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Politically engineered chaos is destabilizing the top of America’s vital public health institutions, as Health and Human Services Secretary Robert F. Kennedy Jr.’s tenure challenges the historic role of government in widening access to vaccines.
The ouster Wednesday of Dr. Susan Monarez as director of the US Centers for Disease Control and Prevention — less than a month after she was sworn in — deepened concerns about the role of Kennedy, who has a history of vaccine skepticism. It will fuel fresh concerns the Trump administration is politicizing medicine, rejecting science and creating new risks to public health.
Several other top CDC officials also announced they were quitting Wednesday, sending shock waves through an agency long regarded as the global gold standard that has been seriously diminished by the Trump administration.
Top health experts described the loss of senior staffers as “reckless,” a “disaster,” and ruinous to evidence-based public health policy — leaving the country more vulnerable.
CNN reported that Monarez’s firing comes after days of pressure from Kennedy’s deputy chief of staff and confidante Stefanie Spear, according to two people familiar with the situation. Monarez also clashed with Kennedy and his team over vaccine policies, including an impending announcement that could draw links between immunizations and autism, a person familiar with the situation told CNN.
The latest drama at the CDC follows an attack by a gunman on the agency’s headquarters in Atlanta earlier this month, which killed a police officer. The horror further fractured morale at an agency devastated by mass layoffs by RFK Jr.’s Department of Health and Human Services.
Combined with vast changes to health guidance and policy being pushed through by the Trump administration, and huge cuts to federal health funding at elite research universities that have forged lifesaving breakthroughs, the latest shocks are plunging American public health into deep uncertainty.
The administration has also made massive reductions to US-funded health programs worldwide, including with the demolition of the US Agency for International Development, tarnishing the country’s reputation as a global health superpower.
All of this raises the risk that an administration devoted to “Making America Healthy Again” could end up complicit in many unnecessary deaths in years to come.
But Kennedy told Fox News on Thursday that the CDC’s priorities need changing. “There’s really a deeply, deeply embedded, I would say, malaise at the agency,” he said. He added: “It may be that some people should not be working there anymore.”
‘Destructive chaos’ and an ‘absolute disaster’ for public health
RFK Jr.’s nomination as Health and Human Services secretary owes much to the synergy between his past vaccine skepticism and the distrust of public health agencies among Trump’s conservative base that ballooned during the Covid-19 pandemic.
His tenure is already precipitating transformations in top health agencies that would take many years to reverse under future administrations.
“Ousting the first Senate-confirmed CDC director weeks into the start of her tenure makes absolutely no sense and underscores the destructive chaos at RFK Jr.’s Department of Health and Human Services,” said Dr. Robert Steinbrook, health research group director at Public Citizen, a nonprofit consumer advocacy organization.
“To make matters even worse, there are reports of additional resignations of critical high-ranking CDC staff,” Steinbrook said. “The CDC is being decapitated. This is an absolute disaster for public health.”
Dr. Tina Tan, the president of the Infectious Diseases Society of America, warned that politically motivated attacks on the country’s public health system must end.
“The mass resignations of CDC expert leaders present a clear and present danger to Americans of all ages and leave our nation extremely vulnerable to a wide range of public health threats from outbreaks to bioterror attacks,” Tan said. “As we near respiratory virus season, it is imperative that our country have expert public health leadership for effective surveillance, communications and responses.”
Tam added, “The administration’s current trajectory for destroying the public health system is reckless and cannot continue.”
Monarez’s lawyers said in a statement that “Secretary Kennedy and HHS have set their sights on weaponizing public health for political gain and putting millions of American lives at risk.” They also made clear that she had not resigned nor received notice of her dismissal from the White House as of late Wednesday.
The White House responded with a statement explicitly firing Monarez. “As her attorney’s statement makes abundantly clear, Susan Monarez is not aligned with the President’s agenda of Making America Healthy Again. 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,” White House spokesperson Kush Desai said on Wednesday night.
The fact that Monarez has been ousted just weeks after she was confirmed by the Senate underscores the administration’s contempt for the legislative branch and its constitutional oversight role at a time when Trump is dismantling constraints on presidential power every day.
Monarez, a longtime government scientist, wasn’t even the president’s first choice to run the CDC. His initial pick, Dr. Dave Weldon, a former Florida lawmaker, was withdrawn in March amid concerns in the White House about his public comments expressing skepticism about vaccines.
