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Just weeks after being confirmed by the Senate, Susan Monarez has been forced out as director of the Centers for Disease Control and Prevention (CDC), in what the White House did not try to conceal as another significant shake-up for the beleaguered public health agency.

The initial reports of Monarez’s ouster, first by The Washington Post and citing multiple officials in the Trump administration, were confirmed by the Department of Health and Human Services (HHS) in response to a query from Ars Technica, which was directed to the HHS’s post on its official X account. That post read:

Susan Monarez is no longer director of the Centers for Disease Control and Prevention. 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 did not specify what caused the abrupt change. The Washington Post reported that US Health Secretary Robert F. Kennedy Jr., a high-profile anti-vaccine activist, had repeatedly pressured Monarez on her stance on the COVID-19 vaccines. He had asked her to withdraw approvals of the COVID-19 vaccines, which she refused to do without consulting the CDC’s vaccine advisory committees. Kennedy then asked her to resign, accusing her of failing to support Trump.

Monarez, however, did not acquiesce. Instead, she reached out to Senator Bill Cassidy (R-La.) , who, after extracting written assurances from him, had played a significant role in Kennedy’s own Senate confirmation earlier this year. This, according to multiple reports, led to a pushback by Cassidy to Kennedy’s demands, which then led to a “heated back-and-forth” between the two. After that, according to the officials, Monarez was told she had to either resign or be fired.

Lawyers for Monarez, Mark Zaid, and Abbe Lowell stated on social media, claiming she had not resigned and had not yet received any formal written notice of her firing from the White House. “Her ouster came after she refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts,” it read. “She chose protecting the public over serving a political agenda,” Zaid confirmed to Ars Technica that Monarez had not received any official termination notice as of 8:15 p.m. ET on August 27.

CDC in Desperate Need of Stability

Monarez’s confirmation in late July had been seen as a breakthrough. Confirmed 51–47 strictly along party lines, Monarez became the first ever CDC director to go through Senate confirmation after a 2022 law made it a requirement. Kennedy himself administered the oath of office to her on July 31, lauding her “impeccable scientific credentials” and expressing confidence in her ability to restore the credibility of the CDC.

Her credentials were long and notable. Monarez has a PhD in microbiology and immunology and served as deputy director at the Advanced Research Projects Agency for Health (ARPA-H) in the Biden administration. Her previous roles included the Biomedical Advanced Research and Development Authority (BARDA), the Department of Homeland Security, the White House Office of Science and Technology Policy, and the National Security Council. Monarez also briefly led the CDC as acting director earlier this year before vacating the role upon Trump’s nomination of her to be the formal director.

Many public health experts had applauded her confirmation. Jennifer Nuzzo of Brown University, for instance, called Monarez “a loyal, hardworking civil servant who leads with evidence and pragmatism.” Georges Benjamin, executive director of the American Public Health Association, lauded her as a “strong researcher and capable manager.”

Her short tenure, however, ended in chaos. CDC has been hemorrhaging staff by the hundreds through layoffs and buyouts, while many of its programs have been cut or crippled. Kennedy himself had fanned the flames by himself, calling COVID-19 vaccines “the deadliest vaccine ever made” and calling the CDC “a cesspool of corruption.”

On August 8, a gunman radicalized by vaccine misinformation opened fire at the CDC campus. A fusillade of nearly 500 rounds was unleashed, with some 200 of those rounds hitting six different CDC buildings. One local police officer was killed, and terrified staff scrambled for cover. The shooter had blamed vaccines for his own health problems and was specifically targeting the CDC.

The reaction to Monarez’s reported firing has only deepened the sense of crisis at the agency. Stat News confirmed the resignations of three other high-ranking officials: Daniel Jernigan, director of the National Center for Emerging Zoonotic Infectious Diseases; Deb Houry, the CDC’s Chief Medical Officer; and Demetre Daskalakis, who had previously led the National Center for Immunization and Respiratory Diseases.

In his departure message, Daskalakis wrote, “I am not able to serve in this role any longer because of the ongoing weaponization of public health.” Houry also penned a parting note that emphasized science should “never be censored or subject to political interpretations.”

Politico earlier that day also reported the resignation of Jennifer Layden, the head of the Office of Public Health Data, Surveillance, and Technology.

For many, both inside and outside the CDC, the series of events is the low point of an agency that had once been regarded as the bedrock of evidence-based public health. It now faces a situation of mass resignations, political interference, and a crisis of trust at a time of public health challenges.