Who’s in charge? CDC’s leadership ‘crisis’ apparent amid new COVID-19 vaccine guidance

By AMANDA SEITZ and MIKE STOBBE WASHINGTON AP There was a notable absence last week when U S Healthcare and Human Services Secretary Robert F Kennedy Jr communicated in a -second video that the governing body would no longer endorse the COVID- vaccine for healthy children or pregnant women The director of the Centers for Disorder Control and Prevention the person who typically signs off on federal vaccine recommendations was nowhere to be seen The CDC a billion-a-year agency tasked with reviewing life-saving vaccines monitoring diseases and watching for budding threats to Americans vitality is without a clear leader I ve been disappointed that we haven t had an aggressive director since February March April May fighting for the support that CDC demands disclosed Dr Robert Redfield who served as CDC director under the first Trump administration and supported Kennedy s nomination as the nation s fitness secretary billion-a-year agency without leader as nomination awaits The leadership vacuum at a foremost federal citizens medical agency has existed for months after President Donald Trump suddenly withdrew his first pick for CDC director in March A hearing for his new nominee the agency s former acting director Susan Monarez has not been scheduled because she has not submitted all the paperwork necessary to proceed according to a spokesman for Sen Bill Cassidy R-La who will oversee the nomination HHS did not answer written questions about Monarez s nomination her current role at the CDC or her salary An employee directory lists Monarez a longtime cabinet employee as a staffer for the NIH under the Advanced Research Projects Agency for Fitness Redfield described Kennedy as very supportive of Monarez s nomination Instead a lawyer and political appointee with no curative experience is carrying out particular of the duties of director at the agency that for seven decades has been led by someone with a medicinal degree Matthew Buzzelli who is also the chief of staff at the CDC is surrounded by highly qualified medicinal professionals and advisors to help fulfill these duties as appropriate Andrew Nixon an HHS spokesperson revealed in a message Adding to the confusion was an employee-wide email sent last week that thanked new acting directors who shave stepped up to the plate The email signed by Monarez listed her as the acting director It was was sent just days after Kennedy mentioned at a Senate hearing that Monarez had been replaced by Buzzelli The lack of a proven director will be a dilemma if a society strength exigency such as the COVID- pandemic or a rapid uptick in measles cases hits commented Michael Osterholm an epidemiologist at the University of Minnesota CDC is a emergency waiting for a dilemma to happen explained Osterholm At this point I couldn t tell you for the life of me who was going to pull what trigger in a emergency situation An acting director rarely seen and stalled decisions At CDC headquarters in Atlanta employees say Monarez was rarely heard from between late January when she was appointed acting director and late March when Trump nominated her She also has not held any of the all hands meetings that were customary under previous CDC chiefs according to several staffers One employee who insisted on anonymity because they were not authorized to speak to the media and fears being fired if identified mentioned Monarez has been almost invisible since her nomination adding that her absence has been cited by other leaders as an excuse for delaying action The situation already has led to confusion In April a -member CDC advisory panel of outside experts met to discuss vaccine strategy The panel makes recommendations to the CDC Director who routinely signs off on them But it was unclear during the meeting who would be reviewing the panel s recommendations which included the expansion of RSV vaccinations for adults and a new combination shot as another option to protect teens against meningitis HHS representatives disclosed the recommendations were going to Buzzelli but then weeks passed with no decision A month after the meeting ended the CDC posted on a web site that Kennedy had signed off on recommendations for travelers against chikungunya a viral sickness transmitted to humans by mosquitos But there continues to be no word about a decision about the other vaccine recommendations Controversial COVID- vaccine recommendations bypassed CDC panel The obstacle was accentuated again last week when Kennedy rolled out recommendations for the COVID- vaccine saying they were no longer recommended for healthy children or pregnant women even though expectant mothers are considered a high-risk group if they contract the virus Kennedy made the surprise announcement without input from the CDC advisory panel that has historically made recommendations on the nation s vaccine schedule The CDC days later posted revised guidance that noted healthy kids and pregnant women may get the shots Nixon the HHS spokesman announced CDC staff were consulted on the recommendations but would not provide staffer s names or titles He also did not provide the specific input or research that Kennedy reviewed to reach his conclusion on the new COVID- recommendations just weeks after he mentioned that he did not think people should be taking diagnostic advice from him As Secretary Kennedy noted there is a clear lack of statistics to backing the repeat booster strategy in children Nixon reported in a declaration Related Articles More at-home vitality tests are now available How to know what s right for you RFK Jr says healthy pregnant women don t need COVID boosters What the science says Measles vaccination rates drop after COVID- pandemic in counties across the US Texas hospital that discharged woman with doomed pregnancy violated the law a federal inquiry finds Jimmy Fund s Scooper Bowl kicks off with all-you-can-eat ice cream at City Hall Plaza Research shows that pregnant women are at higher exposure of severe illness mechanical ventilation and death when they contract COVID- infections During the height of the pandemic deaths of women during pregnancy or shortly after childbirth soared to their highest level in years Vaccinations also have been recommended for pregnant women because it passes immunity to newborns who are too young for vaccines and also vulnerable to infections Nixon did not address a written question about recommendations for pregnant women Kennedy s decision to maneuver around the the advisory panel and announce new COVID- recommendations on his own prompted a key CDC official who works with the committee Dr Lakshmi Panagiotakopoulos to announce her resignation last Friday My career in population strength and vaccinology started with a deep-seated desire to help the the majority vulnerable members of our population and that is not something I am able to continue doing in this role she wrote in an email seen by an Associated Press reporter Signs are mounting that the CDC has been sidelined from key decision-making under Kennedy s watch disclosed Dr Anand Parekh the chief physiological adviser for The Bipartisan Initiative Center It s laborious to ascertain how we will reverse the chronic syndrome epidemic or be prepared for myriad residents wellness emergencies without a strong CDC and visible empowered director Parekh stated It s also worth noting that every region in the country is served by a local or state community wellbeing department that depends on the scientific expertise of the CDC and the leadership of the CDC director