Who is in charge at the US Centers for Disease Control and Prevention? | Trump administration

Who is in charge of the US Centers for Disease Control and Prevention (CDC)? The answer is more complicated than it seems.

According to the agency, the director of the confirmed or interim CDC, Robert F Kennedy Jr has direct control over the agency, allowing it to sign – or not – vaccine recommendations, according to legal experts.

However, Kennedy, the Secretary of the United States Department of Health and Social Services (HHS), testified before a Senate committee in May that someone else runs the agency – creating a confusion that could lead to legal challenges.

“There is no director of the CDC or acting director. Essentially, RFK JR is the director of the CDC,” said Paul Offer, professor of pediatrics at the University of Pennsylvania Perelman School of Medicine.

Kennedy has now “much more opportunities to really influence the results of these decisions and take measures in the absence of a director confirmed by the Senate,” Prénée Landers, Professor and Director of the Health Law Society, said Suffolk University Law Company in Boston.

The dismissal of 17 independent vaccination advisers and their replacement by less experienced advisers, some of whom have history of anti-vaccine activism, is “very worrying”, in particular given the rejection of Kennedy of the theory of germs and its own anti-vaccine activism, said Landers.

Thursday, independent vaccine advisers appointed by Kennedy voted to ban Thimeralal, a curator (also known as Thiomersal) with a demonstrated security file, 4% of flu vaccines in the United States.

The remaining 96% of flu vaccines, as well as all other infant vaccines, were already free from Thimérosal by abundance of prudence, despite decades of research indicating the safety of the conservative. This decision will make more difficult for some people to access the flu vaccine.

The recommendation would normally be taken up by the CDC director, either to reject or to implement official advice from the agency. But for the moment, these decisions go directly to Kennedy, who has already exercised these capacities before.

On May 13, “with confirmation unanswered by a new director of the CDC”, the Secretary of Health adopted the recommendations for the vaccines of Chikungunya which will be officially recommended by the CDC, according to the agency’s website.

Kennedy did not sign the votes of the committee for two other RSV vaccines and meningitis.

These vaccines, recommended in April by the independent advisers that Kennedy rejected this month, have still not obtained official recommendations from the CDC; We don’t know if or when they do.

Kennedy has also recently ordered the CDC to modify its vaccination recommendations stucks, softening the recommendation for children and puts it at the end of pregnant people, despite solid evidence that pregnancy is a major risk factor in serious illness and death.

“It is concern that the power vacuum cleaner leaves its ability to make these decisions incompatible with a scientific consensus,” said Landers.

The congress presented a new law in 2023 according to which CDC directors must now undergo confirmation from the Senate. This appointment has been the first time that the CDC director has gone through the process.

“It’s a bit of unexplored waters,” said Landers.

David Weldon was appointed for the first time then withdrawn hours before his Senate confirmation audience in March.

Susan Monarez was an acting director from January 23 until her nominated on March 24, when she resigned. Once someone was nominated for the director, he cannot be acting director.

Monarez testified during his confirmation hearing of the Senate on Wednesday, but it is not clear when the legislators voted on the appointment,

In the absence of an acting director, the HHS chief has control of the agency, according to the Facancies Reform Act of 1998.

The signature – or not – on the recommendations of the CDC cannot be “delegated” to other officials under the law on vacant posts, said Anne Joseph O’Connell, professor at Stanford Law School; “He can only go up” to the HHS secretary.

“What is unusual in this situation is that we generally think that having exclusive tasks” at the head of the agency when there is a lower level vacancy is a good thing. But here, many do not trust the secretary of these questions, “said O’Connell.

Kennedy presented a different name for which is in charge of the CDC in the testimony of May before the Health, Education, Labor and Pensions of the Senate Committee.

“Who is the director of the acting CDC?” Lisa Blunt Rochester, the Democratic Senator of Delaware, asked.

“The acting director was Susan Monarez, but she is now ready for the permanent director, she was therefore replaced by Matt Buzzelli,” said Kennedy, describing Buzzelli as “a public health expert”.

But nothing indicates that Buzzelli, a lawyer who is listed as chief of staff to the office of the director of the CDC, is acting director, and he is not qualified for the position.

“Buzzelli cannot be the head of the acting CDC,” said O’Connell. He is not the first assistant to the director of the CDC, he is not confirmed by the Senate, and he did not serve 90 days in the year preceding the last director of the CDC, O’Connell said: “There is no room for maneuver.”

The lack of clarity is aggravated by the non-compliance of the Trump administration with information requirements, experts said. The CDC, as well as other agencies, must update a staff management office on which occupies what jobs, a deadline that agencies lacked in March.

Buzzelli “has exercised some of the functions of the CDC director as senior officials, if necessary, and is surrounded by highly qualified professionals and health advisers to help fulfill these tasks, as the case may be,” Andrew Nixon, HHS communications director, told Stat News in May. (HHS did not respond to the Guardian media investigation.)

Such actions could open civil servants to legal challenges. Without the official documentation appointing Buzzelli and other decision -makers in official positions, they would not have the designated power to make certain decisions, which means that their actions could be disputed.

For example, they cannot be authorized to conclude new contracts or to end the previous agreements early with the governments of states, states, tribal and territorial – potentially opening such actions to prosecution.

“The person who takes action must be someone legally appointed to the position.