We've been following an extraordinary US Senate hearing, where the ousted boss of the Centers for Disease Control and Prevention (CDC) claims she faced an ultimatum from Secretary of Health Robert F Kennedy Jr - sign off on vaccine policies before seeing the research, and fire scientists, or quit.

Dr Susan Monarez says she was fired for refusing to bow to this pressure.

The hearing has just come to an end. Here is what senators on the Health, Education, Labor and Pensions committee heard today:

• Monarez detailed a meeting with RFK Jr where she says he called CDC staff "horrible people" and called the agency "corrupt"
• Monarez says she refused to sign off on vaccine recommendations made by a newly overhauled advisory board, and it caused RFK Jr to become "very upset"
• RFK Jr had previously told this same Senate committee he fired Monarez after he asked if she was trustworthy and she replied "no". Monarez says that is not what happened
• Former CDC Chief Medical Officer Dr Debra Houry is also a witness today, and says she quit when Monarez was fired because the agency no longer made decisions based on "evidence" and in consultation with scientists
• Both witnesses say they fear violence caused by people who have consumed misinformation about vaccines
• There was some confusion about whether Senator Markwayne Mullen was in possession of a previously unknown recording of the firing conversation between Kennedy and Monarez. Mullen first said the recording existed and later, in a sudden reversal, reportedly said he was "mistaken" and that no recording exists

The hearing ended with a bit of scientific education for the senators and members of the public in the audience.

Committee Chairman Bill Cassidy, who is also a doctor, used his closing statements to offer an explanation of how newborns can contract the liver infection hepatitis - as the newly overhauled vaccine advisory board ACIP is expected to vote tomorrow to recommend delaying the hepatitis B vaccine in children.

There has been some confusion about whether the disputed conversation between Monarez and Kennedy was recorded.

Committee Chairman Bill Cassidy interjects that he has never heard that a recording exists of the conversation in which Kennedy fired Monarez, as implied by Senator Markwayne Mullen a few minutes ago.

He says that if a record has been referenced in a committee hearing, all other senators on the committee have the right to see those records.

"I will also note that if HHS has a recording, I ask them to release the recording. I would also like to know why it was recorded."

"If a recording does not exist, I would like Mr Mullen to retract his line of questioning," he adds.

He says he wonders why - if such a recording does exist - only one senator was given the recording and why Kennedy didn't present this recording at his Senate Finance Committee hearing earlier this month.

A few minutes later, Cassidy takes the mic again, saying that Senator Mullen has just told reporters in a swift reversal that he was "mistaken" and that no recording of that conversation exists after all.

"In case (Mullen) is mistaken that he was mistaken, if there is a recording, it should be released. And would beg the question of what other conversations have been recorded."

He says they have sent a request to HHS for records relating to these instances, but have not received them yet.

Image source, Getty Images

Republican Senator Markwayne Mullen questions Monarez about what day and time she was fired and what day and time she retained her attorneys.

Monarez says she can't remember the exact instance in which she first spoke to and hired her lawyers, which Mullen says he doesn't believe, and he believes she has "an honesty problem".

Then he asks her more about the conversation between Kennedy and Monarez, where the health secretary claims she told him she wasn't trustworthy. Monarez has claimed Kennedy told her he didn't trust her.

Mullen takes issue with that and says he doesn't believe her account of events. "It was a recorded meeting, so you can testify one way and prove that you're lying or you can be honest with this committee," Mullen says.

This is the first time we are hearing a reference to this conversation being recorded.

Monarez again repeats her recollection of the conversation, which we have heard multiple times: "He told me he could not trust me, and I told him if he could not trust me, he could fire me."

Mullen continues to appear irritated with Monarez, accusing her of being dishonest in this hearing: "We have to question you, because your personality and your answers aren't correct."

Republican Senator Ashley Moody asks Monarez if she will introduce the lawyers she has brought with her.

