Analysis: What led to the firing of CDC Director Susan Monarez

WASHINGTON — Susan Monarez, less than a month into the job as director of the Centers for Disease Control, entered a meeting Monday with Health Secretary Robert F. Kennedy Jr. in his office in Washington, D.C., along with his deputy, Stefanie Spear. They asked for her resignation, citing concerns about insubordination and her integrity, including instances related to vaccine policy.

When she refused, Kennedy offered her another choice: Accept all recommendations from the agency’s vaccine advisory committee, whose members he had replaced with hand-picked allies who shared his hostile views about childhood immunizations, and fire a number of high-level officials at the agency. 

Barely two weeks after the shooting at the agency’s main campus, Monarez declined again to step down, kicking off a days-long struggle between her and Kennedy over the leadership — and future — of the CDC and vaccine policy. Monarez’s resistance to Kennedy’s moves to assert control over vaccine guidance is at the center of the fight, according to an HHS official with direct knowledge of the dynamics that led up to her ouster, who recounted the events on condition of anonymity because they were not authorized to speak publicly. She had clashed repeatedly with Kennedy and Spear over vaccine policy and messaging.