in resigning.
In a statement given to press and published on social media Wednesday evening, lawyers representing Monarez characterized plans to remove the director as the latest move by HHS Secretary Robert F. Kennedy Jr. to upend the nation's public health institutions.
"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," Mark S. Zaid and Abbe David Lowell, lawyers who said they represent Monarez, wrote in a statement. "For that, she has been targeted."
Monarez, they continued, hasn't voluntarily resigned and (as of 7:00 p.m. Wednesday) had not received any word from the White House regarding her removal.
"As a person of integrity and devoted to science, she will not resign," they wrote.
Monarez had also been the public health agency’s acting director since January, earning the nod after the administration’s first pick was revoked over vaccine skepticism controversy. Prior to that, she had served as the deputy director of the Advanced Research Projects Agency for Health.
News of her removal was first reported by The Washington Post and subsequently confirmed by the HHS in a social media post.
"Susan Monarez is no longer director of the Centers for Disease Control and Prevention," the HHS wrote in its afternoon X post confirming the change. "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."
A spokesperson for the HHS referred Fierce Healthcare to the social media post when asked for comment on the departure.
Reports, citing anonymous insiders, also described a clash between Monarez and RFK Jr. related to vaccine policy that began Monday. Monarez, per the reports, looped in Senate health committee Chair Bill Cassidy, M.D., R-La., and other senators after being pressured to resign, further angering the secretary and sparking an ultimatum: Quit or be fired.
White House Deputy Press Secretary Kush Desai, in a statement given to the press later in the evening, said Monarez's removal had the president's blessing.
“As her attorney’s statement makes abundantly clear, Susan Monarez is not aligned with the President’s agenda of Making America Healthy Again,” Desai reportedly told the Post, The New York Times and others via email. “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.”
Despite her 51-47 party-line confirmation vote, Monarez's background as a microbiologist and longtime civil servant contributed to a widespread perception that she was a relatively grounded choice for the director role.
However, recent weeks have seen the CDC embroiled with turmoil amid a targeted shooting, employee terminations, revoked union recognition and some controversial decisions around vaccines.
Monarez, in a statement released immediately after the Aug. 8 shooting and an internal meeting held the following day, pointed to "the dangers of misinformation and its promulgation" when discussing the event with staff. Still, multiple reports from recent weeks citing CDC employees suggested that many of the agency's rank and file were disappointed that she wasn’t taking stronger steps to push back against actions and other top officials they believed were undermining the agency’s mission—most notably, her boss, RFK Jr.
RFK Jr., in a March statement posted online shortly after Monarez's nomination, said he "handpicked Susan for this job because she is a longtime champion of MAHA [Make America Healthy Again's] values, and a caring, compassionate and brilliant microbiologist and a tech wizard who will reorient CDC toward public health and gold-standard science."
The Post's report noted that Monarez had scheduled an agencywide call for Monday that was canceled on Friday.
Boiling tensions trigger high-profile resignations
Of particular note, Monarez's potential removal comes hours after RFK Jr. and the CDC's sister agency, the Food and Drug Administration (FDA), announced more narrow approvals for this season's COVID-19 vaccines—a decision reflecting the secretary and his allies' more critical view of the shots that is not shared by much of the medical community.
Further, other leaders within the CDC also appear to have reached a breaking point with their superiors. At least four top officials have announced on social media or reportedly told colleagues they are resigning due to, broadly, the secretary's views and abrupt policy changes they say undermine science and public health.
Debra Houry, M.D., chief medical officer and deputy director for program and science; Daniel Jernigan, M.D., head of the National Center for Emerging and Zoonotic Infectious Diseases; and Demetre Daskalakis, M.D., head of the National Center for Immunization and Respiratory Diseases, each circulated letters of resignation. Jennifer Layden, M.D., Ph.D., director of the Office of Public Health Data, Surveillance and Technology, was also reported earlier in the day to be resigning.
