The Trump administration has selected Jim O’Neill — the agency’s deputy secretary — to serve as acting CDC director after Susan Monarez, PhD, was ousted from the role after one month, according to an Aug. 28 report from The Washington Post.

Seven things to know:

1. Prior to his new role, Mr. O’Neill had served as HHS deputy secretary since early June. Most recently, Mr. O’Neill was CEO of SENS Research Foundation, where he led research on advancing regenerative medicine on age-related diseases like Alzheimer’s, cancer and heart disease, according to a June 9 news release.

He also served as managing director for Clarium Capital, a global macro investment fund, as CEO of the Thiel Foundation and as co-founder for the Thiel Fellowship. Prior to that, Mr. O’Neill served at HHS from 2002 to 2008, and was principal associate deputy secretary from 2007 to 2008, where he helped implement Food and Drug Administration reforms and launch the Administration for Strategic Preparedness and Response.

“All Americans deserve to be healthy, happy and prosperous, and President Trump and Secretary Kennedy have the right vision and leadership to get us there,” Mr. O’Neill said in the June 9 news release. “I’m eager to help my colleagues find the root causes of chronic disease, support families making healthy choices, and help businesses make health care more affordable and accessible. Together all of us can make America healthy again.”

Dr. Monarez would have been among the first CDC directors who did not hold a medical license. Since the CDC was established in 1946, there have been a handful of non-physicians who have served in an interim capacity.

2. Dr. Monarez’s removal came abruptly Aug. 27, after HHS announced the departure despite a statement on X from her lawyers, Mark Zaid and Abbe Lowell, that she neither resigned nor received formal notice of termination from the White House.

The statement claimed Dr. Monarez was forced out for rejecting “unscientific, reckless directives,” to benefit HHS Secretary Robert F. Kennedy Jr. and the agency’s political agenda. However, the White House responded that Dr. Monarez’s removal was due to her refusal to align with President Trump’s ‘Make America Healthy Again’ agenda.

3. Dr. Monarez’s exit also resulted in four additional CDC leader resignations in protest: Debra Houry, MD, chief medical officer and deputy director for program and science of the Centers; Demetre Daskalakis, MD, director of the National Center for Immunization and Respiratory Diseases; Daniel Jernigan, MD, director of the National Center for Emerging and Zoonotic Infectious Diseases; and Jen Layden, MD, PhD, director of the Office of Public Health Data, Surveillance and Technology.

4. The shakeups leave the agency without a steady rank of leaders heading into respiratory virus season. On Aug. 27, the FDA approved updated COVID-19 vaccines with new limits. The shots were approved only for individuals at risk of severe illness, including everyone 65 and older and younger individuals with at least one condition that puts them at risk for severe outcomes. Healthcare groups condemned the narrow approvals, saying the move will limit access to the shots and raise the risk of severe illness.

The CDC’s Advisory Committee on Immunization Practices is set to vote on who should receive the updated vaccines in September. In June, Mr. Kennedy fired all of the committee’s 17 members and appointed new members, several of whom have a history of anti-vaccine rhetoric.

5. Following the leadership departures, Louisiana Sen. Bill Cassidy, MD, who cast the tie-breaking vote for Mr. Kennedy’s nomination as HHS secretary, is calling for the September ACIP meeting to be postponed.

“Serious allegations have been made about the meeting agenda, membership, and lack of scientific process being followed for the now announced September ACIP meeting,” the senator said in a statement. “These decisions directly impact children’s health and the meeting should not occur until significant oversight has been conducted. If the meeting proceeds, any recommendations made should be rejected as lacking legitimacy given the seriousness of the allegations and the current turmoil in CDC leadership.”

6. Healthcare groups and public health experts say upheaval at the CDC dampens the nation’s ability to respond to public health threats, including infectious diseases.

“The mass resignations of CDC expert leaders present a clear and present danger to Americans of all ages and leave our nation extremely vulnerable to a wide range of public health threats from outbreaks to bioterror attacks,” Tim Tan, MD, president of the Infectious Diseases Society of America, said in a statement. “As we near respiratory virus season, it is imperative that our country have expert public health leadership for effective surveillance, communications and responses.”

In an Aug. 28 statement, the American College of Emergency Physicians expressed concern about what turbulence within the agency could mean for its future.

“We urge the administration to prioritize continuity and carry on the CDC’s history of a strong commitment to public health and science in its next steps,” the group said. “The stakes are too high to risk uncertainty in one of our most vital health institutions.”

7. Lawmakers have also weighed in on the shakeup. In an Aug. 27 X post, Vermont Sen. Bernie Sanders called it “outrageous” that Mr. Kennedy would remove Dr. Monarez “for her commitment to public health and vaccines.” He also urged the Senate Committee on Health, Education, Labor and Pensions to hold a hearing with Mr. Kennedy and the CDC director “as soon as possible.”

Dr. Cassidy also said in an Aug. 27 X post that these high-profile CDC departures will require HELP Committee oversight.

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