Dr. Céline Gounder
@celinegounder.com
MEDICINE / INFECTIOUS DISEASES / EPIDEMIOLOGY / JOURNALISM
🔹 Senior Fellow & Editor-at-Large for Public Health at @KFFhealthnews.bsky.social
🔹 Medical Contributor for CBS News
🔹 Prof/Doc at NYU Grossman School of Medicine & Bellevue Hospital
🔹 Senior Fellow & Editor-at-Large for Public Health at @KFFhealthnews.bsky.social
🔹 Medical Contributor for CBS News
🔹 Prof/Doc at NYU Grossman School of Medicine & Bellevue Hospital
5/ COVID shots are available in 34 states on the basis of FDA approval.
In 16 states + DC, they’re also awaiting CDC guidance. In most of those states, a prescriber’s prescription can still unlock access—except MA, NV & NM for now.
State regulations can change at any time.
In 16 states + DC, they’re also awaiting CDC guidance. In most of those states, a prescriber’s prescription can still unlock access—except MA, NV & NM for now.
State regulations can change at any time.
September 1, 2025 at 4:31 PM
5/ COVID shots are available in 34 states on the basis of FDA approval.
In 16 states + DC, they’re also awaiting CDC guidance. In most of those states, a prescriber’s prescription can still unlock access—except MA, NV & NM for now.
State regulations can change at any time.
In 16 states + DC, they’re also awaiting CDC guidance. In most of those states, a prescriber’s prescription can still unlock access—except MA, NV & NM for now.
State regulations can change at any time.
4/ Why does this matter?
When CDC recommendations narrow, health insurance, especially government health insurance, may narrow too.
And it creates confusion in pharmacies & clinics.
When CDC recommendations narrow, health insurance, especially government health insurance, may narrow too.
And it creates confusion in pharmacies & clinics.
September 1, 2025 at 4:31 PM
4/ Why does this matter?
When CDC recommendations narrow, health insurance, especially government health insurance, may narrow too.
And it creates confusion in pharmacies & clinics.
When CDC recommendations narrow, health insurance, especially government health insurance, may narrow too.
And it creates confusion in pharmacies & clinics.
3/ This season, the FDA narrowed COVID vaccine approvals:
🔹People 65+
🔹People 6m to 64y if they have at least one risk factor for severe COVID (including pregnancy)
Off-label use:
🔹Healthy people 6m to 64y in consultation with your doctor
🔹People 65+
🔹People 6m to 64y if they have at least one risk factor for severe COVID (including pregnancy)
Off-label use:
🔹Healthy people 6m to 64y in consultation with your doctor
September 1, 2025 at 4:31 PM
3/ This season, the FDA narrowed COVID vaccine approvals:
🔹People 65+
🔹People 6m to 64y if they have at least one risk factor for severe COVID (including pregnancy)
Off-label use:
🔹Healthy people 6m to 64y in consultation with your doctor
🔹People 65+
🔹People 6m to 64y if they have at least one risk factor for severe COVID (including pregnancy)
Off-label use:
🔹Healthy people 6m to 64y in consultation with your doctor
2/ Normally, FDA reviews products, then CDC’s vaccine advisers (ACIP) publicly weigh evidence & vote.
CDC adopts guidance, which insurers & programs like Medicaid, the Children's Vaccine Program (CHIP), & Vaccines for Children follow.
That process has been corrupted.
CDC adopts guidance, which insurers & programs like Medicaid, the Children's Vaccine Program (CHIP), & Vaccines for Children follow.
That process has been corrupted.
September 1, 2025 at 4:31 PM
2/ Normally, FDA reviews products, then CDC’s vaccine advisers (ACIP) publicly weigh evidence & vote.
CDC adopts guidance, which insurers & programs like Medicaid, the Children's Vaccine Program (CHIP), & Vaccines for Children follow.
That process has been corrupted.
CDC adopts guidance, which insurers & programs like Medicaid, the Children's Vaccine Program (CHIP), & Vaccines for Children follow.
That process has been corrupted.
1/ Why the confusion over COVID vaccines now?
What’s changed isn’t the science. It’s the process.
Policy is increasingly announced by officials online & outside the usual evidence review, creating mixed messages for families.
on @cbsnews.com
What’s changed isn’t the science. It’s the process.
Policy is increasingly announced by officials online & outside the usual evidence review, creating mixed messages for families.
on @cbsnews.com
September 1, 2025 at 4:31 PM
1/ Why the confusion over COVID vaccines now?
What’s changed isn’t the science. It’s the process.
Policy is increasingly announced by officials online & outside the usual evidence review, creating mixed messages for families.
on @cbsnews.com
What’s changed isn’t the science. It’s the process.
Policy is increasingly announced by officials online & outside the usual evidence review, creating mixed messages for families.
on @cbsnews.com
3/ Within hours of the firing of CDC Director Dr. Susan Monarez’s, 3 leaders—responsible for vaccine safety, respiratory diseases, & the chief medical officer role—resigned.
Earlier that week, CDC’s head of data systems also stepped down.
More departures are expected.
