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In what was only the latest high-level shake-up at the beleaguered agency, Susan Monarez has been forced out as director of the Centers for Disease Control and Prevention (CDC) just weeks after her Senate confirmation.

The Washington Post was the first to break the news, citing several sources in the Trump administration. After Ars Technica asked the Department of Health and Human Services (HHS) to confirm the development, the department instead shared a post from its official X account. The message, released Sunday evening, stated:

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 details about the circumstances surrounding the change. The Post, however, reports that Kennedy, who has a history of anti-vaccine activism, had been pressuring Monarez repeatedly over the course of the past few weeks to reverse her approval of the COVID-19 vaccines. Monarez refused to go along with Kennedy’s demands until after consulting with the CDC’s vaccine advisory committees, The Post reports, leading Kennedy to tell her to resign over her perceived lack of support for Trump.

Monarez, unwilling to resign, contacted Senator Bill Cassidy (R-La.) instead, who had helped engineer Kennedy’s own Senate confirmation earlier this year, extracting concessions in writing from the controversial appointee beforehand. Cassidy apparently registered his disapproval with Kennedy’s directive, at which point the two engaged in a heated argument. Following that call, other administration officials informed Monarez that her only options were to either resign or be fired.

Lawyers Mark Zaid and Abbe Lowell, representing Monarez, released a statement to social media on the events that read, “Ms. Monarez has not resigned. To date, she has not received official termination paperwork from the White House. Her ouster came after she refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts. She chose protecting the public over serving a political agenda.” Lowell later confirmed to Ars Technica that, as of 8:15 p.m. ET on August 27, Monarez had yet to receive any official paperwork terminating her employment.

The CDC at a Breaking Point

Monarez’s confirmation in late July had previously been hailed as a major win. She was confirmed 51–47 along party lines to become the first director of the CDC ever to be subject to Senate confirmation after a 2022 law mandated it. Kennedy, who was confirmed in a 50–49 party-line vote of his own back in June, swore her in on July 31, saying she “brings unimpeachable scientific credentials to the table” and that he was “confident she will do her part to restore the CDC’s reputation.”

The résumé spoke for itself. Monarez is a PhD holder in microbiology and immunology and served as the deputy director of the Advanced Research Projects Agency for Health (ARPA-H) in the Biden administration. She had previously worked for 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 had also previously been the acting director of the CDC at the start of the year before Kennedy took over, briefly leading the agency before stepping down when Trump nominated her to the position officially.

Her reputation preceded her. Jennifer Nuzzo of Brown University said Monarez is “a loyal, hardworking civil servant who leads with evidence and pragmatism.” Georges Benjamin, who leads the American Public Health Association, said of her that she was “a solid researcher” and “someone who knows how to manage a large organization.”

In recent months, however, the CDC has been hemorrhaging staff through layoffs and buyouts, with many programs facing severe cutbacks or obstacles. Kennedy, in particular, has not helped matters, having previously said of the COVID-19 vaccines that they were “the deadliest vaccine ever made” and calling the CDC “a cesspool of corruption.”

On August 8, the agency was the site of a mass shooting after one gunman was radicalized by vaccine misinformation and began firing rounds at CDC employees on campus. The shooter was carrying 499 rounds, with an estimated 200 actually finding their mark across six different CDC buildings. One local police officer was killed as well, and numerous others were injured. Terrified CDC staff members fled for cover, some locked out of their offices during the commotion. In an interview with The Washington Post, the shooter himself explained that he had blamed the vaccines for his own health problems, leading to his own use of firearms to target the CDC.

The apparent firing of Monarez only adds to the agency’s ongoing staffing crisis. Stat News independently confirmed the resignation of three other high-ranking officials within the CDC: Daniel Jernigan, who previously served as 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.

Daskalakis wrote in his parting message that, “I am not able to serve in this role any longer because of the ongoing weaponization of public health.” Houry, for her part, wrote in her own farewell post that she was “heartened by the CDC’s public health professionals, who speak truth to power, share data with transparency, and are unwavering in their commitment to the agency’s mission” and that science should “never be censored or subject to political interpretations.”

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