The U.S. CDC faces unprecedented upheaval as former director Susan Monarez testified that Health and Human Services Secretary Robert F. Kennedy Jr. demanded her to approve vaccine recommendations without scientific support, leading to her dismissal and subsequent resignations of high-ranking CDC officials. Amid this, states independently modify COVID vaccine access and policies, diverging from traditional federal guidance. These developments raise concerns over vaccine confidence, public health policy stability, and future advisory committee deliberations impacting immunization schedules nationwide.