President Trump has approved a plan to remove FDA Commissioner Marty Makary, though insiders caution the decision isn't final and could still change. Multiple outlets including The Wall Street Journal and Bloomberg confirmed the planned dismissal, which would mark another dramatic shift at the regulatory agency that has faced intense scrutiny under the current administration.

Makary's tenure has been marked by significant conflict, particularly around vape product approvals. Trump recently criticized him for moving too slowly on flavored nicotine products, and after presidential pressure, the FDA authorized menthol, mango, and blueberry flavors from Los Angeles manufacturer Glas on Tuesday. Administration officials viewed Makary as resistant to fulfilling Trump's campaign pledge to protect vaping interests.

If Makary is dismissed, it would deepen the leadership crisis across federal health agencies. The CDC currently lacks a director, there's no surgeon general, and multiple high-level positions remain vacant under Health Secretary Robert F. Kennedy Jr., who has taken an anti-vaccine stance.