In his resignation letter published online, Daskalakis wrote he is "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."
He cited changes to the CDC's Advisory Committee on Immunization Practices, COVID vaccine recommendations for children and pregnant women and "the cowardice of a leader that cannot admit that HIS and his minions' words over decades created an environment where violence like the Aug. 8 shooting] can occur." He also described major policy changes announced on social media with no input from CDC scientists, misuse of research data and instructions to "retrofit analyses and policy actions to match inadequately thought-out announcements."
"Having worked in local and national public health for years, I have never experienced such radical non-transparency, nor have I seen such unskilled manipulation of data to achieve a political end rather than the good of the American people," he wrote.
Houry, in her message to colleagues, wrote that "the science at CDC should never be censored or subject to political pauses or interpretations" and added that "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."
Tina Tan, M.D., president of the Infectious Diseases Society of America, a professional group for infectious disease specialists, said in a statement that the resignations "present a clear and present danger" to the nation and laid the blame squarely at the feet of the Trump administration.
“This loss of highly experienced CDC leadership is the latest devastating result of the Administration’s sustained attacks on public health, and it absolutely must be the last. It is time for fundamental changes and a return to evidence-based policy," she said. "The Administration’s current trajectory for destroying the public health system is reckless and cannot continue.”
American Medical Association President Bobby Mukkamala, M.D., described the removal and departures as "highly alarming," and said the agency's "credibility and leadership are more essential than ever" amid budget and workforce cuts. He also reinforced the need for confidence in public health institutions and for "scientific expertise and data [to] drive guidance and policy."
Sen. Cassidy, in a Wednesday evening social media post, said the departures "will require oversight" from his committee.
The administration has already shuffled around other health agency leaders in response to external pressure. Earlier this month, Vinay Prasad, M.D., who leads the FDA’s Center for Biologics Evaluation and Research, was pushed out of the role amid a highly watched regulatory showdown but was reinstated within two weeks. Numerous other career scientists in top positions across HHS have also left or been pushed out of their roles amid disagreements on health policy.
RFK Jr. criticizes CDC's track record, priorities in next-day interview
Amid the CDC's upheaval, RFK Jr. suggested during a Thursday morning interview with Fox & Friends that the public health agency could afford to shed staff who don't agree with MAHA policies—while also describing the agency's championing of public health tools like vaccines and water fluoridation as missteps.
"The agency is in trouble and we need to fix it—and we are fixing it, and it may be that some people should not be working there anymore," the secretary said.
RFK. Jr. declined to address specifics regarding Monarez and other leaders' positions, calling it a "personnel issue." However, he spoke broadly of a "deeply, deeply embedded ... malaise at the agency" that requires "strong leadership that will go in there and that will be able to execute on President Trump’s broad ambitions for this agency."
The secretary made his argument by referencing "misinformation" from the agency during the COVID-19 pandemic, saying the CDC "got the testing wrong, they got the social distancing, the masks, the school closures that did so much harm to the American people." While shortages of diagnostic tests early in the public health emergency are generally viewed as a misstep, there is limited consensus within the scientific community on whether the other guidance referenced by RFK Jr. were a net societal benefit or harm.
From there, he described a page on the agency's website where "they list the 10 ... greatest advances in medical science and one of them is abortion, another is fluoridation, another is vaccines. So we need to look at the priorities of the agency."
RFK Jr. appeared to be referencing a 1999 publication of the agency's Morbidity Mortality Weekly Report hosted online titled "Ten Great Public Health Achievements -- United States, 1900-1999", where vaccination, drinking water fluoridation and "family planning" are listed.
The comments Thursday morning do little to quell criticisms from the departing CDC leaders and hundreds of HHS employees that the secretary is undermining his team and spreading controversial, and often incorrect, views on public health interventions.
Editor's note: This story was updated at 11:25 a.m., Aug. 28 with additional statements, comments and announcements.