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“Restoring Trust Through Radical Transparency: Reviewing Recent Events at the Centers for Disease Control and Prevention and Implications for Children’s Health”

Senate HELP Committee

September 17th, 2025 (recording linked here)

WITNESS & TESTIMONY

• Dr. Susan Monarez, PhD: Former CDC Director

• Dr. Debra Houry, MD, MPH: Former CDC Chief Medical Officer

HEARING HIGHLIGHTS

MEMBER OPENING STATEMENTS

• Chair Cassidy (R-LA) framed the hearing as a response to President Trump’s call for “radical transparency” and said senators must prioritize the American people by restoring trust in CDC guidance. He questioned how a unanimously Republican-supported, Senate-confirmed CDC Director could be fired after 29 days and asked whether the Senate missed warning signs. He said allegations about conflicts, judgment, and politics must be examined impartially, with HHS invited later to respond. He emphasized CDC reform, children’s health, and partnering with the President to achieve transparency and a stronger CDC.

• Ranking Member Sanders (I-VT) contrasted Secretary Kennedy’s July 31 praise of Dr. Monarez’s “unimpeachable” credentials with her August 27 firing, calling the reversal political. He argued she was dismissed for refusing to pre-approve vaccine panel recommendations and to oust career scientists, characterizing the Secretary’s approach as a “war on science.” He affirmed the broad medical consensus that vaccines are safe and effective and warned that politicizing public health jeopardizes pandemic preparedness.

WITNESS OPENING STATEMENTS

• Dr. Monarez recounted being sworn in on July 31 and removed 29 days later, saying the stated reasons did not reflect events. She testified that she was directed to commit in advance to approve all ACIP recommendations and to dismiss vaccine-policy career staff without cause, which she refused as inconsistent with scientific integrity and her oath. She asserted her priorities aligned with administration goals but warned the reconstituted ACIP could restrict vaccine access without rigorous review, risking outbreaks like recent measles deaths. She concluded she was fired for upholding evidence-based standards and preserving her integrity.

• Dr. Houry said she resigned because CDC leaders were reduced to rubber stamps under Secretary Kennedy, censoring science and politicizing processes in ways that risk lives. She cited replacing all 17 ACIP voting members with critics, halting flu campaigns despite high pediatric deaths, and weakening surveillance with sharp drops in global sample submissions. She described interference such as vaccine guidance changes announced on social media and removal of a CDC thimerosal document while allowing an unvetted presentation. She praised CDC’s workforce, warned of rising preventable disease, and urged constructive steps within Congress’s remit.

QUESTION AND ANSWER SUMMARY

• Chair Cassidy asked how often meetings occured with the Secretary. Dr. Monarez said twice before August 25 and three times that day. She testified the Secretary directed her to pre-approve all ACIP recommendations and to fire career scientists, told her the childhood schedule would change starting in September, and said he spoke to the President daily about it; she also said he asked her to meet Aaron Siri and offered no supporting data while asserting CDC had no science behind the childhood schedule.

  Chair Cassidy asked who set the ACIP agenda, and Dr. Houry said HHS political appointees worked with staff—an approach she had not seen in the past decade—and described pushback when proposing Hepatitis B birth-dose analyses that might argue against moving away from the birth dose.

• Ranking Member Sanders affirmed the medical consensus that vaccines are safe and effective and asked about consequences of eroding trust and capacity; Dr. Houry warned measles coverage had fallen to about 92.8%, leaving over 200,000 children at risk, and said Operation Warp Speed saved millions of lives and that losing future vaccine capability would be dangerous domestically and globally.

• Sen. Paul (R-KY) pressed whether COVID-19 vaccines prevented transmission and reduced pediatric hospitalization or death, asserting evidence of only modest transmission reduction and no statistically significant benefit in children, while highlighting myocarditis risk estimates. He challenged the medical rationale for a Hepatitis B birth dose in infants of Hep-B–negative mothers and argued ACIP recommendations for children lacked outcome data. He claimed there was a refusal to fire staff who favored vaccinating from six months. Dr. Monarez replied that his characterization did not match her experience and reiterated she would not pre-commit to ACIP outcomes without reviewing evidence.

