Ousted Centers for Disease Control and Prevention (CDC) Director Susan Monarez, Ph.D., testified Wednesday that ahead of her firing, Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. told her there was “no science or evidence” in support of the current childhood vaccine schedule and that he planned to change it in September.
The Senate Health, Education, Labor and Pensions (HELP) Committee hearing comes on the eve of the next meeting of the CDC Advisory Council on Immunization Practices (ACIP). The panel is expected to discuss recommendations around vaccines for COVID-19, hepatitis B and measles, mumps and rubella (MMR).
Monarez recounted her side of the conflict with the secretary that occurred during multiple meetings Aug. 25, two days before she was removed from her position by the White House, for Senate HELP Committee members across a roughly three-hour oversight hearing.
Monarez said she was fired "for holding the line on scientific integrity."
She reiterated claims made in statements and a Wall Street Journal op-ed—RFK Jr. had removed her for refusing to preemptively approve upcoming recommendations made by a vaccine advisory panel he had reconstituted and to fire other career agency scientists in leadership positions without cause. She refused at the time and told lawmakers that agreeing would “compromise her integrity” and break the promises she had made at the time of her confirmation.
“We got into an exchange where I had suggested I would be open to changing the childhood vaccine schedule if the evidence or science were supporting,” Monarez said. “And he responded that there was no science or evidence associated with the childhood vaccine schedule, and he elaborated that CDC had never collected the science or the data to make it available [in relation] to the safety and efficacy."
“To be clear, he said there was not science or data, but that he still expected you to change the schedule?” asked Committee Chairman Bill Cassidy, M.D., R-La.
“Correct,” she said, later adding that RFK Jr. suggested such changes had been communicated to and were supported by President Donald Trump.
RFK Jr., in a contentious Sept. 4 congressional appearance, had refuted Monarez’s account and described her as a “liar” and “untrustworthy.”
Monarez, on Wednesday, told lawmakers that the secretary had similarly told her she was untrustworthy during one of the Aug. 25 meetings, to which she'd responded that “if he believed he could not trust me, he could fire me.” RFK Jr., she said, replied that he had already discussed the topic of her removal with the White House.
In subsequent questioning, Monarez confirmed that the secretary had definitively told her during those meetings that childhood vaccine recommendations would be changed this month.
When contacted by Fierce Healthcare, a HHS spokesperson said, "On the childhood vaccination schedule, the upcoming ACIP meeting will decide the outcome. Any potential changes to the childhood vaccine schedule will be based on the latest available science and only after the ACIP recommends it and the Acting CDC Director reviews and approves those recommendations."
Monarez also confirmed a breaking Washington Post report describing an Aug. 19 email in which the HHS’ chief of staff, Matthew Buckham, told her and others that any major policy decisions at the CDC must first go through political leadership. Further, she said career scientists had no input on the agenda, evidence and makeup of the CDC ACIP—a key panel of policy experts RFK Jr. has rebuilt with members historically critical of recommended vaccine policy, and is scheduled to meet tomorrow—and raised concerns that similar steamrolling of agency staff was occurring at other HHS agencies like the Food and Drug Administration (FDA) and the National Institutes of Health (NIH).
"That is not gold-standard science"
Monarez was the first director of the CDC to be confirmed by the Senate following a law enacted after the COVID pandemic intended to increase oversight of the public health agency.
Despite initial glowing support from RFK Jr. and the administration, she was ultimately fired by the White House less than a month into her tenure. The firing triggered protest resignations from other top CDC officials including Debra Houry, M.D., formerly the chief medical officer and deputy director for program and science, who also testified to the committee Wednesday.
“I resigned because CDC leaders were reduced to rubber stamps, supporting policies not based in science and putting American lives at risk,” Houry said of her departure. “Secretary Kennedy censored CDC science, politicized its processes and stripped leaders of independence. I could not, in good conscious, remain under those conditions.”
Both former officials told senators that career scientists and public servants were being iced out of decision-making at the agency and that they had serious concerns about upcoming vaccine recommendations as well as the nation’s readiness for a new public health emergency.
Monarez, in response to questioning, said she had first learned of RFK Jr. firing all 17 sitting ACIP members from news reports. She added that she was “very nervous” about this week’s meeting, which reports suggest could bring a new recommendation that hepatitis B vaccine given to newborns be delayed to four years of age.
Houry said she and other agency scientists learned of May’s COVID vaccine recommendation changes from a social media post and that a memo she subsequently requested on the policy change differed from what was said in the secretary’s video announcement.
“CDC scientists have still not seen the scientific data or justification for this change,” Houry said. “That is not gold-standard science.”
Houry also noted stark differences in the agency's response to public health issues such as the measles outbreak under RFK Jr.'s leadership. She said she'd been forced to pen notes to leadership teams correcting the secretary's claims that measles vaccines "contain fetal parts" and that she was asked to include specific, unsupported treatments in the agency's physician tool kits that "could lead to harm."
On the ACIP, Houry said agenda recommendations for the upcoming meeting were going through political appointees for the first time in her 10-year tenure at the agency. She described an instance in which she recommended additional questions for the hepatitis B work group to review, but that the appointed senior advisor was concerned the questions could “bias” a planned change.
“You’re suggesting they wanted to move away from a birth dose, but they were afraid that your data would say that they should retain it?” Cassidy asked.
“Yes,” she said, later telling Cassidy the senior advisor implied the planned move to inoculating at age 4 was specified by RFK Jr.
Senators weigh concerns of political interference, trustworthiness, transparency
Throughout the hearing, senators questioned the former CDC officials on the specifics of their departures, whether RFK Jr. was interfering with evidence-based decision-making, the “trustworthiness” of their accounts, the practical impact of the secretary’s changes and whether those actions were justified.
