Every four to eight years, expert scientists at the Centers for Disease Control and Prevention (CDC) see priorities and efforts shift as a new presidential administration takes office. This is an expected and normal process, and the agency is well equipped to respond. But what happened this year at the CDC is unprecedented, former CDC officials say.
Three former CDC leaders say the transition to the second Trump administration has created chaos and disorganization at the agency, and that this destabilization ultimately endangers public health. Additionally, the new administration’s appointees have grossly “ignored” the expertise of scientists, he said in a webinar hosted by the Healthcare Journalists Association on Wednesday (19 November).
you may like
Jernigan was joined by two colleagues: Dr. Debra Hawley, CDC’s former chief medical officer and associate director for programs and science, and Dr. Demetre Daskalakis, former director of CDC’s National Center for Immunization and Respiratory Diseases. All three resigned after CDC Director Susan Monares was fired in August.
In a statement released the same month, Mr. Monares’ lawyers said he was targeted for rejecting “unscientific and reckless directives” issued under Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. (CDC is a division of HHS). Monares was removed from his post by the White House after he refused to resign.
“We knew that if we were to lose the one person who we looked to to hold boundaries and protect the science and integrity of our agency, then so would we,” Howley said. “So we actually voted and walked out together.”
“There was no strategy.”
Jernigan, Awry, and Daskalakis detailed their experiences at the CDC in the weeks and months following President Donald Trump’s inauguration. Awry is the CDC’s transition director, meaning he helped prepare the agency for the incoming administration. “We were cautiously optimistic,” he said, noting that the CDC was able to continue to successfully advance many of its efforts during the first Trump administration. “Unfortunately, it didn’t work out.”
She noted that when a measles outbreak hit West Texas in January and lasted into the fall, RFK Jr. promoted unproven alternative treatments such as cod liver oil and vitamin A over vaccines. The new Department of Government Efficiency (DOGE) will cut thousands of jobs at the CDC, with the earliest layoffs beginning in February. Throughout this process, RFK Jr. did not have any in-person meetings with CDC staff or directors, she said.
Instead, Trump appointees had lawyers seek information from CDC scientists, such as about measles and vaccine safety, Jernigan said. “This is a way of interacting with staff that I’ve never seen before,” he said, noting that he has been with the CDC for 31 years.
His team was asked to provide the data, which was then turned over to a newly hired contractor for review. However, he added, these contractors did not sign the typical nondisclosure and data use agreements that CDC employees have. This led Jernigan to question whether the data was being used and shared ethically.
you may like
Additionally, CDC staff cuts and funding freezes seemed more haphazard than strategic. After the cuts, “you had the secretary come up with a set of priorities that were inconsistent with either the staffing that was left or the budget that was presented,” Jernigan said.
“There was no strategy,” Daskalakis reiterated.
Regarding vaccines, Daskalakis noted that RFK Jr. announced changes to COVID-19 vaccine recommendations through a video shared on social media site X, but the content of the video was inconsistent with updated language on the CDC website. Additionally, neither X’s posts nor the website updates have undergone any of the vetting that is typically required before vaccine policy changes. Daskalakis also expressed concern about HHS’ attempts to discredit the use of mRNA vaccines and to remove prominent scientists from the Advisory Committee on Immunization Practices (ACIP), which advises the CDC on vaccines.
“When Susan [Monarez] “I had a glimmer of hope because Mr. Monares was going to work on ACIP,” he said, but then Mr. Monares was blocked from working on vaccine policy unless he got explicit permission from HHS or the secretary, he said.
Amid the chaos, a man stormed the CDC’s Atlanta headquarters in August, firing hundreds of shots into campus buildings. He blamed the coronavirus vaccine for the mental health issues he was experiencing.
“A few days later, the secretary came to visit. That’s when I met him,” Awry said. “Later that day, he gave a media interview and said, ‘Don’t trust the experts.’ That’s not what we needed at the time.” After the shooting, the union representing CDC employees called on the CDC and HHS to denounce disinformation about vaccines that may have fueled the attack.
RFK Jr. admitted to shooting X, but did not accuse him of inciting disinformation. Notably, RFK Jr. himself was spreading some of the disinformation, calling the COVID-19 vaccine “the most lethal vaccine ever created.”
At this point, the three former directors said, the CDC is no longer the reliable source of health information it once was. Instead, they advised the public to refer to other vetted health information sources.
They recommended, for example, that the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota recently launched a special project to share evidence-backed guidance on vaccines. Regionally, state-level partnerships such as the West Coast Health Alliance and Northeast Public Health Collaborative have formed to help provide medical guidance. Additionally, expert groups such as the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics continue to provide helpful guidance on various subspecialties of medicine.
When asked about the future of the CDC, Houry said he sees a lot of hope in the world-class scientists who continue to work at the agency. But she remains deeply concerned about the agency’s long-term prospects.
“Frankly, I don’t know if the CDC is going to survive the way it is,” Houry said.
All three are currently calling out the problems with the current administration’s policy decisions and trying to change the situation.
“I think the real problem was the choice not to embrace science as the primary driver of policymaking,” Jernigan said of the current administration. “The Secretary is really trying to make conclusions first and figure things out later…Someone described it as moving from evidence-based decision-making to evidence-based decision-making.”
Source link
