Susan Monales from the Centers for Disease Control and Prevention (CDC) testified at a Senate hearing on Wednesday regarding a contentious exchange with Robert F. Kennedy Jr. from the Department of Health and Human Services. However, it seemed that the hearing left many questions unanswered.
During the session, Monales avoided clearly addressing her stance on Covid-19 booster shots for children. She also refrained from detailing the interactions she had with a Democratic lawyer and the circumstances surrounding her last meeting with her superior.
Monales discussed the Vaccination Practices Advisory Committee (ACIP), which advises pediatricians on vaccine policies, noting her significant disagreement with Kennedy from an incident in August. This testimony took place before the Senate’s Health, Education, and Pension Committee, where senators expressed concerns about an ACIP meeting happening soon, raising issues about new members and changes.
Senator Bill Cassidy from Louisiana appeared to support Monales, recommending that doctors disregard ACIP’s recommendations issued under Kennedy’s leadership. “It’s hard to discern who’s truthful here, but this hearing is a crucial step towards understanding why there were sudden leadership changes at the CDC,” he stated. “It’s unsettling for national health.”
Monales recounted events leading up to her firing, sharing that she had heard ACIP might adjust its childhood vaccination recommendations without any data to back it up. On August 19, she was told her decision would undergo review by political staff in Kennedy’s office, and by August 21, she received instructions to come to Washington, DC.
On August 25, Monales had multiple meetings with Kennedy, where he expressed his dissatisfaction with her apparent reluctance to adhere to ACIP recommendations and insisted she commit to them and dismiss certain CDC officials.
Kennedy has reorganized ACIP by including new scientists to address concerns about prior members’ links to the pharmaceutical industry. Recently, the FDA introduced a new framework necessitating clinical trials, aimed at making annual Covid boosters for healthy children and younger individuals more feasible.
Senator Tommy Tuberville challenged Monales about her so-called “unreliable” account and whether she had opposed her superiors, including Kennedy and President Trump. “He mentioned that I couldn’t be trusted because of my communications outside his staff,” Monales said.
Monales noted she and Kennedy were deeply involved in examining the scientific evidence for specific vaccines but didn’t elaborate on that process. Senator Mark Wayne Mullen remarked that the discussions Monales described didn’t occur as she recalled, claiming there is a recording that contradicts her testimony.
Mullen also pressed Monales about the need to restrict access to political appointees at the CDC, which she indicated was necessary to make room for staff. Additionally, she hesitated at times when discussing her attorneys.
Monales’ lawyers, Mark S. Zaid and Abbe David Lowell, are known for representing individuals opposing President Trump, yet Monales argued that Zaid never discussed political issues with her. This prompted Senator Jim Banks to express astonishment at her claim.
Kennedy then appointed a new ACIP member, some of whom were labeled “vaccine skeptics” by a senator. Nonetheless, the hearing didn’t clarify the specific sources of concern regarding their credentials or past statements. Monales merely stated that the medical community had voiced worries about Kennedy’s resume.
Details about Monales’ apprehensions relating to alterations in childhood vaccination schedules were scarce, and she mentioned that Kennedy had directed her to meet with an ally and attorney of his who had previously sued a vaccine manufacturer.
This hearing marked Cassidy’s latest endeavor to rein in Kennedy’s approach to vaccine evaluations. When Cassidy supported Kennedy’s appointment in February, he sought various assurances, one being that ACIP would not undergo changes. However, Kennedy dismissed all 17 members in April, seemingly disregarding that promise.
Monales became the first CDC director to seek a confirmation from Cassidy’s committee following new legislative changes that now require Senate input, moving away from the past process where HHS Secretaries made appointments independently. Senator Rand Paul of Kentucky questioned Monales regarding whether the CDC should modify its hepatitis B vaccination schedule for newborns.
“If the mother isn’t infected with hepatitis, what’s the rationale for vaccinating the newborn?” Paul pressed, but Monales didn’t provide an answer. Paul then raised the topic of Covid-19 vaccinations for children as young as six months, emphasizing the need to discuss the science involved rather than categorizing all vaccines uniformly.
Monales asserted that she was open to various perspectives, yet Paul retorted that it didn’t imply she’d endorse ACIP recommendations without scientific basis. Both Monales and former CDC Chief Medical Officer Debra Howey noted that Kennedy had exercised considerable authority over ACIP by shifting decisions that were usually managed by career staff.
Howey highlighted that Kennedy’s direct involvement at HHS significantly influenced ACIP’s agenda, adding that the CDC usually releases voting questions and data ahead of meetings but hadn’t done so this time. Moreover, she learned about modifications in CDC guidelines about Covid vaccines for pregnant women via social media, mentioning a lack of evidence supporting such changes. The FDA had not tested Covid vaccines in pregnant populations in its trials.
