CDC director says she was fired for refusing to give 'blanket approval' to changes in vaccine guidance

Former CDC director Susan Monarez told Congress that Health Secretary Robert F. Kennedy Jr. fired her because she wouldn’t sign off on changes to childhood vaccine schedules without seeing data and “could not replace evidence with ideology.”

Former CDC director Susan Monarez testified at the Senate health committee Wednesday.

Monarez testified before the Senate health committee Wednesday about her dismissal, which came only 29 days after receiving Senate confirmation to hold the post.

She rejected Kennedy’s previous assertions that she was not trustworthy and told senators that the health secretary pressured her to sign off on upcoming changes in vaccine guidance and wanted her to fire top scientists without cause. Monarez said her refusal led to her firing.

Monarez told senators that Kennedy met with her Aug. 25 and insisted she sign off on changes to the childhood vaccine schedule that were going to be released by a federal vaccine advisory panel in September. Kennedy has been criticized for firing the members of that panel, the Advisory Committee on Immunization Practices, and replacing them with vaccine skeptics.

In response, Monarez said she couldn’t give pre-approval to changes in vaccine recommendations without seeing underlying evidence to support them. Kennedy also told her she had to fire top CDC leaders, she said, and if she wasn’t willing to take those steps, then she should resign.

“I responded that I could not pre-approve recommendations without reviewing the evidence, and I had no basis to fire scientific experts. He told me he had already spoken with the White House several times about having me removed,” Monarez said.

“Even under pressure, I could not replace evidence with ideology or compromise my integrity,” she said.

Sen. Bill Cassidy, a Louisiana Republican and a physician who chairs the Senate health committee, asked Monarez to respond to Kennedy’s assertions that she wasn’t asked to sign off on changes to vaccine policy blindly, but merely wanted her to keep an open mind. Cassidy asked if Kennedy offered any data to support changes, and Monarez said he did not provide any.

Monarez said she would be open to revisions if there was evidence to evaluate, but she said that didn’t satisfy Kennedy.

“He just wanted blanket approval,” Monarez said. “And if I could not commit to approval of each and every one of the recommendations that would be forthcoming, I needed to resign. I did not resign, and that is when he told me he had already spoken to the White House about having me removed.”

Monarez said Kennedy told her there is no evidence backing the current vaccine schedule for kids. Monarez said the current schedule has been supported with solid data.

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‘Trust in public health’

Monarez sought to address more than her firing and said that the CDC and trust in public health leaders was being undermined.

“I want to be clear today should not be about me,” Monarez said. “Today should be about the future of trust in public health.”

Monarez said the vaccine advisory committee, which is slated to meet Thursday, could make changes to the recommended vaccine schedule for kids.

“Based on what I observed during my tenure, there is a real risk that recommendations could be made restricting access to vaccines for children and others in need, without rigorous scientific review,” Monarez said. “With no permanent CDC director in place, those recommendations could be adopted.”

While she said some may question her motives, Monarez said, “I am not here as a politician. I'm here as a scientist, a public servant and a parent committed to protecting the health of future generations.”

Monarez was asked if she could be described as trustworthy, given Kennedy’s assertion that she couldn’t be trusted, and she said she couldn’t define how Kennedy viewed the term.

“Secretary Kennedy told me he could not trust me because I had refused to commit to approving vaccine recommendations, without evidence, fire career officials without cause or resign, and I had shared my concerns with this committee,” Monarez told lawmakers.

“I told him, if you cannot trust me, then you can fire me,” Monarez said.

She also testified that Kennedy did not like the fact that Monarez reached out to the Senate health committee about her concerns with the health secretary’s directives, and they had a difficult meeting.

“He was very upset … the entire meeting was very tense. He was very upset throughout the entirety of our discussion, and it was not a productive exchange of information,” Monarez said.

‘Reduced to rubber stamps’

Sen. Bernie Sanders, an independent from Vermont who typically caucuses with the Democrats, blasted Kennedy for firing the CDC director. Sanders and other Democrats have called for Kennedy’s resignation.

"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 throughout the world," Sanders said.

Sen. Roger Marshall, a Kansas Republican and a physician, pressed Monarez for her support of a vaccine schedule that calls for more than 70 shots in a child's lifetime. Monarez responded that the vaccine schedule has been vetted and validated, but Marshall said the CDC is to blame for its problems in winning public confidence.

“I think the CDC is the cause of vaccine hesitancy, and you are the problem," Marshall said.

Marshall also used an analogy of college sports, noting that if a coach clashes with a university president, then it’s time for the coach to go.

When asked if it was time for her to leave the CDC, Monarez said, “I will stand behind scientific integrity with every decision I make.”

Kennedy drew intense scrutiny from lawmakers when he was nominated over his long-running vaccine skepticism. Medical groups and lawmakers have opposed his changes in vaccine policies, including revised guidance on COVID-19 vaccines that don’t recommend them for healthy adults. Critics say that makes it harder for millions to get the vaccines.

Monarez was asked if she felt she’d be able to work with Kennedy in the nomination process. She said she had worked with political appointees previously, and done so successfully. “Data has always been paramount,” she said.

Describing early conversations with Kennedy, Monarez said, “He was excited about my priorities, restoring trust, transforming public health infrastructure, modernizing the agency, preparing for the next pandemic. We had some productive engagements about the technological innovations that I wanted to bring to the CDC. I was enthusiastic and I believe he was as well.”

Dr. Debra Houry, the former chief medical officer of the CDC, also testified before the Senate committee. Houry resigned after Monarez was fired.

“I resigned because CDC leaders were reduced to rubber stamps, supporting policies not based in science, and putting American lives at risk,” Houry said. “Secretary Kennedy censored CDC science, politicized its processes and stripped leaders of independence. I could not and good conscience remain under those conditions.”