News of Monarez’s departure broke after Kennedy announced changes that will narrow access to Covid-19 vaccines. He celebrated the move, on X, claiming that emergency use authorizations had been used by the Biden administration to justify “broad mandates” on the population. His comment underscored how the lingering politics of the pandemic are a motivating force for Trump’s presidency.
The management of the Covid-19 pandemic and recommendations on masking, vaccines and school and business closures caused an unresolved political trauma in the United States and played into an already existing mistrust of Washington institutions and science-based expertise among many conservative voters. The crisis elevated Kennedy and his existing skepticism of vaccines, and he’s now in a position of considerable political power.
“They got the testing wrong. They got the social distancing wrong, the masks, the school closures that did so much harm to the American people,” Kennedy told Fox News Thursday. Health experts were making decisions in real time at the start of a pandemic about a novel virus that had unknown properties in a once-in-a-century emergency. Some of their guidance was later undermined by subsequently emerging science but many insist that public health measures like shutdowns saved many lives.
But it’s become an article of faith on parts of the right that health agencies made decisions for political reasons to suppress freedoms — a feeling that Trump exploited in his wider campaign to discredit elites and to destroy a “deep state” of bureaucrats, scientists, intelligence agencies and Washington officials .
The FDA approved updated vaccines for Covid-19 but constrained criteria for their use. The dose is permitted for adults 65 and older and younger people at higher risk from Covid-19. At a time when Covid-19 cases are spiking, it is now likely to become harder for the general population and especially younger children to get the vaccines.
This decision comes a few weeks after Kennedy announced that the government would terminate investments in 22 mRNA vaccine projects, claiming that they “fail to protect effectively against upper respiratory infections like Covid and flu.” This is despite the role of such vaccines in preventing severe disease and ending the Covid-19 pandemic. Such inoculations can be developed quickly and produced at a massive scale during an emergency and were demonstrated to be safe.
Kennedy has also fired the entire 17-member panel of outside vaccine experts who sit on the CDC’s Advisory Committee on Immunization Practices that reviews vaccine data and replaced them with his own selections, some of whom have expressed anti-vaccine views in the past.
Many observers expected divisions between RFK Jr. and Monarez to emerge — but perhaps not quite so soon.
During her confirmation hearing in June, Monarez described vaccines as “lifesaving” and pledged to prioritize vaccine availability. She said that she had no prejudices against the mRNA platform. And she said she had seen no “causal” link between vaccines and autism.
Kennedy’s boss, President Donald Trump, claimed Tuesday that his first-term Operation Warp Speed, which helped push out mRNA Covid vaccines, was “one of the greatest achievements ever in politics.” But Trump is also leery of highlighting the vaccines since the Republican Party’s base is laced with vaccine skepticism and hostility toward US health institutions that developed it.
At the same Cabinet meeting, Kennedy promised announcements in September and mentioned “certain interventions now that are clearly, almost certainly causing autism.” Trump replied that “there has to be something artificially causing this, meaning a drug or something.” The CDC has previously published several studies looking at a possible link between vaccines and vaccine ingredients and autism. None has found any evidence to suggest that vaccines increase the risk of autism or other neurodevelopmental disorders.
Kennedy’s moves on vaccines in recent months and his comments on autism are heightening anxiety among his critics that vital public health decisions are now being overly influenced by political goals.
It was clear during Monarez’s confirmation hearing that some senators on both sides of the political aisle were hoping that she would emerge as a constraint on Kennedy, who once described the Covid-19 inoculations as “the deadliest vaccine ever made.” Several senators extracted promises from Monarez to follow science. But Virginia Democratic Sen. Tim Kaine said that while he had no concerns about her qualifications, he had questions about “your willingness to follow through on your values.”
In the event, Monarez’s lawyers said Wednesday that she “refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts, (and) she chose protecting the public over serving a political agenda.”
In his own confirmation hearing earlier this year, Kennedy repeatedly denied he was anti-vaccine — even though his denials contradicted on-the-record comments he’d made in the past.
While his record on vaccines at HHS appears to be validating the fears of many Democrats who voted against him — and some Republicans who trusted his undertakings — his views on other issues enjoy more support. Kennedy’s warnings that unhealthy food and lifestyles are making many people sick are based in fact. But his recent implications that some conditions are purely the result of lifestyle and that some victims of Covid-19 might have died because of other health conditions have been disputed by numerous health experts.
Following Kennedy’s purges at HHS, CDC and other agencies, such views will get less pushback.
And with Monarez’s departure, RFK’s control over the government’s public health infrastructure — and by extension, the treatment and health-care options of tens of millions of Americans — is more unchallenged than ever.
This story has been updated with additional details.