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Susan Monarez was forced out of her newly confirmed role as director of the Centers for Disease Control and Prevention (CDC) last week, a prominent shakeup at the beleaguered public health agency.

The Washington Post first reported the news, citing several officials within the Trump administration. After Ars Technica inquired with the Department of Health and Human Services (HHS), the department directed the outlet to a post on its official X account. The post read:

Susan Monarez is no longer director of the Centers for Disease Control and Prevention. We thank her for her dedicated service to the American people. @SecKennedy has full confidence in his team at @CDCgov, who will continue to be vigilant in protecting Americans against infectious diseases at home and abroad.”

The post provided no specific reason for the leadership change. But according to the Post, U.S. Health Secretary Robert F. Kennedy Jr., an outspoken vaccine skeptic, had repeatedly pressed Monarez about her support for COVID-19 vaccines. Kennedy wanted Monarez to rescind approvals of the vaccines, the Post reported. Monarez declined to reverse course until she could confer with the CDC’s vaccine advisory committees. Kennedy told Monarez to resign and accused her of failing to support Trump’s agenda.

Monarez had refused to resign voluntarily. She instead reached out to Senator Bill Cassidy (R-La. ), who had helped secure Kennedy’s own Senate confirmation earlier this year. Kennedy had given Cassidy a list of assurances before the vote, which Cassidy helped broker. After Monarez called Cassidy, Kennedy reportedly pressed her about her request to consult with CDC advisory boards. In response, Kennedy called Monarez’s lawyers, Mark Zaid and Abbe Lowell, and threatened legal action.

According to the Post, Monarez was told after the meeting that she had to either resign or be fired. Later, the two lawyers shared a statement on social media that confirmed Monarez’s version of events. The statement said that Monarez had not resigned, nor had the White House sent her any official notification of termination. “Her ouster came after she refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts,” it said. “She chose protecting the public over serving a political agenda.” Zaid later told Ars Technica that as of 8:15 p.m. ET on August 27, Monarez had not received any official notification of her termination.

Susan Monarez’s ouster comes at a breaking point for the CDC.

Monarez had previously been confirmed by the Senate in late July. It was a milestone; she was approved by a 51–47 vote, along party lines, and became the first-ever CDC director to go through Senate confirmation after a law was passed in 2022. Kennedy himself swore Monarez in at a ceremony on July 31. “We are pleased that you have agreed to lead the CDC,” Kennedy said at the time. “Your unimpeachable scientific credentials and professionalism are a clear indication that you will lead with integrity, objectivity, and without regard to politics, helping restore the integrity of this vital public health agency.”

Monarez came with an impressive résumé. The new CDC head has a PhD in microbiology and immunology. She previously served as deputy director of the Advanced Research Projects Agency for Health (ARPA-H) in the Biden administration. She had also held various positions in the Biomedical Advanced Research and Development Authority (BARDA), the Department of Homeland Security, the White House Office of Science and Technology Policy, and the National Security Council. Monarez had previously served as the acting director of the CDC for several weeks earlier this year before resigning when Trump formally nominated her for the position.

Her appointment had been met with praise from public health experts. Jennifer Nuzzo of Brown University said Monarez is a “loyal, hardworking civil servant who leads with evidence and pragmatism.” Georges Benjamin, head of the American Public Health Association, said in a statement that Monarez was “a very strong researcher” with managerial capabilities.

But the short-lived Monarez era ended in the middle of a broad crisis at the agency. The CDC has been shedding hundreds of staff via layoffs and buyouts. Programs have been reduced or otherwise curtailed. Kennedy himself has often stoked controversy by calling COVID-19 vaccines “the deadliest vaccine ever made” and saying the CDC was “a cesspool of corruption.”

On August 8, the CDC was also the site of a mass shooting that left one local police officer dead. A gunman, who had been radicalized by vaccine misinformation, targeted the CDC campus after blaming vaccines for his own medical conditions. Six CDC buildings were hit, with around 200 of some 500 rounds fired hitting the CDC campus. Staff had to scramble to safety, with some hearing multiple gunshots near their own offices. The shooter was killed by police after entering the CDC campus.

Monarez’s reported ouster has only deepened the chaos at the agency. Stat News separately reported that three more high-ranking officials resigned this week: Daniel Jernigan, director of the National Center for Emerging Zoonotic Infectious Diseases; CDC Chief Medical Officer Deb Houry; and Demetre Daskalakis, who previously led the National Center for Immunization and Respiratory Diseases.

In his farewell message, Daskalakis wrote, “I am not able to serve in this role any longer because of the ongoing weaponization of public health.” Houry’s note to her colleagues echoed that sentiment, saying that scientific work must “never be censored or subject to political interpretations.”

Politico had earlier reported that Jennifer Layden, director of the Office of Public Health Data, Surveillance, and Technology, had also resigned on the same day.