Monarez declines to name them, saying that she wants to remain focused on the substance of their conversation and that their names have already been widely reported.

Their exchange turns tense, with Moody continuing to request Monarez state her the name of her lawyers - who Moody says are known to be Trump opponents - for the record, with Monarez continuing to decline.

Moody then turns the question to Houry, who names the lawyers offering counsel to the two doctors today as Abbe Lowell and Mark Zaid.

We're only here because you talked to the chairman of the committee and wanted to talk about this, Moody says. She asks if Monarez had any advance plans to "coordinate this public spectacle surrounding your firing?"

Monarez says "I did not coordinate with anyone surrounding my leaving. I was terminated abruptly."

Republican committee Chairman Bill Cassidy, who is also a doctor, then says he wants to make a comment since his own name was brought up.

"It is entirely appropriate for someone with oversight concerns to contact my office or me or frankly any of us," he says.

Democratic ranking member Bernie Sanders chimes in: "I find it rather astounding that anyone is concerned that government heads of agencies talk to the elected officials of the United States of America. hat is what they are supposed to do."

Image source, Reuters

Kayleen Devlin
BBC Verify senior journalist

In her testimony to the Senate earlier, Susan Monarez spoke about a meeting that is set to begin tomorrow with the new Advisory Committee on Immunization Practices (ACIP), which is now made up of new members after Health Secretary Robert F Kennedy Jr fired all sitting 17 members in June.

"Based on what I observed during my tenure there, is a real risk that recommendations could be made restricting access to vaccines for children and others in need without rigorous scientific review," said Monarez.

The published agenda, external for the ACIP meeting suggests that three vaccines are going to be discussed: the covid, MMRV, and hepatitis B vaccines.

Reports, external have suggested that the committee - which makes vaccine recommendations - may be given a presentation which links the coronavirus vaccine to the deaths of a number of children.

Previous monitoring by the Centers for Disease Control (CDC), after millions of Covid-19 vaccine doses were administered to children in 2021, found that serious side effects were rare.

According to data, external from the Centers for Disease Control, this has been the worst year so far for measles - which is prevented by the MMR vaccine - in the US for more than three decades, with 1,491 cases and three deaths as of September 2025.

Democratic Senator Time Kaine begins his remarks by offering an apology to Dr Monarez.

"When you were here for your confirmation hearing, I questioned you... not on your qualifications (but) on your backbone" and that's why I voted against your confirmation, he says.

"I was wrong, and I apologise to you for being wrong," he says.

He also asks her if she was directed to not speak to senators during her time running the CDC.

Monarez says she was, which Kaine says is surprising, since his committee is used to regularly communicating with the CDC, especially during the pandemic.

The witnesses are asked what keeps them up at night.

"The next outbreak, and I don't believe that we will be prepared," Dr Monarez says.

"If we continue down this path, we are not prepared not just for pandemics... we're going to see kids dying of vaccine-preventable diseases," Dr Houry says.

Senator Chris Murphy, a Democrat, asks about any fears Monarez has - referencing the August attack on the CDC headquarters in Atalanta, in which a police officer was killed.

"I myself was subject to threats," she says. Monarez goes on to say misinformation will exacerbate tensions, and the willingness for some people to do harm.

Dr Houry chimes in that the Atlanta gunman actually shot 500 rounds at the headquarters.

"Each bullet was meant for a person," she says. "I had staff that were covering their kids in the daycare parking lot."

"I have many (staff) that won't speak about vaccines now, that have removed their names off of papers," Dr Houry says.

She adds that they fear putting their names on scientific papers because of possible violence against them.

Image source, EPA

Following that exchange, Republican Senator Tommy Tuberville says Donald Trump was elected by the American people to bring change.

He asks Monarez whether she agrees that the CDC head reports to the HHS secretary, who then reports to the president. She says she agrees with those statements.

"The American people want bureaucrats to understand that you're not elected," Tuberville says. "We want you to do your job."

