The Senate voted 51, 44 to confirm Dr. Erica Schwartz as the 22nd director of the Centers for Disease Control and Prevention, ending a turbulent stretch that saw two failed nominees and months of acting leadership at the Atlanta-based agency.
Schwartz, 54, is the third person President Trump nominated for the job in roughly 18 months, and the first to survive the full confirmation process intact. She holds both medical and law degrees, served as deputy surgeon general during Trump's first term, and held a leadership post at the U.S. Coast Guard. The New York Post reported that public health experts expressed cautious optimism about her credentials, even as the agency she inherits has shed more than 3,000 employees, over one-quarter of its workforce, through layoffs and resignations.
The vote fell largely along party lines. The Washington Examiner reported that only one Democrat, Sen. Tim Kaine, crossed over to support her. Five senators did not vote.
The road to a confirmed CDC director has been anything but smooth. Trump's first pick, former Florida congressman Dr. David Weldon, never got a hearing. His scheduled appearance before the Senate Health, Education, Labor and Pensions Committee was canceled in March 2025, roughly an hour before it was set to begin. Weldon said at the time that he had been told not enough senators were willing to vote for him.
Trump's second nominee, Susan Monarez, cleared the Senate, only to be ousted from the job in less than a month. Trump administration officials said she was not aligned with the president's agenda. The Washington Examiner added that Monarez was fired by HHS Secretary Robert F. Kennedy Jr. after she refused to pre-approve changes to the childhood vaccine schedule.
After Monarez's departure, a series of HHS officials rotated through as acting CDC director. The agency has been without a Senate-confirmed leader for nearly a year, a vacancy that coincided with plummeting morale and a front office staffed, in the words of the reporting, by political appointees with little or no training in medicine or public health.
The administration has faced similar confirmation struggles across other agencies, with nominees stalling or drawing resistance from within the president's own party.
The sharpest questions at Schwartz's HELP Committee hearing last month came not from Democrats but from the panel's own chairman, Sen. Bill Cassidy of Louisiana. Cassidy, a physician himself, pressed Schwartz on whether she would stand up to Kennedy on vaccine policy, a question that carried obvious weight given Monarez's fate.
Fox News reported that Cassidy told colleagues on the Senate floor:
"We need a CDC director that will actually stand up to crazy, stupid things being said that undermine faith in immunization."
Cassidy ultimately voted to confirm Schwartz, saying he had spoken with her after the hearing and with others who knew her, and that those conversations gave him confidence in her ability to lead the agency. He told the Senate he was satisfied.
"I'm confident that she knows what she is doing and will stand against those who do not."
Schwartz herself addressed the central concern directly. She told the Senate during her confirmation hearing that she did not believe Kennedy would ask her to do something along the lines of what led to Monarez's firing, a statement that amounted to a public bet on her own independence.
The White House has had to lean hard on the Senate to move several nominees forward this year, and Schwartz's confirmation counts as a concrete win for the administration on that front.
Whatever independence Schwartz brings to the job, she takes over an agency in rough shape. The CDC has lost more than 3,000 employees since Trump returned to office, a figure that represents over one-quarter of the workforce. Morale has cratered. The succession of temporary leaders left the agency without a clear chain of command on policy for months at a stretch.
Her confirmation also comes against a backdrop of active public health concerns. Fox News noted that the vote took place as a Cyclospora outbreak linked to contaminated lettuce was spreading across the country and measles cases were rising, the kind of bread-and-butter infectious disease work the CDC exists to handle.
Dr. Georges Benjamin of the American Public Health Association framed the stakes plainly. AP News reported his statement:
"With all the turmoil of the past two years, the CDC desperately needs stability, experienced leadership and a steadfast commitment to science."
The National Public Health Coalition struck a more cautious note, saying Schwartz "needs to prove that her leadership will serve science and not the whims of politicians."
The CDC is not the only federal health agency operating without permanent leadership. The positions of U.S. surgeon general and FDA commissioner also remain vacant, gaps that leave major pieces of the nation's public health infrastructure under acting or interim management.
The pattern mirrors what has played out elsewhere in the federal government, where narrow Senate confirmation votes have become the norm for the administration's nominees.
One detail that has drawn less attention than it deserves: Schwartz was Trump's pick, not Kennedy's. The distinction matters because Kennedy, as HHS secretary, oversees the CDC and other federal health agencies. His well-documented skepticism of vaccines preceded his appointment and has shaped the political environment around every CDC leadership decision since.
Trump nominated Schwartz in April after the Weldon and Monarez episodes made clear that the CDC director slot had become one of the most difficult confirmations in the administration's portfolio. That the president chose someone with mainstream medical credentials, a former deputy surgeon general who oversaw COVID-19 testing during the pandemic, rather than deferring to Kennedy's orbit, suggests the White House wanted a nominee who could survive Senate scrutiny.
Whether Schwartz can hold that ground once she is inside the building, answering to Kennedy's department, is the question that Cassidy raised and that no confirmation vote can settle. The Senate has done its part on several contested nominations this year. Now the real test begins.
The CDC has spent nearly a year drifting without a confirmed director while losing thousands of employees and facing active disease outbreaks. Schwartz has the credentials. The question is whether the people above her will let her use them.