Earlier that week, CDC’s head of data systems also stepped down.
More departures are expected.
September 1, 2025 at 4:12 PM
3/ Within hours of the firing of CDC Director Dr. Susan Monarez’s, 3 leaders—responsible for vaccine safety, respiratory diseases, & the chief medical officer role—resigned.
Earlier that week, CDC’s head of data systems also stepped down.
More departures are expected.
Earlier that week, CDC’s head of data systems also stepped down.
More departures are expected.
2/ These aren’t just headlines about “palace intrigue.”
What’s unraveling is the basic machinery that keeps Americans safe: vaccines, outbreak detection, lab guidance, and expert support for state health departments.
What’s unraveling is the basic machinery that keeps Americans safe: vaccines, outbreak detection, lab guidance, and expert support for state health departments.
September 1, 2025 at 4:12 PM
2/ These aren’t just headlines about “palace intrigue.”
What’s unraveling is the basic machinery that keeps Americans safe: vaccines, outbreak detection, lab guidance, and expert support for state health departments.
What’s unraveling is the basic machinery that keeps Americans safe: vaccines, outbreak detection, lab guidance, and expert support for state health departments.
1/ It’s been a chaotic week at the CDC.
The director was fired less than a month into her tenure, four senior leaders resigned in protest, & the agency is still reeling from a shooting at its Atlanta HQ.
on @cbsnews.com
The director was fired less than a month into her tenure, four senior leaders resigned in protest, & the agency is still reeling from a shooting at its Atlanta HQ.
on @cbsnews.com
September 1, 2025 at 4:12 PM
1/ It’s been a chaotic week at the CDC.
The director was fired less than a month into her tenure, four senior leaders resigned in protest, & the agency is still reeling from a shooting at its Atlanta HQ.
on @cbsnews.com
The director was fired less than a month into her tenure, four senior leaders resigned in protest, & the agency is still reeling from a shooting at its Atlanta HQ.
on @cbsnews.com
4/ HHS Secretary Robert F. Kennedy Jr. later confirmed Jim O’Neill as acting CDC director.
In a message to staff, he pledged to “restore trust, transparency, & credibility," but did not mention Monarez’s removal.
In a message to staff, he pledged to “restore trust, transparency, & credibility," but did not mention Monarez’s removal.
September 1, 2025 at 4:06 PM
4/ HHS Secretary Robert F. Kennedy Jr. later confirmed Jim O’Neill as acting CDC director.
In a message to staff, he pledged to “restore trust, transparency, & credibility," but did not mention Monarez’s removal.
In a message to staff, he pledged to “restore trust, transparency, & credibility," but did not mention Monarez’s removal.
3/ Resigned last week:
🔹Dr. Dan Jernigan, Director of the National Center for Emerging and Zoonotic Infectious Diseases
🔹Dr. Jen Layden, Office of Public Health Data, Science, Technology
🔹Dr. Dan Jernigan, Director of the National Center for Emerging and Zoonotic Infectious Diseases
🔹Dr. Jen Layden, Office of Public Health Data, Science, Technology
September 1, 2025 at 4:06 PM
3/ Resigned last week:
🔹Dr. Dan Jernigan, Director of the National Center for Emerging and Zoonotic Infectious Diseases
🔹Dr. Jen Layden, Office of Public Health Data, Science, Technology
🔹Dr. Dan Jernigan, Director of the National Center for Emerging and Zoonotic Infectious Diseases
🔹Dr. Jen Layden, Office of Public Health Data, Science, Technology
2/ Resigned last week:
🔹Dr. Debra Houry, CDC’s Chief Science & Medical Officer
🔹Dr. Demetre Daskalakis, Director of the National Center for Immunization & Respiratory Diseases
➡️
🔹Dr. Debra Houry, CDC’s Chief Science & Medical Officer
🔹Dr. Demetre Daskalakis, Director of the National Center for Immunization & Respiratory Diseases
➡️
September 1, 2025 at 4:06 PM
2/ Resigned last week:
🔹Dr. Debra Houry, CDC’s Chief Science & Medical Officer
🔹Dr. Demetre Daskalakis, Director of the National Center for Immunization & Respiratory Diseases
➡️
🔹Dr. Debra Houry, CDC’s Chief Science & Medical Officer
🔹Dr. Demetre Daskalakis, Director of the National Center for Immunization & Respiratory Diseases
➡️
1/ 4⃣senior CDC officials resigned last week, citing political interference in the agency’s scientific work, especially around vaccines.
Meanwhile, CDC Director Susan Monarez was fired last week, less than a month into her tenure.
Meanwhile, CDC Director Susan Monarez was fired last week, less than a month into her tenure.
September 1, 2025 at 4:06 PM
1/ 4⃣senior CDC officials resigned last week, citing political interference in the agency’s scientific work, especially around vaccines.
Meanwhile, CDC Director Susan Monarez was fired last week, less than a month into her tenure.
Meanwhile, CDC Director Susan Monarez was fired last week, less than a month into her tenure.
9⃣ CDC Directors going back to 1977 speak out.
They served under BOTH Democratic & Republican Presidents.
