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NEW YORK: The nation’s top public health agency was left reeling Thursday as the White House worked to expel the Centers for Disease Control and Prevention director and replace her with a top adviser to Health Secretary Robert F. Kennedy Jr.
The turmoil triggered rare bipartisan alarm as Kennedy tries to advance anti-vaccine policies that are contradicted by decades of scientific research.
Two administration officials said Jim O’Neill, a former investment executive, would supplant Susan Monarez, a longtime government scientist. O’Neill worked at the Department of Health and Human Services under President George W. Bush, but he does not have a medical background. The officials requested anonymity to discuss personnel decisions before a public announcement.
A flashpoint is expected in the coming weeks as a key advisory committee, which Kennedy has reshaped with vaccine skeptics, is expected to issue new recommendations on immunizations. The panel is scheduled to review standard childhood shots for measles, hepatitis and other diseases.
Two Republican senators called for congressional oversight and some Democrats said Kennedy should be fired. He is scheduled to testify on Capitol Hill on Sept. 4.
No explanation given for CDC director’s ouster
Kennedy has not explained the decision to oust Monarez less than a month after she was sworn in, but he warned that more turnover could be coming.
“There’s a lot of trouble at the CDC and it’s going to require getting rid of some people over the long term, in order for us to change the institutional culture,” Kennedy said at a news conference in Texas.
The White House has only said that Monarez was “not aligned with” President Donald Trump’s agenda.
Monarez’s lawyers said she refused “to rubber-stamp unscientific, reckless directives and fire dedicated health experts.” She is fighting her dismissal, saying the decision must come directly from Trump, who nominated her in March. The president has not said anything publicly about the matter.
Monarez tried to block political interference, departing CDC officials say
The saga began Wednesday night with the administration’s announcement that Monarez would no longer lead the CDC. In response, three officials — Dr. Debra Houry, Dr. Demeter Daskalakis and Dr. Daniel Jernigan — resigned from senior roles at the agency.
The officials returned to the office Thursday to collect their belongings, and hundreds of supporters gathered to applaud them as they left the Atlanta campus. There were bouquets of flowers, cheers and chants of “USA not RFK.”
Daskalakis, who resigned as head of the National Center for Immunization and Respiratory Diseases, said, “I fear that children will be hurt by poor decision making around vaccines.”
“You cannot dismantle public health and expect it to still work,” he said.
Jernigan stepped down as director of the National Center for Emerging and Zoonotic Infectious Diseases and Houry quit her post as the agency’s deputy director and chief medical officer.
Houry told The Associated Press that Monarez had tried to guard against political meddling in scientific research and health recommendations.
“We were going to see if she was able to weather the storm. And when she was not, we were done,” Houry said.
Dr. Richard Besser, a former CDC acting director, said Monarez told him that she had refused orders to fire her management team. He also said she refused to automatically sign off on any recommendations from Kennedy’s handpicked vaccine advisers.
“Dr. Monarez was one of the last lines of defense against this administration’s dangerous agenda,” said Besser, now president of the Robert Wood Johnson Foundation, which helps support The Associated Press Health and Science Department.
Health agencies have faced turmoil since Trump took office
The CDC has long been the target of controversy, particularly during the COVID-19 pandemic, as the agency struggled to balance politics and public health.
The strife only increased this year with Kennedy elevating unscientific ideas at the Department of Health and Human Services, which oversees the CDC, while pushing waves of layoffs.
Earlier this month, a police officer was killed when a man opened fire at the agency’s headquarters because of anger over COVID-19 vaccines, which have been the subject of falsehoods and conspiracy theories. A memorial to the officer remains outside the building, close to where staff members gathered Thursday.
Monarez stands to become the shortest-serving director since the CDC was founded in 1946, exacerbating a leadership vacuum that has persisted since Trump took office. He initially chose David Weldon, a former Florida congressman who is a doctor and vaccine skeptic, but yanked the nomination in March.
Monarez was tapped next to lead the $9.2 billion agency while serving as its interim director. However, questions immediately emerged within Kennedy’s circle about her loyalty to the “Make America Healthy Again” movement, especially given her previous support of the COVID-19 vaccines that Kennedy has routinely criticized.
Vaccine panel changes prompt demands for new oversight
Kennedy rarely mentioned Monarez by name in the way he did other health agency leaders such as Mehmet Oz of the Centers for Medicare and Medicaid Services or Marty Makary of the Food and Drug Administration.
One issue has been Kennedy’s handling of the CDC’s Advisory Committee on Immunization Practices, a group of outside experts who make recommendations to the CDC director on how to use vaccines. The recommendations are then adopted by doctors, school systems, health insurers and others.
The panel is expected to meet next month, and Sen. Bill Cassidy, R-Louisiana, said any recommendations issued then will be “lacking legitimacy.”
“Serious allegations have been made about the meeting agenda, membership, and lack of scientific process being followed,” said Cassidy, who heads the Senate committee overseeing Kennedy’s department. He added that “these decisions directly impact children’s health and the meeting should not occur until significant oversight has been conducted.”
Cassidy, a doctor, provided crucial support for Kennedy’s nomination after saying Kennedy had assured him that he would not topple the nation’s childhood vaccination program.
And yet, according to a government notice, the committee on Sept. 18 will take up votes on vaccines that have been settled fixtures for children, including shots to protect against hepatitis B and a combination shot against measles, mumps, rubella and chickenpox.
Kennedy is a longtime leader in the anti-vaccine movement, and in June, he abruptly dismissed the entire panel, accusing members of being too closely aligned with manufacturers. He replaced them with a group that included several vaccine skeptics and then he shut the door to several doctors organizations that had long helped form vaccine recommendations.
Departing CDC officials worry science will be compromised
Houry and Daskalakis said Monarez had tried to make sure scientific safeguards were in place.