From a political standpoint, the most consequential inquiries came from Cassidy, who had called Wednesday’s oversight hearing and earlier this year was the deciding vote to advance RFK Jr.’s confirmation. Shortly after Monarez’s firing and the departures, he had urged the ACIP’s September meeting be postponed amid the “serious allegations” of bias and said any recommendations “should be rejected as lacking legitimacy” without “significant oversight.”
During his questioning, the chairman largely sought clarifications on what was said during RFK Jr. and Monarez’s Aug. 25 meetings and whether CDC staff was involved with vaccine recommendation policy.
Cassidy, a hematologist, was particularly pointed in regard to this week’s ACIP meeting and used the hearing’s closing comments to underscore data on the benefit of hepatitis B vaccines at birth: 20,000 babies infected at birth before 1991, a 68% reduction by 2001 and now fewer than 20 babies infected annually.
“That is an accomplishment to make America healthy again, and we should stand up and salute the people who made that decision because there’s people who would otherwise be dead if those mothers were not given the option to give their child that vaccine,” he said. Shortly after the hearing, he told press bluntly that the American people should not trust a recommendation change on newborn hepatitis B vaccination from ACIP.
Fellow Republican physicians on the committee didn’t share his view, as Roger Marshall, M.D., of Kansas, and Rand Paul, M.D., of Kentucky, both questioned whether “mandating” the shot was necessary.
Monarez said the CDC’s role is to give vaccine recommendations, not mandates. "What CDC does is provide the evidence associated with the recommendations so that a parent and a physician can make the best determination for them,” she told lawmakers on the committee.
In an exchange (shared by RFK Jr. on social media with a “thank you”), Paul questioned Monarez on whether “specific vaccines” like those for COVID and hepatitis B were effective—but derided responses outlining supportive evidence as “ridiculous” and the assertion that she would support vaccine schedule changes if presented with sufficient data as “untrue.”
Other Republicans on the committee said they were grappling with questions of Monarez’s “trustworthiness” amid conflicting accounts, and pointed to the CDC’s diminished standing with the public following the COVID pandemic and Monarez’s choice of “anti-Trump” legal representation as cause for concern.
Moderates including Sens. Susan Collins, R-Maine, and Lisa Murkowski, R-Alaska, followed Cassidy’s interest in the specific events of the firing and added that a breakdown between political appointees and career scientists was significant cause for concern.
Democrats, who had voted in lockstep against Monarez’s appointment over concerns she would bow to the secretary’s demands, offered apologies and applauded the officials for drawing hard lines against what they described as public health endangerment.
“Dr. Monarez was fired because she refused to act as a rubber stamp to implement Secretary Kennedy’s dangerous agenda to substantially limit the use of safe and effective vaccines that would endanger the lives of the American people and people around the world,” Bernie Sanders, I-Vt., the committee’s ranking member, said during his opening statement.
Digging deeper into the Aug. 25 meetings, Sen. Maggie Hassan, D-N.H., asked Monarez how RFK Jr. justified overruling prior evidence for the childhood vaccine schedule and his demand to fire CDC officials without cause. Monarez said the secretary made “particularly pointed, and particularly hurtful and disparaging” comments about the agency’s track record and its staff.
RFK Jr., she said, called the CDC “the most corrupt federal agency in the world, emphasized that CDC employees were horrible people. … He said that CDC employees were killing children and they don’t care, he said that CDC employees were bought by the pharmaceutical industry, he said CDC forced people to wear masks and social distance like a dictatorship," Monarez testified.
“And the one I think hurt me the most was a particularly vivid phrase—he said during the COVID outbreak, CDC told hospitals to turn away sick COVID patients until they had blue lips before allowing them to get treatment. … Those statements are not true,” she said.
Senator Andy Kim, D-N.J., asked Monarez about who was intended to replace the career staff she was instructed to fire. The former director said RFK Jr. intended to promote lower staff into the roles but to continue the firings if they similarly refused to blanket support favored policy choices until amenable individuals were found.
“[Kennedy] had said, though I have no means to verify this, that … FDA, NIH and [the Centers for Medicare & Medicaid Services] were engaging in this practice,” Monarez said.
Democrats also asked about the secretary’s response to the Aug. 8 shooting at the CDC’s headquarters, in which DeKalb County Police Officer David Rose, 33, was killed by an individual with grievances over perceived COVID vaccine harms.
Monarez said she didn’t hear anything from RFK Jr. until he arrived for an on-site tour three days later. Both former officials said the incident heightened concerns of personal safety due to misinformation—which RFK Jr. has been accused by HHS staff of promoting.
“It was 500 rounds, it was 180 that hit the building—each bullet was meant for a person,” Houry said. “Each of my staff were very traumatized afterwards. I had staff that were covering their kids in the daycare parking lot. There were people that were out at the rideshare as bullets were passing over their head. I have many that won’t speak about vaccines now, have removed their names off of papers. They don’t wish to present publicly anymore because they feel they were personally targeted because of information.”
Democrats, as well as Cassidy, rankled during later questioning when Monarez said she was rebuked for bringing her concerns to the HELP Committee and told “never to do it again.”
“It is entirely appropriate for someone with oversight concerns to contact my office, or me, or frankly any of us,” Cassidy said amid Democrats’ cries of censorship.
“Putting a gag order on a CDC director and directing her not to speak to those who have confirmed her, to whom she is responsible for oversight, is a very serious matter,” added Sen. Tim Kaine, D-Va. Other senators noted that the secretary's alleged reaction is a stark contrast to the "radical transparency" he had promised lawmakers.
Cassidy said the committee has requested information, recordings or other materials from the HHS as part of its investigation into Monarez’s firing but has not yet received anything. He also said the committee will give HHS officials an opportunity to speak with him and refute Monarez's and Houry’s claims.