The Senate confirmed Dr. Erica Schwartz as the 22nd CDC director on a 51, 44 vote, ending nearly a year without permanent leadership at an agency that has shed more than a quarter of its workforce.
Schwartz, a former deputy surgeon general who oversaw COVID-19 testing during the first Trump administration, cleared the Senate on Wednesday after a confirmation process that saw two prior nominees fall away and a hearing the Washington Examiner described as "turbulent." She is only the second CDC director ever to go through Senate confirmation, a requirement Congress added after the pandemic exposed how much power the position carries.
The vote split along predictable lines. Sen. Tim Kaine of Virginia was the sole Democrat to back Schwartz. Six senators, three from each party, did not vote, including Republicans Ron Johnson of Wisconsin, Thom Tillis of North Carolina, and Mitch McConnell of Kentucky, along with Democrats Ruben Gallego of Arizona, Mazie Hirono of Hawaii, and Amy Klobuchar of Minnesota.
The road to a confirmed director was long. Schwartz was Trump's third nominee for the post in a year and a half, AP News reported. The first pick, Dr. David Weldon, was withdrawn before a hearing ever took place. The second, Susan Monarez, won confirmation but lasted barely a month before HHS Secretary Robert F. Kennedy Jr. fired her.
Monarez's ouster became the central flashpoint of Schwartz's own confirmation hearing. Monarez told the Senate Health, Education, Labor, and Pensions Committee that she refused to follow a Kennedy directive to preapprove changes to the childhood vaccine schedule before the CDC's Advisory Committee on Immunization Practices could meet. Kennedy removed her shortly afterward.
Democrats pressed Schwartz on whether she would stand up to Kennedy if faced with a similar order. She told the committee she did not believe Kennedy would make such a request of her, an answer that did little to satisfy her critics on the left but apparently reassured enough Republicans to move the nomination forward.
Sen. Bill Cassidy, the Louisiana Republican, offered a more direct endorsement. As the New York Post reported, Cassidy said during the process:
"I'm confident that she knows what she is doing and will stand against those who do not."
Sen. Bernie Sanders, the Vermont independent who caucuses with Democrats, framed the stakes differently. Sanders asked during the proceedings whether the administration would have leaders willing to resist what he called anti-science positions, a clear reference to Kennedy's well-documented skepticism of vaccine policy.
Schwartz inherits a CDC that looks nothing like the one she left when she served as deputy surgeon general from 2019 to 2021. The agency has lost more than 3,000 employees, over one quarter of its workforce, through layoffs and resignations, Breitbart reported. The revolving door at the top only compounded the institutional instability.
For nearly a year, the CDC operated without a Senate-confirmed director. That gap, created by Monarez's firing and the withdrawal of Weldon's nomination, left the agency adrift during a period of significant restructuring under Kennedy's HHS. The confirmation process itself, which mirrored other drawn-out Senate battles over Trump nominees, tested whether any candidate could thread the needle between the administration's reform agenda and the public health establishment's expectations.
Trump nominated Schwartz in April, according to Just The News, to replace acting director Dr. Jay Bhattacharya. Her background set her apart from other officials drawn from the Make America Healthy Again movement that Kennedy has championed. Schwartz built her career in the Public Health Service Commissioned Corps, the uniformed service that staffs federal health agencies, before rising to deputy surgeon general.
Public health groups offered guarded support. The National Public Health Coalition said Schwartz now "needs to prove that her leadership will serve science and not the whims of politicians." Dr. Georges Benjamin of the American Public Health Association struck a similar note, calling for "stability, experienced leadership and a steadfast commitment to science" after what he described as two years of turmoil.
The near-party-line result was no surprise. Democrats spent the confirmation hearing trying to extract guarantees that Schwartz would resist Kennedy's influence on vaccine policy, guarantees she declined to give in the blunt terms they wanted. Her answer that she did not expect Kennedy to push preapproval of vaccine schedule changes was careful rather than confrontational, and it left most Senate Democrats unconvinced.
But Democrats lacked the votes to stop her. And the broader pattern of contentious Senate confirmation fights across the administration has shown that Republicans, even when individual members harbor reservations, have generally held together on Trump's nominees.
Kaine's crossover vote stood out. The Virginia Democrat offered no public explanation in the available reporting, but his willingness to break ranks underscored that Schwartz's traditional public health credentials carried weight even across the aisle, whatever misgivings remained about the chain of command above her.
The confirmation also came against a backdrop of heated confirmation hearings that have defined this Congress. Schwartz's hearing before the HELP Committee drew pointed questions from both parties, though the specific exchanges that earned the proceeding the label "turbulent" were not detailed in available reporting.
The open question hanging over Schwartz's tenure is straightforward: what happens if Kennedy asks her to do what Monarez refused? Schwartz told senators she did not expect the request. That is not the same as saying she would refuse it.
Kennedy's directive to Monarez, to preapprove changes to the childhood vaccine schedule before the CDC's own advisory panel could weigh in, struck at the heart of how vaccine policy has been made for decades. The Advisory Committee on Immunization Practices, a panel of outside medical experts, has traditionally reviewed evidence and made recommendations that the CDC director then accepts or rejects. Kennedy's approach, as Monarez described it, would have reversed that order, putting political leadership ahead of the expert review.
Schwartz's supporters point to her career in uniformed public health service and her hands-on management of COVID-19 testing as evidence she will not be a rubber stamp. As one group of public health experts told reporters, Schwartz was notably "the choice of Trump and not Kennedy", a distinction that may matter if the two principals diverge on policy.
Whether that distinction holds up under pressure is the test ahead. The CDC has been caught in the crosscurrents of broader administration power struggles, and Schwartz will have to rebuild an agency that has lost thousands of employees while navigating a boss at HHS who has made no secret of his desire to reshape federal health policy from the top down.
The CDC finally has a confirmed director. Now the country gets to find out whether that director has the independence the job demands, or whether the title is all that changed.