The White House said late Wednesday that it had fired Susan Monarez, the new director of the Centers for Disease Control and Prevention, after a tense confrontation in which Health Secretary Robert F. Kennedy Jr. tried to remove her from her position and she refused to resign.
Dr. Monarez, an infectious disease researcher, was sworn in just a month ago by Mr. Kennedy, but had clashed with the secretary over vaccine policy, people familiar with the events said. Four other high-profile C.D.C. officials quit en masse, apparently in frustration over vaccine policy and Mr. Kennedy’s leadership.
Because Dr. Monarez had been confirmed by the Senate — previous C.D.C. directors were not subject to such confirmation — she served at the pleasure of the president. Mr. Kennedy most likely did not have the authority to dismiss her.
Her lawyers insisted she was staying put. But at 9:30 p.m., a spokesman for President Trump, Kush Desai, said in an email message that Dr. Monarez had been terminated.
“As her attorney’s statement makes abundantly clear, Susan Monarez is not aligned with the President’s agenda of Making America Healthy Again,” Mr. Desai wrote.
“Since Susan Monarez refused to resign despite informing HHS leadership of her intent to do so, the White House has terminated Monarez from her position with the C.D.C.”
Dr. Monarez’s firing, along with the resignations of four of the C.D.C.’s top leaders, will undoubtedly throw the nation’s public health agency into further turmoil after a tumultuous month in which agency employees were laid off and a gunman fired a barrage of bullets at the Atlanta headquarters, killing a policeman and terrifying employees.
Dr. Monarez’s lawyers, Mark S. Zaid and Abbe Lowell, asserted in a statement earlier Wednesday that Dr. Monarez’s situation was symbolic of larger issues.
“It is about the systematic dismantling of public health institutions, the silencing of experts, and the dangerous politicization of science,” Mr. Zaid and Mr. Lowell wrote. “The attack on Dr. Monarez is a warning to every American: Our evidence-based systems are being undermined from within.”
The clash between Mr. Kennedy and Dr. Monarez, which had been brewing for days, burst into public view on Wednesday. That afternoon, the Department of Health and Human Services announced on X that Dr. Monarez was “no longer” director of the C.D.C.
Without elaborating, the agency thanked her for “her dedicated service to the American people,” adding, “@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.”
Hours later, Mr. Lowell and Mr. Zaid disputed the department’s account, saying Dr. Monarez “has neither resigned nor received notification from the White House that she has been fired, and as a person of integrity and devoted to science, she will not resign.”
Mr. Kennedy and his department, they said, “have set their sights on weaponizing public health for political gain and putting millions of American lives at risk.”
Neither Dr. Monarez nor the department responded to requests for comment.
Dr. Monarez and Mr. Kennedy were at odds over vaccine policy, according to an administration official who is familiar with the events.
The official, who spoke on condition of anonymity for fear of retribution, said Mr. Kennedy summoned Dr. Monarez to his office on Monday and demanded that she resign. When she refused, Mr. Kennedy demanded that she remove the agency’s top leadership by the end of the week.
Dr. Monarez then called Senator Bill Cassidy, the Republican chairman of the Senate health committee, who in turn called Mr. Kennedy, according to the official. Mr. Kennedy, furious, summoned Dr. Monarez to a second meeting on Tuesday and accused her of “being a leaker,” according to the official, and told her she would be fired.
The official said Dr. Monarez spoke to other senators as well. On Wednesday, a White House official told Dr. Monarez that if she did not resign by the end of the day, Mr. Trump would terminate her.
The four high-ranking agency officials who did resign are Dr. Debra Houry, the C.D.C.’s chief medical officer; Dr. Demetre Daskalakis, who ran the center that issues vaccine recommendations; Dr. Daniel Jernigan, who oversaw the center that oversees vaccine safety; and Dr. Jennifer Layden, who led the office of public health data.
Some cited an increasingly tense environment within the administration that had become intolerable.
“I am not able to serve in this role any longer because of the ongoing weaponization of public health,” Dr. Daskalakis wrote in an email to colleagues, adding that they “continue to shine despite this dark cloud over the agency and our profession.”
Dr. Jernigan was deeply involved in the agency’s response to anthrax, swine flu and Covid; Dr. Daskalakis helped the nation cope with an mpox outbreak; Dr. Layden established the Covid strategic science unit; and Dr. Houry built the agency’s opioid response program.
Former C.D.C. leaders said the departures would harm the agency and the nation.
Dr. Mandy Cohen, who ran the agency during the second half of the Biden administration, called the officials “exceptional leaders who have served over many decades and many administrations,” and warned that “the weakening of the C.D.C. leaves us less safe and more vulnerable as a country.”
