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Susan Monarez was forced out as the director of the Centers for Disease Control and Prevention just weeks after the Senate confirmed her for the role, in the latest major shakeup for the beleaguered public health agency.

The Washington Post first reported the news, citing multiple officials within the Trump administration. When Ars Technica reached out to the Department of Health and Human Services (HHS), the department redirected the outlet to a post on its official X account. The post 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.”

The post did not offer a reason for the change in leadership. In her conversations with the U.S. Health Secretary Robert F. Kennedy Jr.—himself an outspoken anti-vaccine advocate—Monarez had been repeatedly pressed on her approach to COVID-19 vaccines, according to The Washington Post. Kennedy reportedly asked her to reverse prior approvals for COVID vaccines. She refused without first bringing the matter to the CDC’s vaccine advisory committees. Kennedy then told Monarez to resign, accusing her of not supporting President Trump’s agenda.

Monarez, however, refused to step down. Instead, she reached out to Senator Bill Cassidy (R-La.), who had helped shepherd Kennedy through his own Senate confirmation earlier this year, having first extracted pledges from him. Cassidy himself spoke to Kennedy in protest, at which point they engaged in a “heated” argument, according to The Washington Post. Administration officials later told Monarez she would be fired if she did not resign.

Lawyers for Monarez, Mark Zaid, and Abbe Lowell shared a statement on social media saying that Monarez had not resigned and that the White House had not given her “formal notice of removal.” “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 told Ars Technica that as of 8:15 p.m. ET on August 27, Monarez had not received official word of her termination.

A Public Health Agency at Breaking Point

Monarez’s confirmation in late July had been hailed as a turning point. Approved by a 51–47 margin in a strictly party-line vote, she became the first-ever CDC director subject to Senate confirmation following a 2022 law mandating it. Kennedy himself administered the oath on July 31 and lauded her “impeachable scientific credentials,” pledging she would restore the CDC’s reputation.

Monarez’s résumé is extensive and widely respected. She holds a PhD in microbiology and immunology and most recently served as the deputy director of the Advanced Research Projects Agency for Health (ARPA-H) under the Biden administration. Before that, she worked with 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 acting CDC director earlier this year before resigning to step aside for Trump’s formal nomination.

Monarez’s appointment was greeted with praise from public health experts. Jennifer Nuzzo of Brown University described her as “a loyal, hardworking civil servant who leads with evidence and pragmatism.” Georges Benjamin, head of the American Public Health Association, said she was a “strong researcher” and an “excellent” manager.

But her time in the job has been blighted by turmoil at the agency. Hundreds of CDC staff have left the agency through layoffs and buyouts, and many of its programs have been cut or otherwise curtailed. Kennedy himself has exacerbated tensions by calling COVID-19 vaccines “the deadliest vaccine ever made” and describing the CDC as “a cesspool of corruption.”

On August 8, the agency suffered a mass shooting on its own campus, after a gunman radicalized by vaccine misinformation opened fire. Some 500 rounds were fired, with around 200 striking six different CDC buildings. One local police officer was killed, while staff across the campus rushed for cover. The shooter said he blamed vaccines for his own health issues and had deliberately targeted the CDC.

Monarez’s reported ouster has now further deepened the CDC’s crisis. Stat News has confirmed the resignations of three more high-ranking officials: Daniel Jernigan, the director of the National Center for Emerging Zoonotic Infectious Diseases; CDC Chief Medical Officer Deb Houry; and Demetre Daskalakis, who had headed the National Center for Immunization and Respiratory Diseases.

In a note upon his departure, Daskalakis wrote: “I am not able to serve in this role any longer because of the ongoing weaponization of public health.” Houry, in her own parting message, noted that science “should never be censored or subject to political interpretations.”

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

In the view of many, both inside and outside the CDC, the recent events have signaled a nadir for an agency once viewed as the gold standard for evidence-based public health. Now it is faced with resignations and buyouts in the hundreds, political interference, and a loss of trust, at a time when its work is needed most.