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Less than a month after receiving Senate confirmation, Susan Monarez has been forced out of her role as head of the Centers for Disease Control and Prevention in yet another major shakeup for the beleaguered agency.

According to The Washington Post, which first reported her ouster based on several Trump administration officials, the Department of Health and Human Services (HHS) pushed back on Ars Technica’s request for confirmation of her departure. The HHS directed Ars Technica to a post on its official X account, in which it stated:

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 did not explain the circumstances of Monarez’s replacement, but according to The Washington Post, U.S. Health Secretary Robert F. Kennedy Jr., a high-profile anti-vaccine activist, had repeatedly pressed her to roll back authorizations of COVID-19 vaccines. Monarez refused to do so without first consulting the CDC’s vaccine advisory boards, and Kennedy responded by asking her to resign, accusing her of failing to support Trump’s policies.

Monarez resisted Kennedy’s demands. She reached out to Senator Bill Cassidy (R-La. ), who had helped secure Kennedy’s own Senate confirmation earlier this year by extracting commitments from him and played a key role in Monarez’s confirmation as well. Cassidy “countered Kennedy’s requests,” according to The Washington Post, leading to a shouting match. Monarez was then told by administration officials that she must resign or be fired.

Her lawyers, Mark Zaid and Abbe Lowell, stated on social media. It declared that Monarez “did not resign, and, as of the time of this statement, has not been provided any formal notice of her removal from the White House.” “Her ouster came after she refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts,” the statement continued. “She chose protecting the public over serving a political agenda.” Zaid also confirmed to Ars Technica that Monarez, as of 8:15 p.m. ET on August 27, had not received any official termination notice.

A Public Health Agency in Crisis

Monarez had been seen as a successful candidate after being confirmed by the Senate in late July, following a 2022 law mandating Senate confirmation of CDC directors for the first time. She was confirmed by a 51–47 margin along partisan lines and was sworn in by Kennedy on July 31. “Your unimpeachable scientific credentials speak for themselves,” Kennedy said at the time, promising that Monarez would be able to help restore the CDC’s reputation.

Monarez had a long résumé in government. A PhD in microbiology and immunology, she served as deputy director at the Advanced Research Projects Agency for Health (ARPA-H) during the Biden administration. She also previously worked at 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. Before Kennedy’s appointment, Monarez had also briefly led the CDC herself in an acting capacity earlier this year before being nominated and stepping down.

Her appointment was well-received by public health experts. Jennifer Nuzzo, a senior scholar at Brown University, called her a “loyal, hardworking civil servant who leads with evidence and pragmatism.” Georges Benjamin, the American Public Health Association’s executive director, called Monarez a “research powerhouse” and a “capable manager.”

But her time at the helm has been short and tumultuous. The CDC has lost hundreds of employees through layoffs and buyouts, and many of its programs have been slashed or otherwise hampered. Kennedy has also inflamed controversies by previously calling COVID-19 vaccines “the deadliest vaccine ever made” and branding the CDC “a cesspool of corruption.”

Things came to a head on August 8, when a man radicalized by vaccine misinformation and conspiracy theories drove to the CDC campus and opened fire. Some 480 rounds were discharged, and about 200 struck six CDC buildings. One local police officer was killed, and terrified CDC staff were told to run for their lives. The shooter had written that he blamed vaccines for his own health problems, and that he targeted the CDC deliberately.

In the aftermath, CDC staff have reported a sense of panic and a breaking point at the agency. Stat News has confirmed the resignations of three high-ranking officials, including Daniel Jernigan, director of the National Center for Emerging Zoonotic Infectious Diseases; Deb Houry, the CDC’s Chief Medical Officer; and Demetre Daskalakis, who served as director of the National Center for Immunization and Respiratory Diseases.

Daskalakis announced his resignation in a message, writing, “I am not able to serve in this role any longer because of the ongoing weaponization of public health.” Houry, for her part, wrote that public health should not be “censored or subject to political interpretations.”

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

For many at the CDC and beyond, the recent events are a nadir for an institution that was once the nation’s gold standard of evidence-based public health. Instead, it is now facing a spate of resignations, political interference, and an erosion of trust at a time when public health needs are still mounting.