Dr. Anne Schuchat, the C.D.C.’s principal deputy director until her retirement in May 2021, called them “the best of the best.”
“These individuals are physician-scientist public health superstars,” she said. “I think we should all be scared about the nation’s health security.”
The resignations, which coincided with a decision by the Food and Drug Administration to put new restrictions on updated Covid vaccines for the fall-winter season, occurred at a difficult time for the nation’s public health agency.
Earlier this month, a gunman angry about Covid vaccines opened fire on C.D.C. headquarters in Atlanta, killing a policeman, shattering bullet-resistant windows and traumatizing employees.
After the attack, Dr. Houry and Dr. Daskalakis both pushed for Dr. Monarez to reassure C.D.C. employees that the matter would be given the attention it deserved.
“We’re mad this has happened,” Dr. Houry said in a large group call the day after the shooting. Dr. Daskalakis, whose office was among those hit by bullets, told Dr. Monarez that employees wanted to see a plan for their safety and an acknowledgment that the attack was not just “a shooting that just happened across the street with some stray bullets.”
It seemed to many employees on the call that Dr. Monarez had not spoken to Mr. Kennedy directly after the attack. Mr. Kennedy did not address the shooting until the day afterward, when he posted condolences on his official X accounts. Mr. Trump has still not spoken about the assault.
H.H.S. employees issued an open letter pleading with Mr. Kennedy, who has repeatedly cast doubt on Covid shots and other vaccines, to stop spreading “inaccurate information.”
Dr. Monarez, while not pointing a finger at the health secretary, echoed their concerns about misinformation in a note to employees.
In interviews and opinion articles, many current and former employees — including one of the agency’s most storied directors, Dr. William Foege — also blamed Mr. Kennedy’s rhetoric for playing a part in the shooting.
Dr. Foege, 89, who helped eradicate smallpox in the 1970s, recently wrote that Mr. Kennedy’s “words can be as lethal as the smallpox virus.”
In an email to colleagues, Dr. Jernigan said he was grateful for the opportunity to serve the American public for more than 30 years but “given the current context in the department, I think it is best for me to offer my resignation.”
Dr. Houry, in her own email, said she, too, felt unable to continue, given the circumstances at the agency: “This is a heartbreaking decision that I make with a heavy heart.”
Dr. Monarez was the first nonphysician to lead the C.D.C. in more than 50 years. She had been acting director of the agency since Mr. Trump took office, and she was nominated to the top post after the president withdrew his first choice, Dr. David Weldon.
Morale has plummeted at the agency as Mr. Kennedy severely reduced the work force, sharply cut back C.D.C. funding and eliminated some core functions of the agency.
Dr. Monarez was expected to run her plans by Matt Buckham, the new chief of staff at H.H.S., and Matt Buzzelli, the chief of staff at C.D.C., according to a person familiar with the unusual arrangement.
Her brief leadership included dealing with the fallout from decisions by Mr. Kennedy, who had unseated members of an influential vaccine advisory committee and replaced them with some staunch opponents of existing immunization policies.
Late last week, H.H.S. confirmed that a vocal Covid vaccine opponent had been appointed to lead a subcommittee reviewing the safety of the shots, upsetting public health experts.
In addition, Mr. Kennedy has gone against the consensus of many scientists and public health experts by announcing new efforts and funding for research into whether there is a link between vaccines and autism, despite years of studies that have not found evidence to support his belief.
In recent weeks, the C.D.C. has been under pressure from Mr. Kennedy’s allies to grant access to a large database called the Vaccine Safety Datalink that is managed in part by large health systems around the United States.
Mr. Kennedy brought in David Geier, a widely discredited researcher who has published studies using the database and purporting to show a link between vaccines and autism.
Mr. Geier’s team has been seeking the data from the C.D.C. and other corners of the federal health bureaucracy for the work seeking a tie between vaccines and autism.
Mr. Kennedy previously complained that officials were blocking his access to federal data. But in a presidential cabinet meeting on Tuesday, he suggested that his staff was likely to have a preliminary answer to the cause of autism soon.
“We’re finding interventions, certain interventions now that are clearly, almost certainly causing autism, and we’re going to be able to address those in September,” Mr. Kennedy said.
Sheryl Gay Stolberg covers health policy for The Times from Washington. A former congressional and White House correspondent, she focuses on the intersection of health policy and politics.
Apoorva Mandavilli reports on science and global health for The Times, with a focus on infectious diseases and pandemics and the public health agencies that try to manage them.
Christina Jewett covers the Food and Drug Administration, which means keeping a close eye on drugs, medical devices, food safety and tobacco policy.
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