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Susan Monarez has been removed from her role as director of the Centers for Disease Control and Prevention (CDC) weeks after receiving Senate confirmation, the latest high-level shakeup at the beleaguered public health agency.

The initial news was reported by The Washington Post based on multiple officials within the Trump administration. When asked to confirm the report by Ars Technica, the Department of Health and Human Services (HHS) did not reply directly but instead referred to a post on its official X account. The text of the message 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.”

There was no explanation given for the leadership change. The Washington Post reported that the U.S. Health Secretary Robert F. Kennedy Jr., a high-profile opponent of vaccines, had repeatedly pushed Monarez to revoke approvals for COVID-19 vaccines. Monarez, in turn, declined to do so before first discussing the issue with the CDC’s vaccine advisory committees. Kennedy then reportedly asked her to resign, accusing her of not sufficiently supporting the policies of Donald Trump.

Monarez refused to resign. Instead, she reached out to Senator Bill Cassidy (R-La.), who had helped secure Kennedy’s own Senate confirmation earlier this year by obtaining several assurances from him. Cassidy confronted Kennedy over his demands on Monarez, and the two had a heated exchange. After that, officials told Monarez she would have to either resign or be fired.

Monarez’s lawyers, Mark Zaid and Abbe Lowell, posted a statement on social media saying their client had not resigned and had not yet received an official notification of dismissal from the White House. “Her ouster came after she refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts,” the statement read. “She chose protecting the public over serving a political agenda.” Zaid later told Ars Technica that at 8:15 p.m. ET on August 27, Monarez had yet to receive a formal termination letter.

A Public Health Agency at the Breaking Point

Monarez’s July Senate confirmation had been seen as a breakthrough. The vote was 51–47 along party lines. She was the first CDC director ever to have to undergo Senate confirmation after a 2022 law changed the appointment process. Kennedy himself administered the oath of office on July 31, stating that Monarez had “unimpeachable scientific credentials” and would help the CDC restore its reputation.

Her résumé was extensive and well-regarded. Monarez holds a PhD in microbiology and immunology. She has served as deputy director at the Advanced Research Projects Agency for Health (ARPA-H) during the Biden administration. She also previously worked for 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. She also briefly served as the CDC’s acting director earlier this year, before Trump’s nomination for the official post.

Her appointment was well-received by public health experts. Jennifer Nuzzo of Brown University described Monarez as a “loyal, hardworking civil servant who leads with evidence and pragmatism.” Georges Benjamin, executive director of the American Public Health Association, said that she was a “knowledgeable researcher and a strong manager.”

But her brief tenure ended in the middle of a crisis at the CDC. The CDC has been losing hundreds of staff through layoffs and buyouts, and several of its programs have been cut or impeded. Kennedy himself has been a source of friction, having described COVID-19 vaccines as “the deadliest vaccine ever made” and referred to the CDC as a “cesspool of corruption.”

On August 8, tragedy struck. A gunman radicalized by vaccine misinformation shot his way into the CDC campus. Roughly 500 rounds were fired, and about 200 hit six different CDC buildings. One local police officer was killed, and staff scrambled to safety. The shooter had blamed vaccines for his own health issues and specifically targeted the CDC.

The aftershocks of Monarez’s reported ouster have intensified the turmoil at the agency. Stat News confirmed the resignation of three more 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, the director of the National Center for Immunization and Respiratory Diseases.

Daskalakis, in his parting message, wrote, “I am not able to serve in this role any longer because of the ongoing weaponization of public health.” Houry’s message emphasized that news should “never be censored or subject to political interpretations.”

Politico reported that Jennifer Layden, the director of the Office of Public Health Data, Surveillance, and Technology, had also resigned the same day.

The events were a low point for many people, both inside and outside of the CDC. An agency once held up as the gold standard of evidence-based public health now faces cascading resignations, political interference, and a crisis of confidence at a time when public health challenges are surging.