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Susan Monarez has been ousted as director of the Centers for Disease Control and Prevention, barely a month after being confirmed in that role by the US Senate. It’s the latest in a series of major disruptions to hit the beleaguered public health agency.

The first news of Monarez’s removal came from The Washington Post, which reported the news, citing a number of officials from inside the Trump administration. After Ars Technica requested a statement from the Department of Health and Human Services (HHS), a spokesperson for the department instead pointed to an HHS post on its official X account. That post said:

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 did not give a reason for her removal. According to The Washington Post, Monarez had been repeatedly pressured by US Health Secretary Robert F. Kennedy Jr. — an influential anti-vaccine activist in his own right — to reverse approval of COVID-19 vaccines. She refused to do so without consulting the CDC’s vaccine advisory committees, whereupon Kennedy told her to resign on the grounds of insufficient support for Trump’s agenda.

Monarez declined to resign of her own accord. Instead, she reached out to Senator Bill Cassidy (R-La. ), who had been a key figure in Kennedy’s own Senate confirmation process earlier this year after extracting some assurances from him. When Cassidy challenged Kennedy over the removal, Kennedy and his team reportedly clashed with Cassidy and his staff in a phone call. Following that call, the administration officials informed Monarez that if she did not resign, she would be removed from her position.

Monarez’s lawyers, Mark Zaid and Abbe Lowell, then took to social media to post a statement which said that Monarez “has not resigned and has not received official notice of termination by the White House.” “Her ouster came after she refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts,” the statement continued. “She chose protecting the public over serving a political agenda,” Zaid confirmed to Ars Technica that as of 8:15 p.m. ET on August 27, she still had not received official notification of her termination.

CDC at a Breaking Point

Monarez’s Senate confirmation in late July was seen as a major step forward. In a 51–47 vote along strict party lines, she was confirmed to the position and, in a historic first, swore herself in on July 31 with Kennedy personally administering the oath of office. Kennedy, at the time, had praised her “unimpeachable scientific credentials” and promised that with her at the helm, the CDC’s reputation would be repaired.

Her resumé is extensive. Monarez has a PhD in microbiology and immunology and was formerly deputy director at the Advanced Research Projects Agency for Health (ARPA-H), an organization under the Biden administration. She was also previously part of 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. She briefly served as the CDC’s acting director earlier this year before resigning to accept the Trump nomination.

Experts in public health have been generally positive about her appointment. Jennifer Nuzzo, with Brown University’s department of public health, described her as a “loyal, hardworking civil servant who leads with evidence and pragmatism.” Georges Benjamin, who heads the American Public Health Association, similarly called her a strong researcher and capable manager.

In the time since her confirmation, however, the CDC has continued to see major turmoil. The agency has been losing staff through a combination of layoffs and buyouts numbering in the hundreds, while other programs have been cut or otherwise made more difficult. Kennedy himself has not helped matters by characterizing COVID-19 vaccines as “the deadliest vaccine ever made” and calling the CDC “a cesspool of corruption.”

On August 8, the CDC campus was rocked by a mass shooting, with the perpetrator having been radicalized by vaccine misinformation. The shooter opened fire, discharging as many as 500 rounds. Around 200 of these hit six separate CDC buildings, and one local police officer was killed, and staff members scattered in panic. One CDC employee was also injured before the shooter, who had blamed vaccines for his own health problems, was killed. He had deliberately targeted the CDC, the building that was riddled with bullet holes.

It has since been reported that three more high-level officials have resigned following Monarez, in what Stat News called a “brain drain” from the CDC. The resignations of Daniel Jernigan, the director of the National Center for Emerging Zoonotic Infectious Diseases; Deb Houry, the CDC’s Chief Medical Officer; and Demetre Daskalakis, who led the National Center for Immunization and Respiratory Diseases, have been confirmed.