Departures roil the CDC leadership. What's next for the agency?
[August 29, 2025]
By JONEL ALECCIA
The firing of the director of the U.S. Centers for Disease Control and
Prevention and the resignation of several high-profile agency leaders
pose immediate challenges to the operations of the nation's premiere
public health agency, experts said.
It could take “several months” to identify and confirm a replacement for
CDC Director Susan Monarez, who was terminated Wednesday after less than
a month on the job, said Dr. Georges Benjamin, director of the American
Public Health Association. And it could take more time to fill at least
four key vacated positions that oversee disease outbreaks, vaccines and
public health data.
“The whole chain of command has just been disrupted,” Benjamin told The
Associated Press. “It's like getting rid of your generals in the middle
of a war.”
Health experts said Americans could see immediate effects, from
confusion over the availability of COVID-19 vaccines to delayed
responses to outbreaks of infectious diseases such as measles or
foodborne illnesses caused by germs such as E. coli or listeria.
“The average American should worry about their safety and their health
and whether information coming out of Health and Human Services is
reliable or trustworthy,” said Dr. Anne Schuchat, former principal
deputy director of the CDC, who left the agency in 2021.
Here's what you need to know about the sudden changes at the CDC.
What happened this week?
The White House ousted Monarez on Wednesday after apparent clashes
between the CDC director and Health Secretary Robert F. Kennedy Jr. over
changes to the nation's vaccine policy.
Officials at the White House said Monarez was dismissed because she was
not aligned with President Donald Trump's agenda and refused to resign.
That action coincided with the resignation this week of at least four
top CDC agency leaders: Dr. Debra Houry, the agency’s deputy director;
Dr. Daniel Jernigan, leader of the agency’s work on emerging infectious
diseases; Dr. Demetre Daskalakis, a top vaccine official; and Dr.
Jennifer Layden, who led public health data efforts.
What happens next?
Monarez was the first CDC director to require Senate confirmation under
a law that took effect in 2023. Replacing her would require Trump to
nominate a new director, who would then need to be considered and
confirmed by the Senate. On Thursday, Republican Sen. Bill Cassidy said
the high-profile departures will “require oversight” of the Senate
Health, Education, Labor and Pensions Committee, which he chairs.
In the meantime, Jim O'Neill, a top adviser to Kennedy, was tapped
Thursday to serve as acting CDC director, according to an administration
official who requested anonymity to discuss a personnel change that has
not been formally announced. O'Neill was serving as the deputy secretary
of HHS.
Replacing the leaders in the other positions, including those who held
the jobs for years, will be difficult, Schuchat said.
“The four people who resigned led important parts of the agency and had
the respect of the nation and the world,” she said.
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Susan Monarez, President Donald Trump's nominee to be director of
the Centers for Disease Control and Prevention, arrives to testify
before the Senate HELP Committee, at the Capitol in Washington,
Wednesday, June 25, 2025. (AP Photo/J. Scott Applewhite, File)
 In an appearance on “Fox & Friends,”
Kennedy declined to directly comment on the CDC shake-up. But he
said he is concerned about CDC officials adhering to the
administration's view of 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.”
How could the changes affect average Americans?
The clash at CDC was apparently triggered by conflict over changes
in policy regarding recommendations for COVID-19 vaccinations that
could make getting a shot more complicated for people.
The Food and Drug Administration approved updated COVID-19 shots on
Wednesday but limited their use for many Americans — and removed one
of the two vaccines available for young children. The new jabs from
three manufacturers are approved for all seniors, but the FDA
narrowed their use for adults and children to those with high-risk
health conditions, such as asthma or obesity.
The FDA approval is typically reviewed by a CDC vaccine advisory
committee, which makes recommendations for use. Monarez said she
would not automatically sign off on recommendations of the
committee, which was handpicked by Kennedy, according to Dr. Richard
Besser, a former CDC acting director. (Besser is now president of
the Robert Wood Johnson Foundation, which helps support The
Associated Press Health and Science Department.)
The changes present new barriers to access for millions of
Americans, who would have to prove their risk, and others who may
want the shots but suddenly no longer qualify. The vaccines were
previously recommended for Americans 6 months and older.
“These decisions, made without supporting evidence, reflect a
troubling pattern by HHS of interfering in the relationship between
patients and their healthcare providers and limiting access to
vaccines — public health tools proven to save lives and reduce
costs,” said Michael Osterholm, a University of Minnesota infectious
disease researcher.
In addition, the disruption at the CDC could jeopardize many local
health services undergirded by the agency's support and expertise,
Schuchat noted. That could mean tracking a simmering infectious
disease outbreak, such as measles, or outbreaks of foodborne
illness.
“It's the water that you drink, the lead in your pipes. Look around
your community," she said. “If people are doing well and healthy,
it's probably partly because of the CDC.”
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AP reporter Michelle Price contributed from Washington.
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