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Two weeks after being confirmed by the Senate, Susan Monarez was forced out of her role as director of the Centers for Disease Control and Prevention in the latest shake-up of the beleaguered public health agency.

News of Monarez’s removal first came from The Washington Post, which reported it had been informed by several officials within the Trump administration. Ars Technica reached out to the Department of Health and Human Services (HHS), which deferred to its official X account, where a brief post confirmed the news:

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 made no mention of the reason for the change in leadership. According to The Washington Post, U.S. Health Secretary Robert F. Kennedy Jr., a notorious anti-vaccine activist, had been pressing Monarez on her decisions to allow COVID-19 vaccines to remain approved for use and then asked her to reverse course on her decision to approve these vaccines, among others. She had refused to do so without the input of the CDC’s vaccine advisory committees, at which point Kennedy asked for her resignation, accusing her of not backing Trump’s agenda.

Monarez was not about to resign, of course. She reached out to Senator Bill Cassidy (R-La.), who had helped Kennedy secure his own Senate confirmation earlier this year with assurances from the future secretary. After Cassidy pushed back against Kennedy’s orders to Monarez, the two men reportedly engaged in a testy conversation. After that, administration officials gave Monarez an ultimatum: resign or be fired.

Monarez’s lawyers, Mark Zaid and Abbe Lowell, subsequently put out a statement on social media platforms declaring that, per the client, Monarez had not resigned and had not been officially informed of her termination by 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 later confirmed to Ars Technica that at 8:15 p.m. ET on August 27, Monarez had yet to receive an official letter terminating her employment.

Another Public Health Agency at Breaking Point

Monarez’s late July confirmation had been hailed as a breakthrough. She was confirmed by a 51–47 vote on strict party lines and was swiftly sworn in by Kennedy on July 31. The health secretary praised her “impeachable scientific credentials” and expressed hope that her leadership would restore some of the CDC’s lost reputation.

The résumé certainly spoke for itself. Dr. Monarez has a PhD in microbiology and immunology and has previously been deputy director at the Advanced Research Projects Agency for Health (ARPA-H) under the Biden administration. Before that, she served in positions 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. She had previously also led the CDC as its acting director earlier this year before stepping down when Trump nominated her for a formal appointment.

Public health experts had welcomed her to the job, as well. “She’s a loyal, hardworking civil servant who leads with evidence and pragmatism,” said Jennifer Nuzzo of Brown University. “She is a smart, thoughtful, experienced manager and a strong researcher,” said Georges Benjamin, the head of the American Public Health Association.

But trouble has lurked in the background. The CDC has laid off and encouraged the buyout of hundreds of staff, even as many of its programs have been cut or neutered. Kennedy himself has stoked tensions by making remarks like calling COVID-19 vaccines “the deadliest vaccine ever made” or accusing the CDC of being “a cesspool of corruption.”

A further low point came on August 8 when a gunman who had been radicalized by vaccine misinformation shot at the CDC’s campus. He fired off around 500 rounds, with roughly 200 rounds hitting six different CDC buildings. One local police officer was killed, and dozens of terrified staff members had to scramble for cover. The shooter was later found dead by suicide, having blamed vaccines for his own health problems and specifically targeted the CDC.

The news of Monarez’s apparent removal has made that situation even worse. Stat News confirmed the resignations of three high-ranking officials, including Daniel Jernigan, the director of the National Center for Emerging Zoonotic Infectious Diseases; Deb Houry, the CDC’s Chief Medical Officer; and Demetre Daskalakis, head of the National Center for Immunization and Respiratory Diseases.

In a farewell message, Daskalakis wrote, “I am not able to serve in this role any longer because of the ongoing weaponization of public health.” Houry also took to social media with her own farewell note in which she said science should “never be censored or subject to political interpretations.”

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

The latest events have left many people both inside and outside the CDC shocked and bewildered. As Politico summarized, the CDC has traditionally been “the closest thing to a gold standard in the U.S. public health world” but is now rapidly burning through its leadership, undermining its scientific mission, and being politicized in ways not seen since before World War II.