He then references something Kennedy testified to in his own congressional hearing: "Did you tell the secretary you were untrustworthy?"

"He told me he could not trust me" because I had shared information about our conversation beyond his staff, Monarez says.

"I told him: 'If you cannot trust me, then you can fire me'."

Tuberville asks Monarez if she ever refused policy changes at the CDC as directed by the president, such as removing the words "birthing person" or "health equity" from the agency's website.

She says she never did.

Image source, Reuters

We're hearing more now on the 25 August meeting between Robert F Kennedy Jr and Dr Susan Monarez, when she says he instructed her to approve vaccine recommendations, and dismiss certain staff, or resign.

"He was very upset, the entire meeting was very tense," she tells the senators.

"He was very upset throughout the entirety... it was not a productive exchange."

She says RFK Jr called CDC employees "horrible people" and the "most corrupt federal agency in the world". He claimed CDC employees were killing children.

"He was extremely animated towards me in that room," she says.

Monarez testifies that RFK Jr "was very concerned" that she had spoken to members of Congress about the changes he had ordered, and was told that she should "never do it again".

Senator Tammy Baldwin, a Democrat from Wisconsin, then accuses the health secretary of "censorship" and says he is not delivering on the transparency he had promised.

"It is unacceptable," Baldwin says.

Next up to ask questions is Republican Senator Susan Collins.

Collins asks Monarez for more details about the conversations Monarez had with RFK Jr on 25 August, ahead of her firing.

Monarez says Kennedy confronted her, saying he'd heard that she may not sign off on vaccine recommendations made by the newly overhauled advisory board.

He was "very upset" and "very animated" during that conversation, she says.

Monarez says she told Kennedy that she could not sign off on recommendations without seeing data and evidence. She says Kennedy then insisted that there is no data or evidence collected by the CDC about the safety and efficacy of vaccines.

Kennedy said "I needed to commit to signing off on each and every one of those recommendations, and if I could not commit to that, I needed to resign," Monarez tells Collins.

Collins points out Kennedy has denied telling Monarez to do that.

Image source, Reuters

• You can watch some of this exchange in the video carousel at the top of the page

Monarez is now being questioned by Senator Rand Paul, a Republican from Kentucky.

Paul asks her first about Covid vaccines: "Does the Covid vaccine reduce transmission?"

Monarez says it can, as it reduces "viral load".

Paul then asks if the Covid vaccine reduces hospitalisation for children under 18.

"It can," Monarez replies.

"It doesn't," Paul says.

Paul then asks if the Covid vaccine reduces the rate of death for children under 18.

"It can," Monarez replies.

"That's a ridiculous answer - no it doesn't," says Paul, before claiming that statistics show no benefit for children.

"You resisted firing people who have this idea that the Covid vaccine should be at six months," Paul says. "That's what this is about."

Monarez says that is not "commensurate" with her experience.

Paul then asks her why the Hepatitis B vaccine is given to newborns if the mother is not infected with the virus.

He argues there should be changes to childhood vaccine schedules.

"What is the medical, scientific reason and proof for giving a Hepatitis B vaccine to a newborn?" he asks. "The burden is upon you, and the people you wouldn't fire, to prove to us that we need to give our six-month-old a Covid vaccine, and we need to give our one-day-old a Hepatitis vaccine."

Monarez responds by saying she agrees, but she would't "pre-commit to approving all the ACIP recommendations without the science".

"Untrue," Paul claims.

Dr Houry is asked by Senator Sanders what will happen if "trust in vaccines is diminished".

Houry says we are "already beginning to see that", as "childhood vaccination rates decrease".

She says a drop in measles vaccine take-up to 92.8% means there is risk of measles outbreaks. (CDC data, external shows there have been 1,491 measles cases reported in the United States this year - the highest total in more than three decades.)

Houry says they are less ready for the next pandemic due to staff cuts, there is less visibility into global pathogens, and less ability to respond, she says.

