Melissa Stiles, MD, FAAFP

#Retired #FamMed #Geriatrician #HealthCareReform and #ViolencePrevention #Advocate. #MedEd and #AgingWell Consultant #StreetPhotographer

[Melissa Stiles, MD, FAAFP @mmstiles]

Taking a X break….

[Melissa Stiles, MD, FAAFP @mmstiles]

@IowaWBB @_taylormccabe You are a joy to watch play -so sorry for your injury, and I wish you all the best with surgery and rehab-you'll get through this!

[Melissa Stiles, MD, FAAFP @mmstiles]

https://t.co/UUQjEUWDty

[DrDemetre @dr_demetre]

My resignation letter from CDC.

Dear Dr. Houry,

I am writing to formally resign from my position as Director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC), effective August 28, 2025, close of business.   I am happy to stay on for two weeks to provide transition, if requested.

This decision has not come easily, as I deeply value the work that the CDC does in safeguarding public health and am proud of my contributions to that critical mission. However, after much contemplation and reflection on recent developments and perspectives brought to light by Secretary Robert F. Kennedy Jr., I find that the views he and his staff have shared challenge my ability to continue in my current role at the agency and in the service of the health of the American people. Enough is enough.

While I hold immense respect for the institution and my colleagues, I believe that it is imperative to align my professional responsibilities to my system of ethics and my understanding of the science of infectious disease, immunology, and my promise to serve the American people.  This step is necessary to ensure that I can contribute effectively in a capacity that allows me to remain true to my principles.

I am unable to serve in an environment that treats CDC as a tool to generate policies and materials that do not reflect scientific reality and are designed to hurt rather than to improve the public’s health.  The recent change in the adult and children’s immunization schedule threaten the lives of the youngest Americans and pregnant people.   The data analyses that supported this decision have never been shared with CDC despite my respectful requests to HHS and other leadership.  This lack of meaningful engagement was further compounded by a “frequently asked questions” document written to support the Secretary’s directive that was circulated by HHS without input from CDC subject matter experts and that cited studies that did not support the conclusions that were attributed to these authors.  Having worked in local and national public health for years, I have never experienced such radical non-transparency, nor have I seen such unskilled manipulation of data to achieve a political end rather than the good of the American people.

It is untenable to serve in an organization that is not afforded the opportunity to discuss decisions of scientific and public health importance released under the moniker of CDC.  The lack of communication by HHS and other CDC political leadership that culminates in social media posts announcing major policy changes without prior notice demonstrate a disregard of normal communication channels and common sense.  Having to retrofit analyses and policy actions to match inadequately thought-out announcements in poorly scripted videos or page long X posts should not be how organizations responsible for the health of people should function.  Some examples include the announcement of the change in the COVID-19 recommendations for children and pregnant people, the firing of scientists from ACIP by X post and an op-ed rather than direct communication with these valuable experts, the announcement of new ACIP members by X before onboarding and vetting have completed, and the release of term of reference for an ACIP workgroup that ignored all feedback from career staff at CDC.

The recent term of reference for the COVID vaccine work group created by this ACIP puts people of dubious intent and more dubious scientific rigor in charge of recommending vaccine policy to a director hamstrung and sidelined by an authoritarian leader.   Their desire to please a political base will result in death and disability of vulnerable children and adults.  Their base should be the people they serve not a political voting bloc.

I have always been first to challenge scientific and public health dogma in my career and was excited by the opportunity to do so again.  I was optimistic that there would be an opportunity to brief the Secretary about key topics such as measles, avian influenza, and the highly coordinated approach to the respiratory virus season.  Such briefings would allow exchange of ideas and a shared path to support the vision of “Making America Healthy Again.”  We are seven months into the new administration, and no CDC subject matter expert from my Center has ever briefed the Secretary.  I am not sure who the Secretary is listening to, but it is quite certainly not to us.  Unvetted and conflicted outside organizations seem to be the sources HHS use over the gold standard science of CDC and other reputable sources.  At a hearing, Secretary Kennedy said that Americans should not take medical advice from him.  To the contrary, an appropriately briefed and inquisitive Secretary should be a source of health information for the people he serves. As it stands now, I must agree with him, that he should not be considered a source of accurate information.

The intentional eroding of trust in low-risk vaccines favoring natural infection and unproven remedies will bring us to a pre-vaccine era where only the strong will survive and many if not all will suffer.  I believe in nutrition and exercise.  I believe in making our food supply healthier, and I also believe in using vaccines to prevent death and disability.  Eugenics plays prominently in the rhetoric being generated and is derivative of a legacy that good medicine and science should continue to shun.

The recent shooting at CDC is not why I am resigning.  My grandfather, who I am named after, stood up to fascist forces in Greece and lost his life doing so.  I am resigning to make him and his legacy proud.   I am resigning because of the cowardice of a leader that cannot admit that HIS and his minions’ words over decades created an environment where violence like this can occur.  I reject his and his colleagues’ thoughts and prayers, and advise they direct those to people that they have not actively harmed.

For decades, I have been a trusted voice for the LGBTQ community when it comes to critical health topics.  I must also cite the recklessness of the administration in their efforts to erase transgender populations, cease critical domestic and international HIV programming, and terminate key research to support equity as part of my decision.

