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An escalating conflict over an influential vaccine committee was one of the final straws that led to the firing of Centers for Disease Control and Prevention Director Susan Monarez and the exodus of other highly regarded top officials.

Health Secretary Robert F. Kennedy Jr. had repeatedly undermined the agency’s independent Advisory Committee on Immunization Practices, firing the committee’s members and appointing new members , including vaccine skeptics.

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Early Wednesday, Monarez suggested to Dr. Richard Besser that she was going to be forced to sign off on new vaccine recommendations.

“She said there were two things she would never do in the job,” said Besser, a former acting C

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