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Only a few weeks after being confirmed by the Senate, Susan Monarez has been forced out as director of the Centers for Disease Control and Prevention. This is the latest of several high-profile shakeups in the beleaguered public health agency.

The first word of her removal came from The Washington Post, which reported her ouster, citing several Trump administration officials. The Department of Health and Human Services (HHS) was asked for comment by Ars Technica. When we did, the department referred to a post on its official X account. The statement said:

“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, of course, gave no reason for the change in leadership. According to The Washington Post, US Health Secretary Robert F. Kennedy Jr., a known anti-vaccine activist, had repeatedly pressed Monarez to change her position on the COVID-19 vaccines. Kennedy demanded that Monarez reverse the approvals of COVID vaccines, but she refused to do so before going to the CDC’s vaccine advisory committees. Kennedy then ordered her to resign, accusing her of failing to support Trump.

Monarez refused to resign. She instead went to Senator Bill Cassidy (R-La. ), who had led Kennedy’s Senate confirmation this year by extracting guarantees from him. Cassidy objected to Kennedy’s requests, and an angry confrontation followed. After that, administration officials told Monarez she would have to either resign or be fired.

Lawyers Mark Zaid and Abbe Lowell, both of whom represent Monarez, released a statement on social media asserting that Monarez has not resigned and that she had not been formally terminated by the White House as of publication. “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 confirmed to Ars Technica that, as of 8:15 p.m. ET on August 27, Monarez had still received any formal notice of termination.

A Health Agency on the Edge

Monarez’s confirmation last month had been seen as a breakthrough. Confirmed in a 51–47 vote on party lines, she became the first CDC director ever to be subject to Senate confirmation, after a 2022 law required it. Kennedy himself administered her oath of office on July 31, and he praised her “unimpeachable scientific credentials” and his confidence that she would restore the CDC’s reputation.

Monarez has an impressive and well-respected résumé. The new director holds a PhD in microbiology and immunology and had recently served as the deputy director at the Advanced Research Projects Agency for Health (ARPA-H) under the Biden administration. She had also 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 had even previously served as the acting director of the CDC this year, leading the agency briefly until she stepped down when Trump nominated her.

Public health experts had praised her appointment. Jennifer Nuzzo of Brown University said that Monarez is a “loyal, hardworking civil servant who leads with evidence and pragmatism.” Georges Benjamin, the head of the American Public Health Association, said that she’s a strong researcher and a capable manager.

But her short tenure comes amid the agency’s turmoil. The CDC has been shedding several hundred employees in layoffs and buyouts, and many programs have been cut or otherwise hampered. Kennedy himself has not helped matters, repeatedly calling COVID-19 vaccines “the deadliest vaccine ever made” and dismissing the CDC as “a cesspool of corruption.”

On August 8, the CDC was the subject of a tragic shooting when a man radicalized by vaccine misinformation opened fire on the CDC campus. Approximately 500 shots were fired, and around 200 hit six different CDC buildings. A local police officer was killed, and other staff members fled in panic. The shooter had blamed vaccines for his own health conditions and had targeted the CDC as a result.

Now, as the impact of Monarez’s reported firing has been made clear, the agency’s crises have only deepened. Stat News reported the resignations of three senior officials: Daniel Jernigan, the director of the National Center for Emerging Zoonotic Infectious Diseases; Deb Houry, the CDC’s Chief Medical Officer; and Demetre Daskalakis, who was leading 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’s note was equally clear, ending on the principle that science must “never be censored or subject to political interpretations.”

Hours earlier, Politico had reported that Jennifer Layden, who heads the Office of Public Health Data, Surveillance, and Technology, also resigned.

The chain of events has been seen by many inside and outside the CDC as the agency’s nadir, with an organization that had long been the foundation of evidence-based public health collapsing in a wave of resignations, overt politicization, and a broader trust crisis while public health issues continue to rise.