Former CDC Director Says HHS Secretary Pressed Her to Pre-Approve Vaccine Recommendations

Susan Monarez, the ousted director of the Centers for Disease Control and Prevention, told a Senate committee on Wednesday that Health and Human Services Secretary Robert F. Kennedy Jr. pressured her to approve vaccine recommendations in advance and to remove career officials responsible for vaccine policy — demands she said conflicted with her oath and that she refused.

Monarez testified before the Senate Committee on Health, Education, Labor and Pensions that Kennedy "directed me to commit in advance to approving every [Advisory Committee for Immunization Practices] recommendation, regardless of the scientific evidence. He also directed me to dismiss career officials responsible for vaccine policy without cause." She said Kennedy told her to resign if she would not comply. "I responded that I could not pre-approve recommendations without reviewing the evidence, and I had no basis to fire scientific experts," she said, adding that the discussion was "very tense" and unproductive.

Monarez, who was dismissed last month after about a month on the job, said she chose to speak to the committee to highlight what she described as a broader threat to public trust in health agencies. "Today should not be about me. Today should be about the future of trust in public health," she told senators. "I could have stayed silent, agreed to the demands, and no one would have known. What the public would have seen were scientists dismissed without cause, and vaccine protections quietly eroded." Her attorneys said she was targeted for refusing to "rubber-stamp unscientific, reckless directives and fire dedicated health experts."

Monarez’s firing prompted several senior CDC officials to resign, including then-Chief Medical Officer Debra Houry, who also appeared before the committee on Wednesday. Nine former CDC directors published an opinion piece in The New York Times in the weeks following Monarez’s removal, saying Kennedy’s actions endangered public health.

Lawmakers pressed Kennedy’s approach to vaccine policy as part of broader questioning about his leadership. Sen. Bernie Sanders, an independent from Vermont, praised Monarez for "standing up for protecting the well-being of the American people," and said her firing reflected "a dangerous war on science, public health, and the truth itself." During an earlier hearing this month, Sen. Tina Smith, a Democrat from Minnesota, asked Kennedy when he had been untruthful about his stance on vaccines; Kennedy replied, "Both are true," after being pressed on past remarks that cast doubt on vaccine safety.

Since Kennedy, a prominent vaccine skeptic, was confirmed earlier this year, he has overseen notable changes to U.S. immunization policy. In May, he announced the CDC would no longer recommend COVID-19 vaccination for pregnant women and healthy children. Several professional medical organizations, including the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, issued their own guidance that diverged from the new federal stance. In June, Kennedy removed all members of the CDC’s Advisory Committee on Immunization Practices and appointed new members some observers said shared his skeptical views on vaccines. In August, the Food and Drug Administration said this year’s COVID-19 shots would be authorized only for people 65 and older and those at higher risk of severe illness — a significant narrowing from previous recommendations that included children as young as 6 months.

The policy shifts have produced confusion over booster eligibility and prompted state-level responses aimed at preserving vaccine access. Massachusetts, California, Oregon and Washington have launched their own efforts to protect immunization programs and access to vaccines amid uncertainty at the federal level.

Public health employees and organizations have voiced alarm. Hundreds of public health workers signed an open letter in late August urging Kennedy to "stop spreading inaccurate health information" and to protect staff following a shooting at CDC headquarters in Atlanta that month. The signers said the attack occurred amid growing mistrust in public institutions and politicized rhetoric that has made public health professionals targets.

Kennedy has faced sustained criticism from lawmakers and public health experts for his comments and policy decisions. During a Senate hearing earlier this month, he received heated questioning about his remarks on a podcast and his direction of vaccine policy. Kennedy has not directly responded to Monarez’s testimony, and the Department of Health and Human Services has been contacted for comment.

Monarez framed her decision to testify as a defense of scientific process. "Vaccine policy must be guided by credible data — not predetermined outcomes," she said. She told senators she could have preserved her position by acquiescing but that doing so would have cost her integrity. Her testimony and the resignations it followed have intensified scrutiny of the agency charged with coordinating the nation’s response to infectious disease threats and renewed debate over how vaccine policy should be set and defended in the United States.