Fired CDC Director to Tell Senate Kennedy Pressed Her to Preapprove Vaccine Recommendations

Susan Monarez, the Centers for Disease Control and Prevention director who was dismissed weeks into the job, will tell the Senate Health Committee that Health Secretary Robert F. Kennedy Jr. pressured her to endorse new vaccine recommendations before she had seen the supporting scientific evidence, according to a copy of her prepared testimony obtained by The Associated Press.

In remarks Monarez plans to deliver Wednesday, she says Kennedy presented her with an ultimatum: "Preapprove" new vaccine recommendations from a controversial CDC advisory panel that he had reconstituted with some members skeptical of vaccine safety, or be fired. "Even under pressure, I could not replace evidence with ideology or compromise my integrity," Monarez will tell senators. "Vaccine policy must be guided by credible data, not predetermined outcomes."

Monarez, who was initially handpicked by Kennedy and nominated by President Donald Trump, said she was dismissed after resisting the directive. She also alleges Kennedy instructed her to fire several high-ranking CDC officials without cause. Monarez said in her opening remarks that she was "fired for holding the line on scientific integrity."

The hearing comes one day before the CDC's Advisory Committee on Immunization Practices is scheduled to meet in Atlanta for a two-day session at which members are expected to discuss and possibly vote on recommendations for COVID-19, hepatitis B and chickenpox vaccines. The ACIP's recommendations must be endorsed by the CDC director before they become official; with Monarez gone, Health and Human Services Deputy Secretary Jim O'Neill is serving as acting CDC director and would be responsible for any endorsement.

Committee members have signaled differing concerns about the advisory panel's work. Some have raised questions about whether hepatitis B vaccination for newborns is necessary and suggested COVID-19 vaccine recommendations should be more restricted. Monarez and former CDC Chief Medical Officer Debra Houry, who will also testify, are expected to face sharp questions from Republicans critical of prior CDC vaccine policy and COVID-19 guidance. Democrats are expected to probe Kennedy's approach to vaccines and the personnel changes at the agency.

Kennedy has denied Monarez's account that he sought "rubber-stamped" endorsements of advisory panel proposals. During a contentious Senate hearing earlier this month, Kennedy acknowledged that he ordered Monarez to fire several top officials at the agency but said Monarez had described herself to him as "untrustworthy," a characterization Monarez's attorney has denied.

Sen. Bill Cassidy, R-La., the physician who presides over Wednesday's hearing and cast a key vote for Kennedy's confirmation, has called for oversight of "serious allegations" at the CDC without explicitly assigning blame to the secretary. The hearing offers the Senate an opportunity to question both the circumstances surrounding Monarez's departure and the potential public health implications of recent leadership and advisory changes at the nation's leading public health agency.

The turmoil at the CDC has heightened attention to the advisory committee's imminent meeting in Atlanta and to who will decide whether its proposals become agency guidance. With the agency's leader removed and an acting director in place, public health officials and lawmakers alike are watching how the process for evaluating and adopting vaccine recommendations proceeds amid disputes over scientific standards and policy direction.

Associated Press writers Mike Stobbe in New York and Lauran Neergaard in Washington contributed to this report.