Monarez, who had assumed the CDC directorship just weeks earlier, was summoned to a meeting with Kennedy Jr. and his senior aide, Stefanie Spear. They criticized her management, accusing her of incompetence, according to an anonymous Department of Health and Human Services (HHS) official who recounted the dismissal process.

From the outset, Monarez faced numerous challenges. The agency was still reeling from significant staff cuts earlier in the year, and 8 days after she took office, a deadly shooting at CDC headquarters further destabilized the organization.

Susan Monarez at a Senate hearing in June. Photo: AFP

Susan Monarez at a Senate hearing in June. Photo: AFP

Spear and Kennedy Jr. asked for Monarez's resignation, which she refused. They then demanded she dismiss senior CDC leaders and accept certain vaccine recommendations. Monarez again declined.

Under Kennedy Jr., the HHS had tightened restrictions on vaccine eligibility and drastically reduced mRNA vaccine development funding. Kennedy Jr. himself is a vaccine skeptic.

"Director Monarez made commitments to the President. She also made commitments at her confirmation hearing. You could see how resolute she was in her statements about what the science shows and what she believed as a public health policy leader. They clearly didn't like that," the anonymous official said, referring to the HHS.

After the meeting, Monarez contacted Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Bill Cassidy to report the situation. Cassidy then called Kennedy Jr. The Secretary's response, if any, is unknown, but Monarez's appeal to Cassidy angered him.

Over the next three days, efforts to oust Monarez escalated, demonstrating Kennedy Jr.'s intent to assert control over the CDC, an agency traditionally afforded a degree of independence.

Hours after the call with Cassidy, Monarez was summoned to another meeting with Kennedy Jr., Spear, and HHS Chief of Staff Matt Buckham. They reprimanded her for involving Cassidy.

On 26/8, Monarez received a seemingly conciliatory call from Buckham. However, the following day, HHS intensified the pressure.

On the afternoon of 27/8, a White House official urged Monarez to resign, warning of her imminent dismissal. She again refused. Shortly after, HHS announced on X that she was "no longer the CDC director".

Three top CDC leaders resigned minutes after the announcement: National Center for Immunization and Respiratory Diseases Director Demetre Daskalakis, Chief Medical Officer Debra Houry, and National Center for Emerging and Zoonotic Infectious Diseases Director Daniel Jernigan. This triggered widespread criticism of Kennedy Jr., accusing him of politicizing the agency.

"My line is ideology cannot compromise science, science cannot be weaponized to serve ideology," Daskalakis said. "I feel like over the past few weeks, that is exactly what has happened".

Through her legal team, Monarez declared she would not yield. "When CDC Director Susan Monarez refused to endorse unscientific, reckless directives and fire dedicated health professionals, she chose to protect the public rather than serve a political agenda," lawyers Mark S. Zaid and Abbe David Lowell wrote in a statement following the HHS announcement. "For those reasons, she was targeted. As a person of integrity and commitment to science, she will not resign".

On 28/8, White House Press Secretary Karoline Leavitt defended Monarez's dismissal. "The President has the right to remove individuals who do not align with his mission," she stated.

Bipartisan lawmakers and CDC staff joined the debate. Cassidy called for postponing the Advisory Committee on Immunization Practices (ACIP) meeting scheduled for 18-19/9. This external vaccine advisory panel was hand-picked by Kennedy Jr. Cassidy stated any ACIP recommendations should be rejected.

ACIP has some vaccine-skeptic members. They were about to vote on updated recommendations regarding Covid-19 and other vaccinations. The CDC director must sign off on the panel's changes before they take effect.

"Serious allegations have surfaced concerning the agenda, participant composition, and adherence to scientific process at the September ACIP meeting," Cassidy said. "Should the meeting proceed, any recommendations put forth should be dismissed due to a lack of legitimacy, given the gravity of these accusations and the current turmoil within CDC leadership".

Republican Senator Susan Collins, who voted to confirm Kennedy Jr. as Health Secretary, also expressed concern. "Susan Monarez is a highly capable scientist who brought a wealth of experience to the agency," Collins said. "I am troubled by her dismissal after only three weeks. Her departure led to the immediate resignations of 4 veteran CDC experts, who are not easily replaceable and are respected worldwide".

Both Collins and Cassidy believe the Senate HELP Committee should investigate the dismissal. Senior HELP Committee member Senator Bernie Sanders called for a bipartisan inquiry.

US Health Secretary Robert F. Kennedy Jr. speaks in Washington on 16/4. Photo: AP

US Health Secretary Robert F. Kennedy Jr. speaks in Washington on 16/4. Photo: AP

CDC employees demonstrated their discontent with a protest at the agency's Atlanta headquarters.

"It's time for President Trump to defend his stellar public health legacy and unequivocally reject Kennedy Jr.'s nonsense," former assistant health secretary Brett Giroir said. "It's also time for Senator Cassidy and all Senators to apply maximum pressure".

Around 9:30 p.m. on 28/8, Kennedy Jr. emailed CDC staff, offering reassurance. "I am committed to working with you to restore trust, transparency, and credibility to the CDC. Your daily efforts, often unnoticed, have saved lives," he wrote. "Reform does not diminish your work but strengthens it. The American people are ready to trust this agency again if we show them that integrity, accountability, and science guide every decision".

The Secretary quickly appointed Deputy Secretary Jim O'Neill as acting director. The anonymous official believes O'Neill will not challenge Kennedy Jr. as Monarez did.

"Jim will do whatever Secretary Kennedy Jr. and Stefanie Spear tell him to do," the official said.

However, nominating a permanent replacement for Monarez, given the controversy surrounding her dismissal, "will be very difficult," a senior administration official commented.

Vu Hoang (According to Politico, AFP, Reuters)