Public health and access to lifesaving vaccines are on the line in a high-stakes leadership battle at the Centers for Disease Control and Prevention.
Health and Human Services Secretary Robert F. Kennedy Jr.’s push to fire CDC director Susan Monarez is more than an administrative shake-up. The firing marks a major offensive by Kennedy to seize control of the agency and impose an anti-vaccine, anti-science agenda that will have profound effects on the lives and health of all Americans, public health leaders say.
Kennedy wants to see the Pfizer and Moderna messenger RNA-based covid-19 vaccines pulled from the market, according to two people familiar with the planning who asked not to be identified because they’re not authorized to speak to the press. He’s also set his sights on restricting or halting access to some pediatric immunizations, some public health leaders say.
His actions have already reduced federal help to states, creating the potential for more infectious disease outbreaks and incidences of foodborne illness. Some public health leaders say they expect Kennedy will use the CDC to publicize health information that isn’t grounded in science.
“It’s crazy season,” said Richard Besser, former acting CDC director during the Obama administration. “People want information they can trust to make critical decisions about their health. Until now, we’ve been able to say look at the CDC. Unfortunately, we’re not able to do that anymore.”
HHS spokesperson Emily Hilliard disputed the criticism.
“Secretary Kennedy remains firmly committed to delivering on President Trump’s promise to Make America Healthy Again, dismantling the failed status quo that fueled a nationwide chronic disease epidemic and eroded public trust in our public health institutions,” Hilliard said in a statement.
White House spokesperson Kush Desai said Kennedy and Commissioner of Food and Drugs Marty Makary have reiterated that covid shots will remain available for Americans who need and want them.
“The Trump administration is restoring Gold Standard Science as the sole guiding principle of health decision-making,” Desai said in an email. “Only the Fake News could ignore these facts to continue pushing Democrat talking points and hysteria.”
Behind the Ouster
The shake-up began last week, when Kennedy sought to fire Monarez, a microbiologist who’d just been confirmed by the Senate in July. She refused to leave the position, and her lawyers said Kennedy sought to oust her because she wouldn’t fire senior staff or follow unscientific directives. Four top career officials at the CDC resigned on Aug. 27 in protest.
Career staffers at the CDC and some public health groups had hoped President Donald Trump would intervene and put the brakes on Kennedy. Instead, the White House backed Kennedy, saying Monarez was fired.
Trump on Sept. 1 demanded that drug companies show that covid vaccines work, in a further sign he’s not set on defending the shots.
“I hope OPERATION WARP SPEED was as ‘BRILLIANT’ as many say it was. If not, we all want to know about it, and why???” Trump said on Truth Social.
Operation Warp Speed was the initiative that Trump himself announced in 2020 to accelerate the development of covid vaccines, including the Pfizer and Moderna shots. The vaccines have proved safe and effective in multiple clinical trials; a study published in JAMA Health Forum estimated that they saved about 2.5 million lives worldwide.
CDC staffers are worried the agency’s next director won’t fight for science, according to an employee who asked not to be identified for fear of professional retaliation.
Trump’s support for Monarez’s ouster was a watershed moment that signaled there are no checks on Kennedy and his agenda, public health advocates say. Leading congressional Democrats such as Senate Minority Leader Chuck Schumer called for Kennedy’s firing. Hundreds of HHS staffers have also implored Congress to intervene, saying Kennedy threatens science and public health. He is slated to testify Sept. 4 before the Senate Finance Committee.
Kennedy said in a message to CDC staff that his focus is on boosting the agency’s reputation and leadership. The Atlanta-based agency was already reeling after the Trump administration pushed out thousands of its staff and a gunman who reportedly believed the covid vaccine had caused him health problems fired hundreds of rounds at its campus last month, killing a police officer.
“The CDC must once again be the world’s leader in communicable disease prevention. Together, we will restore trust,” Kennedy wrote. “Together, we will rebuild this institution into what it was always meant to be: a guardian of America’s health and security.” He said his deputy, Jim O’Neill, would serve as acting CDC director.
Nine former CDC directors or acting directors who served under both Republicans and Democrats criticized Kennedy in the aftermath of the Monarez firing, saying in an op-ed in The New York Times that the impact on public health is “unacceptable, and it should alarm every American, regardless of political leanings.”
HHS spokesperson Hilliard took exception with this point, listing four covid vaccines that continue to get the nod for use.
However, the Food and Drug Administration last
week approved updated covid mRNA boosters only for people 65 or older and others at high risk of complications. The CDC has also stopped recommending the shots for healthy children and pregnant women. Previously, the shots had been advised for anyone 6 months or older.
As a result, many people who don’t meet the criteria but want the vaccine will have to get prescriptions or consult with their doctors. Insurance may not always cover the shots, which can run around $200. Major drugstores such as Walgreens and CVS have said the shots may not be available at all pharmacies and may require a prescription.
