Ex-CDC chief details agency turmoil under RFK Jr.

Former Centers for Disease Control and Prevention director Susan Monarez got her turn on Wednesday to tell the Senate health committee about the events that led up to her firing in August after less than a month on the job.

• She recalled how she was forced out after refusing to "pre-approve" vaccine recommendations from Health Secretary Robert F. Kennedy Jr.'s handpicked advisers and to fire career CDC scientists.
• But she also provided a unique lens into the ongoing turmoil at the public health agency — and a few surprises.

Here's what stood out to us:

1. Vaccine recommendations could be further weakened

Monarez raised the alarm that major changes to the childhood vaccine schedule are imminent.

• She said Kennedy told her in an August meeting that changes to the schedule are coming this month, though the substance of the changes is not clear.
• "He did say that he had spoken to the president, he spoke to the president every day about changing the childhood vaccine schedule," Monarez testified.
• An Department of Health and Human Services spokesperson responded that any changes would be based on the "latest available science" and only come after a recommendation from the CDC advisory panel.

2. Cassidy pushes back on hepatitis B vaccine changes

Health committee Chair Bill Cassidy (R-La.), a physician who specialized in gastroenterology and liver diseases, spoke about his experience treating patients with hepatitis and warned against a potential weakening of the recommendation for newborns to receive the hepatitis B vaccine.

• Such a change could be made at the CDC advisory committee meeting this Thursday and Friday. One option would be delaying the shots from birth to age 4.
• "This was my practice for 20 years," Cassidy said. "There are people who would otherwise be dead" if not for hepatitis B vaccination, he added, noting cases had plummeted since the recommendation for newborns began in the early 1990s.
• Cassidy did not openly criticize Kennedy during the hearing, but defended vaccinations and said later Kennedy needs to appear before the committee to respond.

3. RFK: safe but wounded

There is no indication that President Trump is going to fire Kennedy or significantly reel in his operations.

• But a growing number of Republicans in Congress believe Kennedy's views are a distraction. The political heat could lead the White House to put some limits on his discretion.
• Cassidy said that he will invite Kennedy to testify at a future hearing and respond to Monarez's allegations, though it is unclear if that will occur.

• A future hearing with Cassidy would keep the pressure on Kennedy. Sen. John Barrasso (Wyo.), the No. 2 Senate Republican, also pressured him against weakening vaccine recommendations at a Senate Finance hearing earlier this month.

4. Kennedy still has his supporters

Several GOP senators on Wednesday aggressively challenged Monarez's truthfulness and portrayed Kennedy as a change agent.

• Sens. Jim Banks (R-Ind.) and Ashley Moody (R-Fla.) criticized Monarez for hiring lawyer Mark Zaid to represent her. Banks called Zaid "notorious for his anti-Trump activity."
• Other Republicans suggested the administration was well within its rights to fire Monarez.
• "Would you agree with me though at this point in time that you're not the right person for this job?" asked Roger Marshall (R-Kansas), saying that Monarez's belief that "every child needs every vaccine" is a different mindset than Kenn.

5. CDC staff fear for safety

Some CDC staff are so concerned for their safety that they are no longer putting their names on scientific papers about vaccines, said Debra Houry, the CDC's former chief medical officer, who resigned last month and appeared alongside Monarez.

• Since a gunman opened fire on the agency's Atlanta headquarters in early August, some CDC staff "don't wish to present publicly anymore because they feel they were personally targeted because of misinformation," she said.