For example, she tried to replace the official who coordinated the panel’s meetings with someone who had more policy experience. Monarez also pushed to have slides and evidence reviews posted weeks before the committee’s meetings and have the sessions open to public comment, Houry said.
HHS officials nixed that and called Monarez to a meeting in Washington on Monday, Houry said.
Daskalakis described the situation as untenable.
“I came to the point personally where I think our science will be compromised, and that’s my line in the sand,” he said.
Medical and public health organizations said they worried about the future without Monarez in charge.
“The scientific community is beginning to draw a line in the sand and say, ‘No way,’” said Dr. Georges Benjamin, executive director of the American Public Health Association.

Gas stations have run dry in some regions of Russia after Ukrainian drones struck refineries and other oil infrastructure in recent weeks, with motorists waiting in long lines and officials resorting to rationing or cutting off sales altogether.
Wholesale prices on the St. Petersburg International Mercantile Exchange for A-95 gas — the highest octane — spiked to record highs last week, soaring to about 50 percent higher than in January, as demand soared from farmers seeking to bring in the harvest and Russians hitting the roads for their last big vacation of the summer.
Russian media outlets reported fuel shortages are hitting consumers in several regions in the Far East and on the Crimean Peninsula, which was illegally annexed from Ukraine by Moscow in 2014.
Media outlets in the Primorye region, which borders North Korea, reported long lines and prices of about 78 rubles per liter (approximately $3.58 per gallon) at gas stations in the area, where the average monthly wage is about $1,200. Journalists at local news outlet Primpress found other drivers trying to sell gas online for as much as 220 rubles per liter (about $10.12 per gallon).
In the Kurilsky district of the Kuril Islands north of Japan, shortages of lower octane A-92 gas forced officials to halt public sales outright Monday. In Crimea, a popular resort area, some companies sold fuel only to holders of coupons or special cards.
Normal price increases are aggravated this year
Russia is no stranger to gasoline price increases at the end of summer. But this year’s shortages have been aggravated by Ukraine’s attacks on oil refineries in the 3 1/2-year-old war. Larger, more concentrated attacks are causing more damage and hampering production, all timed to coincide with peak demand.
Ukraine has targeted energy infrastructure before, but the recent strikes have been more successful, with more drones targeting a more concentrated group of facilities.
“The Ukrainians are attacking an arc of refineries, starting from Ryazan, which is south of Moscow, all the way to Volgograd. That region is where people are driving through on their way to (resorts on) the Black Sea. That’s the region where most of the harvest operations are going on. And that’s also a rather densely populated region,” Sergey Vakulenko, a senior fellow at the Carnegie Russia Eurasia Center, told The Associated Press.

Between Aug. 2 and Aug. 24, Ukraine attacked oil infrastructure at least 12 times, according to media reports. Of those attacks, at least 10 were targeting sites in the Ryazan-Volgograd arc in southwestern Russia.
These attacks have damaged many oil refineries but have not destroyed them outright, Vakulenko said, adding that most of the facilities are extremely resilient against fires.
But they can slow refinery activity, as shown by a fall in the intake of crude oil to be turned into diesel, gasoline or other products by roughly 200,000 to 250,000 barrels per day, said Gary Peach, oil markets analyst at Energy Intelligence.
“That’s just enough to make their gasoline industry feel some pain, especially during the high consumption months in the summer,” he told AP. Gasoline production fell 8.6 percent in the first 19 days of August, compared with a year earlier, and diesel production was down 10.3 percent.
Other war-related issues have caused even more consumer pain. Ukrainian drone strikes repeatedly have disrupted Russian transportation networks, particularly air traffic, causing more people to travel by car and increasing demand for gas, Vakulenko said.
Inflation also has made it less profitable for suppliers who normally buy gasoline early in the year for sale in the higher-priced summer months, and many entrepreneurs simply decided not to bother this year, he said.
Individually, none of these problems caused lasting or widespread disruption in Russia. But together, they have transformed an expected annual price fluctuation into a problem for the government.
To try to ease the shortage, Russia has paused gasoline exports, with officials Wednesday declaring a full ban until Sept. 30 and a partial ban affecting traders and intermediaries until Oct. 31. Oil company managers have also been summoned to government meetings twice this month to discuss the shortages, Russian media reported.
Moscow is largely spared from shortages
While officials appear to be concerned, the gasoline shortfall “isn’t system critical,” Peach said.
So far, the shortage remains confined to certain areas — the Far East and Crimea — because these regions usually are supplied by fewer refineries and present greater transportation demands.
Moscow has been spared the latest gasoline price spike because it is well-supplied from major refineries in Yaroslavl and Nizhny Novgorod, cities a few hours’ drive away. The capital also has a refinery in the city itself.
Russia is not at immediate risk of grinding to a halt — even in more vulnerable regions, experts say. Although private drivers may feel some pain at the gas pump, most buses and trucks run on diesel, for which Russia has a surplus. The military, which largely uses diesel fuel, also is insulated from any shocks.
Vakulenko wrote in a recent commentary that annual diesel production is “more than double than what is needed.”
That doesn’t mean the situation still couldn’t deteriorate. Refineries that make gasoline for Russia’s domestic market also make diesel and other products for export — a vital source of income amid heavy Western sanctions.
Industry observers say Ukraine’s drones target key refinery equipment, including the distillation column that separates incoming crude oil into other products, including gasoline, diesel, fuel for ships and asphalt. If damaged, it must be repaired or replaced for the refinery to function. Repairs could be difficult if foreign parts are needed.
The gasoline crisis is expected to ease by late September as demand subsides and the annual summer maintenance for many refineries is finished.
Still, the crisis highlights a vulnerability on the home front that has the potential to be exploited further as drone warfare evolves.