Public health is not merely about the health of the individual, but it is about the health of the community, the nation, the world. The nation’s health security is at risk and is in the hands of people focusing on ideological self-interest.

I want to express my heartfelt gratitude for the opportunities for growth, learning, and collaboration that I have been afforded during my time at the CDC. It has been a privilege to work alongside such dedicated professionals who are committed to improving the health and well-being of communities across the nation even when under attack from within both physically and psychologically.

Thank you once again for the support and guidance I have received from you and previous CDC leadership throughout my tenure. I wish the CDC continued success in its vital mission and that HHS reverse its dangerous course to dismantle public health as a practice and as an institution.  If they continue the current path, they risk our personal well-being and the security of the United States.

Sincerely,

Demetre C. Daskalakis MD MPH (he/his/him)

[Melissa Stiles, MD, FAAFP @mmstiles]

@widfm @aafp Awesome choice!!! Congratulations Bill Schwab!!!

[Alice Chen MD @atychen]

I'm a primary care doctor and a mom. I can think of few things that are as important to our lives as our health.

Call Congress and tell them: Their budget bill is bad for our health. Call them every day that health matters to you.

#VoteNO

[Melissa Stiles, MD, FAAFP @mmstiles]

@brilewerke Wonderful shots as always @brilewerke !

[Atul Gawande @Atul_Gawande]

I saw firsthand the impact of stop-work-orders/terminations at USAID & now Harvard.

My new @NewYorker piece is on the serious implications for the lives of millions across the world and the US – including for my own family and very possibly your own. 🧵 https://t.co/kxGcqi8mnf

[Cory Booker @CoryBooker]

ON LEADERSHIP

[Sen. Cory Booker @SenBooker]

Let’s get in Good Trouble.

[Craig Spencer MD MPH @Craig_A_Spencer]

Thousands of the best experts at FDA, NIH, and all across HHS are being terminated right now.

These are the people who make sure the medications you and your children take are safe.

These are the people who perform and oversee research on cancer, infant health, and so so so much more.

These are the people who make sure new devices that physicians and patients use are effective.

These are the people who keep workers safe on the job and help prevent devastating injuries for workers all around the country.

These are the people who track what drugs and medications are experiencing shortages so we can adapt.

These are the people who help tackle HIV and other infectious diseases, asthma, lead poisoning, and everything else that makes many Americans sick.

And now, thousands of them are gone.

There is no way this makes Americans healthier.

We will regret this.

[Melissa Stiles, MD, FAAFP @mmstiles]

"We fell down the staircase. And it is devastating. You report that hundreds of thousands of people have seen their treatment interrupted. The majority of those people will die. Elon Musk tweeted yesterday, “I’ve never physically hurt anyone.” And I just disagree with that. "

[Maddie Bender @MaddieOBender]

I wrote about @johngreen for @nytimes https://t.co/Qw5KaQXMWj

[Melissa Stiles, MD, FAAFP @mmstiles]

Join us tomorrow!!!

[Senator Jeff Merkley @SenJeffMerkley]

Isabella gave her all to serve her country—until she was illegally, unjustly fired.

Please listen to her story. I am fighting for Isabella and for federal workers across the country—these firings cannot stand.

[Melissa Stiles, MD, FAAFP @mmstiles]

The @Sugarbush_VT ski report that sticks!

[Sean Casten @SeanCasten]

Respect to Sugarbush. 2/3

[AAFP Advocacy @AAFP_advocacy]

Family physicians know Medicaid is a lifeline for patients and generates lower costs while improving health outcomes. @aafp chapters sent a joint letter to Senate leadership to express concern over proposals to reduce #Medicaid funding and implement restrictions on eligibility. Read the full letter: https://t.co/wqWpNWYjcg

[Thread Reader App @threadreaderapp]

@DBZYuYuYasha @Craig_A_Spencer @DBZYuYuYasha Hi, you can read it here: https://t.co/GNm8Cgskks Have a good day. 🤖

[Melissa Stiles, MD, FAAFP @mmstiles]

Agree! After working almost 30 years in a #rural setting, I saw firsthand the positive effects of telehealth for #primarycare, #mentalheathcare, #consults, and afterhours care- it’s effective, #patientcentered #costeffective care!

[Bill Hartman, MD, PhD @hartman_bill]

Cutting Telehealth options from patient care is a step backwards. For many patients who need care but cannot get to a hospital or clinic, video visits are an acceptable alternative. For many who work during the day, for farmers, for those in rural communities, telehealth makes healthcare accessible. This is a decision that needs more thought!

[Cory Booker @CoryBooker]

I've had the honor of knowing David Brooks for years. I admire him and have been deeply moved, informed, inspired, and bettered by his books and talks.

He was a Republican when I met him. I don't know his party affiliation now. What I do know is he has always been a man of virtue, objective reasoning, pragmatism, wisdom, and invaluable insights.

What he states here is painful and true.

I will continue to fight to stop this awful reality undermining good governance and causing such awful impact on dedicated public servants who are doing vital work for our safety, strength and national security.

[John Frey @jjfrey3MD]

This has to be publicized and treated with outrage by all primary care societies as an assault on some of the most underserved communities in this country. Evil. @AAFP_advocacy @PCPCC @AAMCtoday