The American Academy of Pediatrics on Aug. 19 broke with the administration, recommending that all young children get the covid vaccine. Insurance still may not cover the cost in some cases and parents could face obstacles in getting the vaccines without a prescription.
Next Move: The Advisory Committee
Kennedy and his team changed official covid vaccine recommendations even though there have been no new safety issues. A dose of the 2023-24 covid mRNA vaccine prevented significant illness and death across all age groups, according to a study published in August led by a University of Michigan researcher. The virus killed about 1,000 people a week in the U.S. in mid-January, and cases are rising again and expected to accelerate this winter.
Kennedy has handpicked a vaccine advisory committee for the CDC that is reviewing mRNA-based covid vaccines, which he falsely claimed in 2021 were “the deadliest vaccine ever made.” The covid vaccine review is being led by Retsef Levi, a professor of operations management at the Massachusetts Institute of Technology who has said without evidence that the shots cause serious harm, including death. If the committee recommends against them, Kennedy and the FDA could then begin the process of removing them from the market.
Taking mRNA-based covid shots off the market would leave consumers with fewer options for protection. Paxlovid, an antiviral medication that treats the infection in high-risk adults, would be available.
The CDC advisory committee reviewing the covid shots is also probing a long-debunked link between aluminum, used in many childhood immunizations such as those for hepatitis A and pneumonia, and autism or allergies.
The group’s findings are expected to support the erroneous link, some public health officials say. HHS could then require drugmakers to undertake costly reformulations of the shots or stop manufacturing them altogether.
“That would set up the elimination of all childhood vaccines,” Besser said.
The advisory group’s next meeting is set for Sept. 18, although Sen. Bill Cassidy (R-La.) has called for the meeting to be indefinitely delayed. Cassidy, a physician who chairs the Senate Health, Education, Labor and Pensions Committee, voted for Kennedy’s confirmation as HHS secretary after receiving assurances, he said, that the longtime vaccine opponent wouldn’t disrupt the U.S. vaccination system. Kennedy’s promises, Cassidy said, included that he wouldn’t change the CDC’s Advisory Committee on Immunization Practices.
Kennedy removed all of the panel’s members in June and replaced them with his own appointees, including anti-vaccine activists.
Kennedy’s move to put his stamp on the CDC means states that have long relied on the agency’s expertise and help in crises such as disease outbreaks will largely be left to fend for themselves, said Ashish Jha, who served as President Joe Biden’s covid response coordinator from 2022 to 2023.
“States are going to be left on their own,” Jha said. “States will struggle with the CDC incapable and dysfunctional. Our system is not designed for states to go it alone.”
The CDC typically plays a critical role by assisting states with disease surveillance, public health interventions, and outbreak response, especially when a crisis spills across state lines. An outbreak of measles this year led to more than 1,400 cases nationwide, and states including Texas, where the outbreak was identified, struggled to get help from the CDC.
A CDC program that has long tracked pathogens in food has already reduced the number of hazards it looks for from eight to two, which public health leaders say is making it harder to identify outbreaks. Staff overseeing a CDC program that tracks outdoor pollution that can exacerbate asthma also have been cut.
The agency runs a hotline that doctors around the country can call to get treatment and other types of advice. Under Kennedy’s watch, the CDC has had to pare assistance because of staffing reductions, said Wendy Armstrong, vice president at the Infectious Diseases Society of America.
“Lives are 100% at stake, no question about it,” Armstrong said. “That you can no longer trust the recommendations out of the CDC is just devastating. It’s appalling to think we can’t trust that information is science-based anymore.”
Kennedy wants to shake up CDC leadership because he sees the agency as the heart of corruption and resistance within the federal health bureaucracy, according to people familiar with his planning. Kennedy has said the agency suffers from malaise and bias.
Many public health leaders, however, view the CDC as under siege by an administration they say is corrupting science for its own ends. HHS staffers signed onto a letter that now has more than 6,800 signatures, saying Kennedy is “endangering the nation’s health by repeatedly spreading inaccurate health information.”
Kennedy has also been fending off mounting criticism of his response to the shooting at the CDC’s headquarters. He responded to the attack on social media, hours later, after first posting pictures of himself fly-fishing.
Some younger staffers are considering leaving and some workers feel like the shooting accelerated Kennedy’s overhaul of the agency, the CDC employee said.
With the battle for control of the CDC still raging, public health leaders are now looking to Congress to put the brakes on Kennedy. Some Republican lawmakers have called for a review of Kennedy’s actions.
“These high profile departures will require oversight by the HELP Committee,” Cassidy said Aug. 27 on the social platform X. Cassidy had backed Monarez to lead the agency.
Renuka Rayasam, KFF Health News senior correspondent, and Andy Miller contributed to this article.