She says she fears "we won't be able to have vaccines to save lives ... and we won't have people that are willing to have vaccines".

Image source, Reuters

Senator Bernie Sanders says RFK Jr called Monarez a liar - he now asks her if she is one.

Monarez replies "that is not accurate".

Sanders then asks what the worst case scenario would be, if she rubber stamped RFK Jr's policies.

Monarez says her worst fear was she "would be in position of approving something that would reduce access to life saving vaccines for children and others who need them".

Senator Bill Cassidy now begins questioning.

He asks Monarez about her removal from the CDC, how aligned she was with RFK Jr on the agency's priorities, and how many times she met with the health secretary.

Monarez responds that she met RFK Jr twice: when she was sworn in as director, and when he came down the tour the CDC buildings that were targeted by a gunman in August.

Cassidy reminds Monarez that she and RFK Jr met a third time on 25 August, when - she says - the health secretary gave her ultimatums.

"That's correct," she says.

Monarez says they had three meetings that day. In one of them, she says he asked her to commit to firing scientists or resign, and asked her for "blanket approval" to forthcoming recommendations from a vaccine panel "regardless or not whether there was scientific evidence".

Monarez adds that she did not resign then. That is when RFK Jr told her that he had already spoken to the White House about having her removed, she says.

She also says he told her he would be changing the childhood vaccine schedule in the US starting in September, and that he had spoken to President Trump frequently, including about the changes.

Image source, EPA

Former CDC Chief Medical Officer Dr Debra Houry now explains why she resigned from the CDC three weeks ago.

She says it was one of the hardest decisions of her career.

During the 10 years she worked at the CDC, she says, the decisions were "grounded in evidence, transparency and consultation with the world's best scientists".

"That has changed," she says.

She resigned "because CDC leaders were reduced to rubber stamps", supporting policies not based on science "and putting American lives at risk".

Secretary Kennedy "politicised the CDC processes," she says, adding that she could "not remain under those conditions".

She adds that she first heard about changes in CDC guidance via a post from Health Secretary Kennedy on X.

Monarez explains how her tenure as CDC ended after "29 days".

"Since my removal, several explanations have been offered...none of those reflect what actually happened," she says, referring to comments from RFK Jr.

She describes her focus "on security, staff and ensuring the CDC could continue working" after a gun attack on staff in August - and her refusal to return to Washington from Atlanta because it would have meant missing the funeral of the police officer killed in the attack.

She speaks of becoming "concerned about my ability to continue to lead the CDC while preserving evidence-based decision making" - a commitment she says she had made to the Senate committee during her confirmation hearing.

Monarez also refers to the demands she says RFK Jr made of her on 25 August - the prior approval of vaccine recommendations from the vaccine committee and the firing of vaccine officials "without cause".

She says these requests were "inconsistent with my oath of office and the ethics required of a public official".

Monarez also claims RFK JR spoke with the White House about having her removed before she lot her job.

She says she could have kept the office, and the title - but she refused to compromise her "integrity".

Susan Monarez is now up - watch live at the top of the page.

Independent Senator from Vermont Bernie Sanders, a ranking member of the committee, is now up.

Sanders begins with recalling that Health Secretary Robert F Kennedy Jr praised Monarez when she was sworn in as CDC director earlier this year.

Less than a month later, Sanders says, Monarez "was fired."

"How did Dr Monarez go from a public health expert with unimpeachable scientific credentials who had the full confidence of Secretary Kennedy, into being a liar and untrustworthy in less than a month?" Sanders asks.

"The answer is fairly obvious," he continues, arguing that Monarez was fired because she refused to be a "rubber stamp" for RFK Jr's agenda.

He lays out two reasons behind her firing: refusing to "pre-approve" the recommendations of a vaccine panel whose membership includes people who are "anti-vaccine", and refusing to fire scientists "for doing their jobs".

"Bottom line, Dr Monarez stood up for science, for public health and for the scientific method," Sanders says.

"For that reason, she was fired."