• Sen. Murray (D-WA) noted the Secretary announced new COVID vaccine guidance via social media. Dr. Houry, then CDC Chief Medical Officer, said she learned of it on social media, received no supporting data, and that a later memo conflicted with the video.

  Sen. Murray asked if they had seen evidence to change schedules for measles, varicella, Hep-B, or COVID. both Dr. Monarez and Dr. Houry said they had not, while affirming confidence in April ACIP recommendations made by the prior expert panel.

  Sen. Murray asked about the reconstituted ACIP meeting the next day. Dr. Monarez and Dr. Houry expressed significant concerns about member expertise, transparency, lack of posted data and agendas, and inadequate public input.

• Sen. Collins (R-ME) pressed on the grounds for her firing and confirmed that Secretary Kennedy neither consulted her on replacing all ACIP members nor provided evidence when demanding pre-approval of forthcoming recommendations. Dr. Monarez testified that the Secretary asserted there was “no science” behind vaccine schedules and told her to resign if she would not commit to blanket approval.

  Sen. Collins asked about risks when political staff supplant career scientists, and Dr. Monarez warned that technically complex, life-saving decisions could be compromised, endangering children and public health.

• Sen. Baldwin (D-WI) examined interference and transparency, eliciting that Secretary Kennedy instructed no communication with Congress after concerns were raised. Dr. Houry testified neither she nor CDC center directors ever briefed the Secretary and that CDC attempted to correct his scientific misstatements but was rebuffed.

  Sen. Baldwin highlighted ongoing measles cases in Wisconsin and asked about consequences of weaker childhood vaccine recommendations. Dr. Houry warned of preventable deaths, long-term complications, and health-system strain.

• Sen. Marshall (R-KS) questioned remote-work decisions after the shooting, office seating for political appointees, and support for the full CDC childhood schedule, pressing on whether vaccines should be mandated. Dr. Monarez said limited telework followed the shooting, denied sidelining political appointees, and reiterated that CDC recommends based on evidence while mandates are outside CDC’s role.

  Sen. Marshall argued CDC practices fueled vaccine hesitancy and contended that “every person needs every vaccine” conflicted with the Secretary’s philosophy.

• Sen. Hassan (D-NH) asked which directives would have violated oath. Dr. Monarez cited pressure to pre-approve ACIP recommendations and fire career scientists without cause. She testified the Secretary dismissed CDC science, labeled CDC staff corrupt and “killing children,” and offered claims she viewed as false, reacting angrily when she insisted on evidence.

  Sen. Hassan confirmed that during those meetings the Secretary did not express condolences for the officer killed in the CDC shooting or for recent pediatric measles deaths.

• Sen. Tuberville (R-AL) affirmed the CDC Director reports to HHS and probed whether political leadership was undermined. Dr. Monarez denied.

  Sen. Tuberville noted conflicting narratives between testimonies and stressed that bureaucrats are unelected and must do their jobs. Dr. Monarez replied she would never cede scientific integrity to keep a job.

• Sen. Murphy (D-CT) established that there was no precedent for dismissing the entire ACIP, for requiring CDC policy and personnel to be cleared by political staff, or for demanding pre-approval of vaccine recommendations sight unseen.

  Sen. Murphy asked whether the Secretary implied presidential support for changes to the childhood schedule. Dr. Monarez said that was her impression, though unverified.

  Sen. Murphy then raised security risks from anti-vaccine conspiracies. Dr. Monarez and Dr. Houry described threats, staff trauma from the CDC shooting, and scientists removing their names from work, with ACIP presentations moved to leadership to shield subject-matter experts.

• Sen. Banks (R-IN) pressed on why an attorney was chosen that he characterized as anti-Trump and asked whether CDC priorities diverged from the administration’s. Dr. Monarez replied her priorities had not changed and that only demands to compromise integrity had.

  Sen. Banks confirmed that the Secretary said he could not trust her after she raised concerns with Congress, and Dr. Monarez testified she told him he could fire her if that were the case.

• Sen. Hickenlooper (D-CO) highlighted nationwide confusion about vaccine access, noting VFC program delays, insurer reliance on federal recommendations, and pharmacy uncertainty. He asked about ACIP guardrails. Dr. Monarez endorsed advance public posting of data and a second comment window, and urged transparency under FACA to rebuild trust.

