The Senate voted 51, 44 to confirm Dr. Erica Schwartz as the new CDC director, installing the agency's first permanent leader in nearly a year after a stretch of firings, withdrawals, and workforce losses.
Schwartz, who served as deputy surgeon general during President Trump's first term, cleared the Senate on Wednesday in a mostly party-line vote. Sen. Tim Kaine of Virginia was the lone Democrat to cross over and support her nomination. The Hill reported that Schwartz becomes the administration's third pick for the job in eighteen months, and the first to actually take office.
She inherits an agency that has shed more than a quarter of its workforce through layoffs and resignations, faces an ongoing measles outbreak, and is contending with the largest-ever outbreak of cyclosporiasis in the United States. The CDC has operated under acting leadership since last August, when Susan Monarez was fired after less than a month on the job. Monarez described her dismissal as the result of a clash with HHS Secretary Robert F. Kennedy Jr. over his attempts to roll back childhood vaccines.
The confirmation almost didn't happen. Sen. Bill Cassidy of Louisiana, the Republican chairman of the Senate health committee, raised pointed concerns during Schwartz's July hearing. He wanted a CDC director willing to defend childhood immunization against what he called misinformation, and he wasn't sure Schwartz fit the bill.
Cassidy told colleagues at the hearing that Schwartz gave him "not quite the direct answer" he had been hoping for on whether she would push back against Kennedy's vaccine skepticism. He put the matter bluntly:
"We need a CDC director that will actually stand up to crazy, s***** things being said that undermine faith in immunization."
What moved Cassidy off the fence was a concrete change: the CDC modified a page on its website addressing vaccines and autism to address his objections. After that revision, Cassidy announced his support. His vote proved critical to clearing the 51-vote threshold.
In a statement backing the nomination, Cassidy said he was now satisfied with Schwartz's credentials: "I'm confident that she knows what she is doing and will stand against those who do not."
That kind of intra-party negotiation has become a recurring feature of Senate confirmations. In recent months, holdout Republican senators have flipped to back other Trump nominees after extracting specific commitments, a pattern that reflects a caucus willing to push for accountability before falling in line.
Schwartz told senators at her July hearing that she would lead with integrity and "never compromise on the science." She publicly supported childhood vaccines. But she largely sidestepped questions about whether she would directly challenge Kennedy's policies, and that evasion gave Democrats their talking point.
Sen. Bernie Sanders of Vermont led the opposition. At the hearing, he framed the stakes in stark terms:
"The issue at hand is not complicated. Will we have people in the Trump administration who have the guts to stand up to people who are antiscience and into conspiracy theories?"
Sanders voted no. So did every other Democrat except Kaine. The Washington Examiner reported that several senators from both parties missed the vote entirely, 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.
Kaine's decision to break ranks drew attention. It fits a broader pattern of individual Democrats occasionally crossing party lines on Trump nominations, even as Democratic leaders work to hold their caucus together amid growing internal fractures.
Schwartz's path to the job was cleared only after two prior attempts fell apart. Dave Weldon, a former Republican congressman from Florida and the administration's first choice, withdrew his nomination after it became clear he lacked the votes. Questions about his preparedness and views on vaccination doomed his candidacy before he ever faced a committee vote.
Monarez, the second director, lasted barely weeks before her firing last August. The administration then turned to Schwartz, nominating her in April 2026. Just The News reported that Schwartz was tapped to replace acting director Dr. Jay Bhattacharya, who had been filling the gap. During Trump's first term, Schwartz oversaw COVID-19 testing operations as deputy surgeon general from 2019 to 2021.
The revolving door at the CDC's top has not been without cost. The agency lost more than 3,000 employees during the turbulence, AP News reported, and outside public health groups have urged the new director to restore stability. Dr. Georges Benjamin of the American Public Health Association put it plainly: "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 similar note but with a sharper edge, saying Schwartz "needs to prove that her leadership will serve science and not the whims of politicians."
Senate dynamics on confirmations have been volatile all year. Two Senate Democrats recently broke ranks to advance Trump's Federal Reserve nominee, and party-line fights have erupted over everything from the attorney general to IRS policy. The Schwartz vote followed the same template: a narrow margin, one crossover, and weeks of behind-the-scenes negotiation before the final roll call.
Whatever the political drama surrounding her confirmation, Schwartz faces an immediate operational challenge. The CDC is tracking an ongoing measles outbreak and managing the largest-ever U.S. outbreak of cyclosporiasis, a parasitic illness typically linked to contaminated food or water. She takes over an agency that has operated without confirmed leadership since last summer and has seen its ranks thinned by more than a quarter.
Schwartz told senators she would not bend on science. The question now is whether she can rebuild an agency that has been battered by leadership churn, workforce losses, and political crossfire, while also navigating the policy priorities of an HHS secretary whose views on vaccines have made him a lightning rod.
Even some Republicans who voted yes made clear their support was conditional. Cassidy's backing came only after the CDC changed its website language on vaccines and autism. That kind of leverage suggests the new director will face scrutiny from her own side, not just from Democrats eager to paint the administration as hostile to public health.
In a Senate where members of both parties have shown a willingness to cross lines when they feel the stakes warrant it, Schwartz's confirmation is less a vote of confidence than a vote of necessity. The agency needed a permanent leader. She was the one who could get the votes.
The CDC doesn't need another placeholder. It needs a director who can run the agency, defend sound science, and do both without waiting for permission from politicians on either side. Schwartz says she's that person. The outbreaks, the staffing crisis, and the next Senate hearing will tell the country whether she's right.