FILE - 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, June 25, 2025. (AP Photo/J. Scott Applewhite, File)

WASHINGTON (AP) — Former Centers for Disease Control and Prevention Director Susan Monarez testified before senators on Wednesday that Health Secretary Robert F. Kennedy Jr. fired her after she refused to endorse forthcoming vaccine recommendations without reviewing scientific evidence to support the guidance.

Monarez was ousted just 29 days into the job, over disagreement with her boss on vaccine policies.

Republican Sen. Bill Cassidy, who chairs the powerful health committee Monarez is appearing before, expressed skepticism over the explanations Kennedy has given over her firing. He carefully praised President Donald Trump for his commitment to promoting health among Americans but made it clear he was befuddled by Monarez's removal. He noted that senators had just approved Monarez's confirmation with Kennedy praising her “unimpeachable scientific credentials.”

“Like, what happened?" Cassidy said. "Did we fail? Was there something we should have done differently?”

Monarez said in her testimony that Kennedy gave her an ultimatum: “Preapprove” new vaccine recommendations from an advisory CDC panel that Kennedy has stocked with some medical experts who doubt vaccine safety or be fired. That panel is expected to vote on new vaccine recommendations later this week. He also demanded Monarez fire high-ranking, career CDC officials without cause, she said.

“He said if I was unwilling to do both, I should resign. I responded that I could not preapprove recommendations without reviewing the evidence, and I had no basis for firing," Monarez told senators. “He said he had already spoken with the White House several times.”

The senate hearing will focus on the impact the turmoil at the nation’s leading public health agency, which is responsible for making vaccine recommendations to the public, will have on children’s health. It will also undoubtedly serve as an opportunity for Monarez and former Chief Medical Officer Debra Houry, who was also testifying before the committee, to respond to a number of Kennedy’s contentious claims about their final days at the agency.

Kennedy has denied Monarez’s accusations that he ordered “rubber-stamped” vaccine recommendations.

He has described Monarez as admitting to him that she is “untrustworthy,” a claim Monarez has denied through her attorney. He did, however, acknowledge during a testy Senate hearing earlier this month that he ordered Monarez to fire several top officials at the CDC.

The Senate hearing is 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.

Monarez and Houry are expected to face tense questions from Republicans over the CDC’s vaccine recommendations and COVID-19 policies. Democrats, meanwhile, are likely to seek more information on Kennedy’s approach to vaccines.

The health committee’s hearing will be overseen by Republican Sen. Bill Cassidy of Louisiana, a physician who cast a key vote for Kennedy’s confirmation. He has expressed concern about “serious allegations” at the CDC and has called for oversight, without blaming Kennedy.

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Associated Press writers Mike Stobbe in New York and Lauran Neergaard in Washington contributed.

News from © The Associated Press, 2025