houry

WASHINGTON — America’s public health system is headed to a “very dangerous place” with Health Secretary Robert F. Kennedy Jr. and his team of anti-vaccine advisors in charge, fired Centers for Disease Control and Prevention chief Susan Monarez warned senators on Wednesday.

Describing extraordinary turmoil inside the nation’s health agencies, Monarez and former CDC Chief Medical Officer Debra Houry described exchanges in which Kennedy or political advisors rebuffed data supporting the safety and efficacy of vaccines.

Monarez, who was fired after just 29 days on the job following disagreements with Kennedy, told senators deadly diseases like polio and whooping cough, long contained, are poised to make a comeback in the U.S.

“I believe preventable diseases will return, and I believe we will have our children harmed by things they don’t need to be harmed by,” Monarez said before the Senate health committee.

Monarez describes her firing by RFK Jr.

Monarez said she was ordered by Kennedy to resign if she did not sign off on new vaccine recommendations, which are expected to be released later this week by an advisory panel that Kennedy has stocked with medical experts and vaccine skeptics. She said that when she asked for data or science to back up Kennedy’s request to change the childhood vaccination schedule, he offered none.

She added that Kennedy told her “he spoke to the president every day about changing the childhood vaccination schedule.”

Republican Sen. Bill Cassidy (R-La.), a physician who chairs the powerful health committee, listened intently as Monarez and Houry described conversations with Kennedy and his advisers.

“To be clear, he said there was not science or data, but he still expected you to change schedule?” Cassidy asked.

Cassidy carefully praised President Trump for his commitment to promoting health policies but made it clear he was concerned about the circumstances surrounding Monarez’s removal.

Houry, meanwhile, described similar exchanges with Kennedy’s political advisors, who took an unprecedented role in preparing materials for meetings of the CDC’s advisory vaccine panel.

Ahead of this week’s meeting of the panel, Houry offered to include data around the hepatitis B shot that is administered to newborns to prevent spread of the deadly disease from the mother. She said a Kennedy advisor dismissed the data as biased because it might support keeping the shots on the schedule.

“You’re suggesting that they wanted to move away from the birth dose, but they were afraid that your data would say that they should retain it?” Cassidy asked.

Critical vaccine decisions are ahead

During the Senate hearing, Democrats, all of whom opposed Monarez’s nomination, also questioned Kennedy’s motives for firing Monarez, who was approved for the job unanimously by Republicans.

“Frankly, she stood up for protecting the well-being of the American people, and for that reason she was fired,” said Sen. Bernie Sanders, an independent from Vermont who caucuses with Democrats.

Monarez said it was both her refusal to sign off on new vaccination recommendations without scientific evidence and her unwillingness to fire high-ranking career CDC officials without cause that led to her ousting.

Kennedy has denied Monarez’s accusations that he ordered “rubber-stamped” vaccine recommendations but has acknowledged he demanded firings. He has described Monarez as admitting to him that she is “untrustworthy,” a claim Monarez has denied through her attorney.

While Senate Republicans have been mostly loath to challenge Trump or even Kennedy, many of them have expressed concerns about the lack of availability of COVID-19 vaccines and the health department’s decisions to scale back some childhood vaccines.

Others have backed up Kennedy’s distrust of the nation’s health agencies.

Kansas Republican Sen. Roger Marshall, a doctor, aggressively questioned Monarez about her “philosophy” on vaccines as she explained that her decisions were based on science. Alabama GOP Sen. Tommy Tuberville said Trump was elected to make change and suggested Monarez’s job was to be loyal to Kennedy.

“America needs better than this,” Tuberville said.

The Senate hearing was taking place just a day before the vaccine panel starts its two-day session in Atlanta to discuss shots against COVID-19, hepatitis B and chickenpox. It’s unclear how the panel might vote on the recommendations, though members have raised doubts about whether hepatitis B shots administered to newborns are necessary and have suggested COVID-19 recommendations should be more restricted.

The CDC director must endorse those recommendations before they become official. Health and Human Services Deputy Secretary Jim O’Neill, now serving as the CDC’s acting director, will be responsible for that.

“I’m very nervous about it,” Monarez said of the meeting.

Seitz and Jalonick write for the Associated Press. AP writers Mike Stobbe in New York and Lauran Neergaard in Washington contributed to this report.

NEW YORK — When the White House fired Susan Monarez as director of the premier U.S. public health agency, it was clear to two of the scientific leaders at the Centers for Disease Control and Prevention that the political meddling would not end and it was time to quit.

“We knew … if she leaves, we don’t have scientific leadership anymore,” one of the officials, Dr. Debra Houry, told the Associated Press on Thursday.

“We were going to see if she was able to weather the storm. And when she was not, we were done,” said Houry, one of at least four CDC leaders who resigned this week. She was the agency’s deputy director and chief medical officer.

The White House confirmed late Wednesday that Monarez was fired because she was not “aligned with” President Trump’s agenda and had refused to resign. She had been sworn in less than a month ago.

Trump’s health secretary, Robert F. Kennedy Jr., declined during an appearance on “Fox & Friends” to directly comment on the CDC shake-up. But he said he continues to have concerns about CDC officials hewing to the administration’s health policies.

“So we need to look at the priorities of the agency, if there’s really a deeply, deeply embedded, I would say, malaise at the agency,” Kennedy said. “And we need strong leadership that will go in there and that will be able to execute on President Trump’s broad ambitions.”

A lawyer for Monarez said the termination was not legal — and that she would not step down — because she was informed of her dismissal by staff in the presidential personnel office and that only Trump himself could fire her. Monarez has not commented.

Dr. Richard Besser, a former CDC acting director, said that when he spoke with Monarez on Wednesday, she vowed not to do anything that was illegal or that flew in the face of science. She had refused directives from the Department of Health and Human Services to fire her management team.

She also would not automatically sign off on any recommendations from a vaccines advisory committee handpicked by Kennedy, according to Besser, now president of the Robert Wood Johnson Foundation, which helps support the Associated Press Health and Science Department.

Houry and Dr. Demetre Daskalakis, who resigned as head of the National Center for Immunization and Respiratory Diseases, said Monarez had tried to make sure scientific safeguards were in place.

Some concerned the 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.

Kennedy is a longtime leader in the antivaccine 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.

Recently, Monarez 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.

Department of Health officials nixed that and called her to a meeting in Washington on Monday, Houry said.

When it became clear that Monarez was out, other top CDC officials decided they had to leave, too, Houry and Daskalakis said.

“I came to the point personally where I think our science will be compromised, and that’s my line in the sand,” Daskalakis said.

Monarez’s lawyers, Mark Zaid and Abbe David Lowell, said in a statement that when she refused “to rubber-stamp unscientific, reckless directives and fire dedicated health experts, she chose protecting the public over serving a political agenda. For that, she has been targeted.”

Stobbe writes for the Associated Press.