  Sen. Hickenlooper probed surveillance capacity, and Dr. Houry attributed a 60% drop in flu samples and 70% drop in COVID samples partly to withdrawing from WHO and eroded partnerships, warning of reduced preparedness.

• Sen. Moody (R-FL) asked for names of the attorneys assisting them in the room. Dr. Houry identified Abby Lowell and Mark Zaid, while Dr. Monarez declined to state names but said counsel had been publicly associated with her.

  Sen. Moody questioned whether their departures and public communications were coordinated. Dr. Monarez denied any advance plan and said she was terminated abruptly, and Dr. Houry said she and two colleagues decided to resign together after the firing due to ethical concerns.

• Sen. Blunt Rochester (D-DE) explored conflict-of-interest claims and the replacement of ACIP members, and Dr. Houry said prior COIs were posted and recusal rules applied, adding she saw no evidence that former members’ COIs impaired decisions. She underscored that liaison organizations and society experts were removed from ACIP workgroups, weakening implementation expertise.

  Sen. Blunt Rochester asked about the Hepatitis B birth dose. Dr. Monarez affirmed historic reductions in infant infections and clarified CDC issues evidence-based recommendations rather than mandates.

• Sen. Murkowski (R-AK) focused on institutional trust and the role of career scientists as continuity between administrations. Dr. Houry said she had been the last career official in the Director’s Office and that about 80% of center directors were now acting due to departures, signaling diminished continuity. Dr. Monarez testified she was directed on August 25 to work only with political appointees and not to speak with career scientists, raising concerns about sidelining scientific expertise during policy formation.

• Sen. Kaine (D-VA) detailed the operational and fiscal burden of a single measles case in Virginia and linked those pressures to HHS rescinding $11.4B in state public-health funds, including $425M from Virginia, with 500 layoffs. Dr. Houry confirmed CDC career staff did not brief the Secretary on measles, that communications went through political staff, and warned that CDC cuts flow directly to state and local readiness.

• Sen. Mullin (R-OK) challenged the timing of the termination and retention of counsel, alleging inconsistencies and suggesting a lack of candor. He pressed about relocating political appointees and access to the main floor. Dr. Monarez said space was made for multiple political staff but disputed his characterization.

  Sen. Mullin asserted a recording existed of the meeting with the Secretary and claimed the account of the “trust” exchange was inaccurate. Dr. Monarez maintained the Secretary told her he could not trust her and that she replied he could fire her if so.

• Sen. Markey (D-MA) detailed the public-health success of the Hepatitis B birth dose, warning that delaying it to age four would endanger infants. Dr. Houry said any such change would not be evidence-based, and Dr. Monarez said she had seen no data to justify it.

  Sen. Markey elicited that CDC staff had prepared evidence in the absence of workgroups but were directed by HHS to remove a document, and Dr. Monarez and Dr. Houry said politics, not science, appeared to be driving proposed changes.

• Sen. Husted (R-OH) argued that CDC’s pandemic guidance had been politicized and harmed children’s education and mental health, citing external reports and concerns about the CDC Foundation. He asked whether not vaccinating healthy school-aged children against COVID would endanger their lives. Dr. Monarez emphasized individualized risk-benefit discussions with pediatricians and noted severe risks when unprotected against diseases like measles or hepatitis B.

• Sen. Kim (D-NJ) asked who would replace career officials if they were fired. Dr. Monarez said the Secretary described a plan to promote deputies and keep firing down the line until compliance. She said the Secretary claimed that similar practices were occurring at FDA, NIH, and CMS, and identified attendees in the August 25 meeting where pre-approval and firings were discussed. Dr. Houry described pressure to grant access to sensitive Vaccine Safety Datalink information and warned of “pre-decided outcomes” with attempts to fit data to decisions.

• Sen. Alsobrooks (D-MD) asked for the Secretary’s stated rationale for firing career scientists. Dr. Monarez recounted the Secretary’s claims that CDC was corrupt, “killing children,” and controlled by industry, and that she was told to surround herself with political staff while avoiding career scientists. She also said the Secretary indicated similar leadership “turnover” efforts at FDA, CMS, and NIH. Dr. Houry, citing misstatements and compromised integrity, said the Secretary should resign.