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There's not been a permanent director of the Centers for Disease Control and Prevention for most of the Trump administration. The latest nominee, Dr. Erica Schwartz, is expected before the Senate later this month, and if confirmed, she will take over a CDC that has been through many challenges. NPR's Pien Huang reports on a set of recently released emails that take us back and show the challenges ahead.
PIEN HUANG, BYLINE: The emails were provided by Dr. Deb Houry, who served as the CDC's chief medical officer until she quit last August. In one email from last July, Houry was asked to schedule a performance review because management at the Department of Health and Human Services, which oversees CDC, thought she was the CDC's acting director, but someone else was in that role. Health Secretary Robert F. Kennedy Jr. said as much in a congressional hearing two months earlier.
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ROBERT F KENNEDY JR: The acting director was Susan Monarez, but she is now up for permanent director. And so she's been replaced by Matt Buzzelli.
HUANG: The confusion over who was in charge at CDC is one of several episodes documented in over 250 pages of emails showing chaos at the agency after the Trump administration took over. They were recently released by Senator Bernie Sanders, an independent from Vermont, and ranking member of the Senate Health Committee. He asked Houry for documents related to, quote, "Secretary Kennedy's politicization of the CDC." Kennedy had long questioned the safety and need for some vaccines and objected to a preservative called thimerosal.
Last June, when CDC advisers voted to recommend removing thimerosal from U.S. flu vaccines, emails show they did so against the advice of CDC's legal counsel and career scientists. Houry talked with NPR's Leila Fadel about this time shortly after she left the agency.
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DEBRA HOURY: You know, that was one of the first times that we really were concerned that there was interference. The vote itself wasn't as problematic because it's only in about 4% of flu vaccines. But to me, it was more concerning that there were changes to vaccine policy that weren't based on data and science.
HUANG: Houry wasn't available to speak again before the story's deadline. But her emails show that CDC scientists pushed back against inaccurate vaccine claims Kennedy made on TV and social media. They sent line-by-line rebuttals up the chain. It's not clear if these emails ever reached Kennedy, but the pressure continued.
Last August, shortly after Susan Monarez became the CDC's Senate-confirmed director, she received an email from Kennedy's then chief of staff. Susan, it read, I wanted to elevate the absolute need for political review of major policy decisions at CDC. Weeks later, Kennedy fired Monarez, and Houry quit in protest.
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HOURY: And I realized at one point, particularly when Dr. Monarez resigned that - or was fired - I no longer had that scientific leadership that was going to push back at all. She was unable to make policy or hiring decisions, essentially meaning that our CDC director would be ineffective.
HUANG: Dr. Demetre Daskalakis was a top CDC official who quit with Houry. Some of their exchanges were released in the emails.
DEMETRE DASKALAKIS: Our outcomes were that we resign but we were probably going to be fired because we stood up for what was right.
HUANG: Daskalakis says he sought to document the serious conflicts of interest and anti-science changes he was seeing.
DASKALAKIS: And frankly, like, it becomes really clear that this is public health by vibes, as opposed to public health by data.
HUANG: And the months since, Kennedy's vaccine policy changes were largely blocked by a federal judge. But Dr. Georges Benjamin, head of the American Public Health Association, says the layers of political review remain.
GEORGES BENJAMIN: The burden is still there. The roadblocks are still there. The political agenda is still there.
HUANG: That poses challenges for Dr. Erica Schwartz, former deputy surgeon general, who's been nominated as the next CDC director. Still, Benjamin says the political winds have shifted a bit since last year.
BENJAMIN: The president said he was going to let the secretary go wild, and he did. He's now had to pull him back because it is creating political damage.
HUANG: Benjamin says it may give the next leader some space to follow the evidence with less political interference. HHS did not respond to NPR's questions about the emails or the independence of the next CDC director by deadline.
Pien Huang, NPR News. Transcript provided by NPR, Copyright NPR.
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