🚨🚨🚨This is not business as usual. 🚨🚨🚨
nytimes.com/2025/09/01/o...
They served under BOTH Democratic & Republican Presidents.
🚨🚨🚨This is not business as usual. 🚨🚨🚨
nytimes.com/2025/09/01/o...
September 1, 2025 at 3:57 PM
9⃣ CDC Directors going back to 1977 speak out.
They served under BOTH Democratic & Republican Presidents.
🚨🚨🚨This is not business as usual. 🚨🚨🚨
nytimes.com/2025/09/01/o...
They served under BOTH Democratic & Republican Presidents.
🚨🚨🚨This is not business as usual. 🚨🚨🚨
nytimes.com/2025/09/01/o...
13/ Dr. Jernigan's farewell email:
September 1, 2025 at 3:56 PM
13/ Dr. Jernigan's farewell email:
12/ And also from Dr. Daskalakis:
September 1, 2025 at 3:56 PM
12/ And also from Dr. Daskalakis:
11/ Dr. Daskalakis' resignation letter:
September 1, 2025 at 3:56 PM
11/ Dr. Daskalakis' resignation letter:
10/ Dr. Daskalakis' farewell email:
September 1, 2025 at 3:56 PM
10/ Dr. Daskalakis' farewell email:
9/ Dr. Houry's farewell email (2 of 2):
September 1, 2025 at 3:56 PM
9/ Dr. Houry's farewell email (2 of 2):
8/ Dr. Houry's farewell email (1 of 2):
September 1, 2025 at 3:56 PM
8/ Dr. Houry's farewell email (1 of 2):
5/ Monarez has hired legal counsel, including attorney Mark Zaid, and is fighting her termination.
September 1, 2025 at 3:56 PM
5/ Monarez has hired legal counsel, including attorney Mark Zaid, and is fighting her termination.
4/ The administration was also unhappy with how Monarez was addressing the CDC shooting.
She was blocked from publishing an op-ed about it.
Notably, President Trump has yet to publicly acknowledge the tragedy.
She was blocked from publishing an op-ed about it.
Notably, President Trump has yet to publicly acknowledge the tragedy.
September 1, 2025 at 3:56 PM
4/ The administration was also unhappy with how Monarez was addressing the CDC shooting.
She was blocked from publishing an op-ed about it.
Notably, President Trump has yet to publicly acknowledge the tragedy.
She was blocked from publishing an op-ed about it.
Notably, President Trump has yet to publicly acknowledge the tragedy.
3/ I’ve spoken with dozens of CDC employees.
They say tensions were building between Monarez & HHS Secretary Robert F. Kennedy Jr., particularly over COVID vaccines & the CDC’s vaccine advisory group (ACIP).
They say tensions were building between Monarez & HHS Secretary Robert F. Kennedy Jr., particularly over COVID vaccines & the CDC’s vaccine advisory group (ACIP).
September 1, 2025 at 3:56 PM
3/ I’ve spoken with dozens of CDC employees.
They say tensions were building between Monarez & HHS Secretary Robert F. Kennedy Jr., particularly over COVID vaccines & the CDC’s vaccine advisory group (ACIP).
They say tensions were building between Monarez & HHS Secretary Robert F. Kennedy Jr., particularly over COVID vaccines & the CDC’s vaccine advisory group (ACIP).
2/ On Monday, Monarez was scheduled to hold a CDC-wide meeting in Atlanta to address staff after the shooting at agency headquarters.
She canceled last minute after being summoned to DC.
She canceled last minute after being summoned to DC.
September 1, 2025 at 3:56 PM
2/ On Monday, Monarez was scheduled to hold a CDC-wide meeting in Atlanta to address staff after the shooting at agency headquarters.
She canceled last minute after being summoned to DC.
She canceled last minute after being summoned to DC.
1/ Massive CDC meltdown:
Just weeks after taking the job, Susan Monarez was fired as CDC Director by the White House.
Her legal team is contesting her ouster.
And 3 CDC leaders resigned yesterday.
on @cbsmornings.bsky.social
Just weeks after taking the job, Susan Monarez was fired as CDC Director by the White House.
Her legal team is contesting her ouster.
And 3 CDC leaders resigned yesterday.
on @cbsmornings.bsky.social
September 1, 2025 at 3:56 PM
1/ Massive CDC meltdown:
Just weeks after taking the job, Susan Monarez was fired as CDC Director by the White House.
Her legal team is contesting her ouster.
And 3 CDC leaders resigned yesterday.
on @cbsmornings.bsky.social
Just weeks after taking the job, Susan Monarez was fired as CDC Director by the White House.
Her legal team is contesting her ouster.
And 3 CDC leaders resigned yesterday.
on @cbsmornings.bsky.social
CDC Director Susan Monarez ousted weeks after she was confirmed by Senate
cbsnews.com/news/cdc-dir...
cbsnews.com/news/cdc-dir...
September 1, 2025 at 3:42 PM
CDC Director Susan Monarez ousted weeks after she was confirmed by Senate
cbsnews.com/news/cdc-dir...
cbsnews.com/news/cdc-dir...