By Jacqueline Howard, Jamie Gumbrecht, Sarah Owermohle, CNN

(CNN) — Dr. Susan Monarez, former director of the US Centers for Disease Control and Prevention, said in a Senate committee hearing on Wednesday that US Health and Human Services Secretary Robert F. Kennedy Jr. put politics before public health when he required that all CDC policy and personnel decisions be cleared by political staff.

Among those possible policy decisions: changes to the childhood vaccine schedule.

Monarez was ousted last month, just 29 days into her tenure as CDC director, amid clashes with Kennedy over vaccine policies. Dr. Debra Houry, who stepped down from her role as the CDC’s chief medical officer in protest after Monarez’s ouster, also testified in Wednesday’s hearing.

“I was fired for holding the line on scientific integrity,” Monarez told the Senate Committee on Health, Education, Labor and Pensions. “I had refused to commit to approving vaccine recommendations without evidence, fire career officials without cause, or resign.”

Monarez: Changes could restrict vaccine access

In the hearing, Monarez offered new details about her brief tenure as CDC director, including saying Kennedy issued a directive that CDC policy and personnel decisions required prior approval from political staff — a break from the practice of past administrations.

Monarez also said that on August 2, she learned from media reports that Kennedy had removed liaison members of the CDC’s Advisory Committee on Immunization Practices, or ACIP — an influential group of outside experts who advise the agency on vaccinations – essentially being blindsided by the news.

Then, “on the morning of August 25, Secretary Kennedy demanded two things of me that were inconsistent with my oath of office and the ethics required of a public official,” Monarez said. “He directed me to commit in advance to approving every ACIP recommendation regardless of the scientific evidence. He also directed me to dismiss career officials responsible for vaccine policy, without cause. He said if I was unwilling to do both, I should resign.”

Monarez said she told Kennedy that she could not “pre-approve recommendations without reviewing the evidence” and that she had no basis to fire scientific experts.

Monarez described Kennedy as “very upset, very animated” during their meeting. “He said that the childhood vaccine schedule would be changing starting in September and I needed to be on board with it,” Monarez said, adding that Kennedy said he had spoken to President Donald Trump “every day” about such changes.

“On August 25, I could have stayed silent, agreed to the demands, and no one would have known,” Monarez said. “What the public would have seen were scientists dismissed without cause and vaccine protections quietly eroded — all under the authority of a Senate-confirmed director with ‘unimpeachable credentials.’ I could have kept the office, the title, but I would have lost the one thing that cannot be replaced: my integrity.”

Kennedy removed all 17 sitting members of ACIP in June. The committee now includes an entirely new group of experts, including five who were announced this week. They are scheduled to meet Thursday and Friday to discuss Covid-19 vaccines as well as immunizations against hepatitis B and measles, mumps, rubella and varicella. Several of the new members have made unproven claims about vaccines, including one who said, without evidence, that Covid shots are causing “unprecedented levels of death and harm in young people.”

White House spokesperson Kush Desai said in a statement Wednesday, “No one, including Secretary Kennedy and President Trump, is calling to throw out the entire childhood vaccine schedule or eliminate access to lifesaving vaccines. Anyone suggesting that such actions are even on the table does not know what they are talking about.”

Monarez said the new composition of the committee has “raised concerns from the medical community,” and she’s “very nervous” about the ACIP meeting this week.

“There is a real risk that recommendations could be made restricting access to vaccines for children and others in need without rigorous scientific review,” she said. “With no permanent CDC director in place, those recommendations could be adopted. The stakes are not theoretical. We already have seen the largest measles outbreak in more than 30 years, which claimed the lives of two children. If vaccine protections are weakened, preventable diseases will return.”

Republican Sen. Rand Paul, an ophthalmologist from Kentucky, grilled Monarez on Covid-19 shots and CDC’s hepatitis B vaccine recommendations — both of which appear on the CDC vaccine advisers’ agenda this week — saying there is “no medical reason” to vaccinate children against hepatitis B shortly after birth.

Hepatitis B can be passed from mothers to their newborns. ACIP could recommend this week that parents delay those immunizations until age 4. Monarez told Paul, “I was open to the science, I just would not pre-commit to approving all the ACIP recommendations without the science.”

Former CDC director disputes Kennedy’s comments on meeting

During Wednesday’s hearing, Monarez disputed that she lied to Kennedy or told him that she was an untrustworthy person, as Kennedy said earlier this month.

“I told her that she had to resign because I asked her, ‘Are you a trustworthy person?’ And she said, ‘no,’ ” Kennedy told the Senate Finance Committee on September 4.

Monarez told a different version of events on Wednesday, saying Kennedy had grown “very concerned” that she had spoken to members of Congress and told her not to do it again.

“He told me he could not trust me because I had shared information related to our conversation. … I told him, ‘if you cannot trust me, then you can fire me,’ ” she said.

Monarez and Houry also told senators that they fear for the safety of CDC staff amid anti-vaccine rhetoric and a recent shooting on the agency’s campus.

A gunman who expressed distrust of vaccines and public health officials fired nearly 500 rounds on the CDC campus on August 8, killing police Officer David Rose. Roughly 180 rounds hit CDC buildings, Houry said.

“Each bullet was meant for a person, and each of my staff were very traumatized afterward,” Houry said.

Houry told senators that CDC staff have since feared speaking publicly about their roles, or want their names removed from scientific papers “because they feel they were personally targeted because of misinformation.”

Monarez told the committee that she had been subject to personal threats and expressed alarm about broader divides about the safety of vaccines.

“I am very concerned that the further promulgation of misleading information will undermine not just the safety and health of our children but will also exacerbate these tensions,” she said.

CNN’s Adam Cancryn contributed to this report.

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