Dr. Jeremy Faust writes a very informative blog called Inside Medicine about federal public health policy and developments. Yesterday was a day filled with drama and chaos.
Robert F. Kennedy, a dedicated foe of vaccines, decided he could not work with the newly appointed Director of the Centers for Disease Control and Prevention, Dr. Susan Monarez. She was sworn in on July 31.
Apparently they disagree over vaccine policy. Monarez recognizes that vaccines are safe and effective, but her boss RFK thinks they are dangerous and cause autism.
He ousted her. She refused to resign. In short order, RFK got Trump to fire her.
When it was clear that RFK had taken control of the CDC, its top leaders resigned. Dr. Faust posted their resignation letters on his Substack blog.
Previously, RFK had fired the expert advisory panel on vaccines and replaced them with a group that included well-known vaccine deniers. RFK announced yesterday that he would place restrictions on eligibility for the new COVID-19 vaccine (those over 65 can get it, but anyone younger has to prove they need it). RFK told Trump that he expects to release a paper on the causes of autism in September, and his critics expect more undermining of the safety of vaccines.
All in all, an ugly demonstration that RFK is utterly unqualified to be the nation’s leading public health official. Given his ignorance of science and his ideological rigidity, he is in fact the leading danger to public health.
Moments ago, Inside Medicine broke news that three top career CDC officials have resigned from the agency, hours after the Washington Post reported that newly-confirmed Director Dr. Susan Monarez has been ousted, having run afoul of Health Secretary Robert F. Kennedy Jr.
Here are the emails that each of the officials sent to their CDC colleagues by Dr. Deb Houry, Dr. Demetre Daskalakis, and Dr. Daniel Jernigan.
Dr. Deb Houry, Deputy Director for Program and Science/Chief Medical Officer:
“Over the past decade, I have had the honor of working for six CDC directors, from both Republican and Democratic administrations. To me, these leaders and my colleagues were not “Red” or “Blue,” but red, white, and blue—united in the shared purpose of protecting health and saving lives in our beloved country and globally. I have served during this time in various leadership roles, including as CDC’s senior-most career leader and lead for the transition as the current administration assumed office.
I’ve always been proud to be part of an institution that is committed to using science and data to drive our life-saving work and inform our messaging. We have worked tirelessly to enhance openness through public-facing data dashboards, providing real-time access to trends for conditions such as mpox, H5N1, measles, and overdose deaths, allowing the public to make informed decisions. Additionally, I have witnessed the rapid translation of science into action, with some Morbidity and Mortality Weekly Reports (MMWRs) being published within a week of an outbreak.
For the good of the nation and the world, the science at CDC should never be censored or subject to political pauses or interpretations. Vaccines save lives—this is an indisputable, well-established, scientific fact. Informed consent and shared decision-making must focus not only on the risks but also on the true, life-saving benefits that vaccines provide to individuals and communities. It is, of course, important to question, analyze, and review research and surveillance, but this must be done by experts with the right skills and experience, without bias, and considering the full weight of scientific evidence. Recently, the overstating of risks and the rise of misinformation have cost lives, as demonstrated by the highest number of U.S. measles cases in 30 years and the violent attack on our agency.
CDC must continue its work on all diseases, including noncommunicable health conditions, which include many of the leading causes of death in the US. I have seen the value of integrating these efforts with those of other CDC programs, as we did with the Zika virus. Integrating expertise from across the agency is critical to our effectiveness in addressing novel and emerging diseases. CDC has proven its value in addressing conditions like hypertension, diabetes, cancer, overdose, and mental health issues, as evidenced by the progress in reducing overdose deaths this year. However, proposed budget cuts and reorganization plans will negatively impact CDC’s ability to address these conditions, worsening the nation’s health.
I love this agency. Nevertheless, I have submitted my resignation today. I am committed to protecting the public’s health, but the ongoing changes prevent me from continuing in my job as a leader of the agency. This is a heartbreaking decision that I make with a heavy heart.
To the CDC staff, you are the reason I stayed and showed up each day during difficult times. I have done my best to provide support so that you can continue your critical work. Thank you for your continued commitment to our mission and the work you do every day.
As I move on to the next phase of my career, I will continue to advocate for the values that have always driven my work—science, data, and evidence-based solutions to public health challenges. I have been privileged to contribute to the CDC’s mission in many roles, including as Chief Medical Officer, and I am deeply grateful to have had the opportunity to serve alongside you.
Deb Houry, MD, MPH.”
Dr. Demetre Daskalakis, Director of the National Center for Immunization and Respiratory Diseases:
“It has been a great pleasure to serve in the role of Director of NCIRD. I wish I could say more in person, but wanted to make sure that you all have heard from me directly that I have submitted my resignation. I am not able to serve in this role any longer because of the ongoing weaponizing of public health. You are the best team I have ever worked with, and you continue to shine despite this dark cloud over the agency and our profession.
Please take care of yourself and your teams and make the right decisions for yourselves. I will send a longer email to our Center this evening or in the morning.
Demetre Daskalakis.”
Dr. Daniel Jernigan, National Center for Emerging and Zoonotic Infectious Diseases:
Colleagues: I wanted to let you know directly that I have submitted my resignation as Director of the National Center for Emerging and Zoonotic Infectious Diseases effective tomorrow. This was a very difficult decision for me. I have had the incredible opportunity to serve the American people doing meaningful and impactful work for over 30 years.
Since 1994, I have worked at CDC with some of the most intelligent, driven, and compassionate people, working to detect, control, and prevent infectious diseases. These efforts have had significant impact mitigating illness, preventing deaths, and improving the lives of millions of people.
I believe strongly in the mission of public health and the leadership that CDC has given for almost 80 years; however, given the current context in the Department, I feel it is best for me to offer my resignation.
I am so grateful for being able to work with all of you and know that you will continue doing the highest level of science and public health.
Thanks
Dan.”
Analysis: The end of an era.
The news of these resignations set off a firestorm in public health circles. This is not normal. There had been speculation that this particular trio of leaders would resign depending on how the September meeting of Secretary Kennedy’s newly-installed CDC Advisory Commitee on Immunization Practices went. There has been mounting fear that Secretary Kennedy will attempt to link vaccines to autism in a forthcoming HHS report, and that ACIP will be expected to remove many of its recommendations, some decades old, that have protected American children from death and severe illness from preventable diseases. But news of Monarez’s ouster meant that the writing was on the wall, moving these resignations up by weeks.
Frankly, the very future of the CDC is unknown. Thousands of good scientists and other agency officials remain. But without these key leaders—non-partisan career officials widely respected both internally and beyond—the agency is genuinely at risk of losing its ability to carry out its core mission. That’s not because any three people, (regardless of how experienced or respected they may be) are irreplaceable, but, rather, for what their departures portend. Other leaders and career scientists may also soon exit or be forced out. At some point, core mission activities that keep us safe will be at risk of being unfulfilled.
When these losses will translate to decreased safety to Americans that is noticeable is an open question. But, we’re about to find out…