Med_Board Perspectives

"Chaos" at the CDC: What Happened, and Why

9.5.25

The Verdict is in on Susan Monarez Ouster

CDC personnel issues were in the spotlight following RFK Jr.'s appearance before the Senate Finance Committee on 9.4.25.

Perception-wise Monaraz is coming out of this better than RFK Jr. is. First, Monarez did herself a favor with a WSJ op/ed in which she laid out a case for the importance of the CDC while standing up for the workers. She managed to avoid partisan attacks on the Trump Administration by giving the President credit for ordering a review of the effectiveness of vaccines during Covid. Where she cited differences with RFK Jr., it was over vaccine policy, not personal or political issues. Senators cited her article in the Finance Committee and forced RFK Jr. to respond to it.

A harsh opinion piece from the Wall Street Journal's Kimberley Strassel, a conservative pundit who often supports the Trump Administration, notes that RFK Jr. himself swore in Monarez, praising her credentials. Her article concludes with the suggestion that the President starts shopping around for another HHS Secretary.

Mainstream media coverage is taking a dim view of the firing well. Our media navigator section highlights well-sourced and detailed accounts of RFK Jr.s appearance before the Senate committee. Notable physician / senators John Barrasso and Bill Cassidy aggressively questioned the Secretary on vaccine policy, which of course, is now driving the news cycle in the wake of the CDC clash and will continue in the weeks ahead leading up to the scheduled Sept. 18 CDC vaccine committee meeting.

9.1.25

A promising start for Susan Monarez

It started off on a positive note. Susan Monarez was widely seen as a consensus figure who could bridge the gap between the public health establishment and RFK Jr., particularly on vaccine policy.

The Washington Post, no fans of the Trump Administration, urged the Senate to confirm the career government scientist as CDC Director in an editorial on June 26. The Post praised her for saying vaccines save lives and for defending mRNA technology.

The executive director of the American Public Health Association expressed confidence in her ability to lead the CDC. Dr. Georges Benjamin, a veteran of the public health establishment and RFK Jr. critic told the Hill newspaper, “I believe the public health community can work with her in a positive manner.”

At her confirmation hearing, Monarez navigated thorny issues such as RFK Jr.’s replacing members of the Advisory Committee on Immunization Practices. She emerged from the Senate committee hearing unscathed and was confirmed on July 29.

A key Senator, Bill Cassidy, who has been at odds with RFK Jr. on vaccine guidance sought assurances from Monarez. The Louisiana Republican (and medical doctor) was concerned about ACIP.

“Someone can speak as a critic, but there should be someone who’s reviewing the overwhelming evidence of the safety of vaccines,” Cassidy said. Monarez replied that the ACIP has a vital role to play and the Senator voted to confirm her.

Both President Trump and RFK Jr. praised the career government scientist as a steady hand that would enable the CDC to advance the Make America Healthy Again agenda. “I’m so grateful for President Trump making this appointment, Kennedy said in a tweet on March 25, describing her as his “handpicked” choice for the job.

A rapid collapse in trust

Less than a month into the job and the whole thing fell apart. Headlines decry that the CDC is now in chaos. Adding to the reported confusion is the sequence of events that led to her dismissal.

According to Stat News’ HHS sources, whether or not to accept vaccine guidance is at the center of the fight. RFK Jr. summoned the CDC Director to his Washington office on August 25 and asked for her resignation. Apparently she refused to resign, so RFK Jr. then asked Monarez to accept all the recommendations of the newly-constituted ACIP.

Monarez then contacted GOP Senators including majority leader John Thune and Bill Cassidy to fight for her job. Upon hearing this, RFK Jr. was said to be furious. The White House personnel office reportedly then told Monarez she would be fired if she didn’t resign. President Trump ultimately fired her.

At this point, Monarez and her attorneys are challenging the legality of her firing. Her lawyers are publicly blaming the firing on her refusal to “rubber-stamp unscientific, reckless directives.” At least four CDC leaders have resigned in the wake of Monarez’ ouster.

What happens now

Hardly a day has gone by where the mainstream media has not labelled RFK Jr. a “vaccine skeptic.” That label is now indelible. New CDC leadership will be under enormous scrutiny. Anti-RFK Jr. voices will become even louder.

The public health association’s Dr. Benjamin said the leadership overhaul at the CDC represents Kennedy’s “failed leadership and reckless mismanagement,” adding that he has a “blatant disregard for science and evidence-based public health.”

Monarez saw legitimacy with her Senate confirmation, but don’t expect that with the newly-appointed acting director anytime soon. According to the Associated Press, citing federal law, Jim O’Neill has 210 days before either stepping aside or being formally nominated. The media is questioning his credentials. Media coverage of RFK Jr. was not good to begin with, and it will get worse.

The mainstream media continues to ignore a number of voices who support RFK Jr. or the Trump Administration. By mainstream media, we mean the Associated Press, ABC, Bloomberg, CBS, MSNBC, NBC, CNN, PBS, Reuters, the New York Times and the Washington Post. Those media outlets appear repeatedly in our media navigator’s “left” column for representing liberal and progressive perspectives. Why is that?

Oftentimes that is because of who is not sought for comment. For example, when is the last time former CDC Director Robert Redfield, who served in the first Trump Administration, was quoted in the above-mentioned media outlets?

Instead, his views about the consequences of mRNA vaccines are confined to conservative media outlets such as NewsMax. His views on mRNA should be part of the debate not stifled. Yet too many public health decisions are not open to debate.

Part of the political upheaval in this country during Covid was vaccine mandates, masking requirements, social distancing rules and school closures. Today, the Trump Administration and RFK in particular are challenging a centralized, monolithic vaccine regimen that a number of medical groups and reporters don’t yet understand.

On the other hand, what appears to be missing from the Trump Administration is a consistent rationale on the purported dangers of vaccines. That explains Trump’s move to conduct a review of his first term’s Operation Warp Speed, a public-private partnership that made vaccines available in record time. As Trump posted in Truth Social, the CDC is getting ripped apart.

A number of expert commentators such as Fox News’ Marc Siegel, former Surgeon General Jerome Adams, and Robert Wood Johnson CEO Richard Besser have praised President Trump for Operation Warp Speed in his first term while questioning the hostility of mRNA technology in Trump’s second term. The President is well aware of this.

Trump’s review of his first term vaccine approach may ultimately decide where the CDC goes from here. In the meantime, keep your eye on RFK Jr.’s scheduled appearance September 4 before the Senate Finance committee. The usual suspects in the media will be there.