Senate health committee advances Erica Schwartz, M.D., J.D., M.P.H., for CDC director

The Senate Health, Education, Labor and Pensions Committee voted 13-10 on July 30 to advance the nomination of Erica Schwartz, M.D., J.D., M.P.H., as director of the U.S. Centers for Disease Control and Prevention (CDC), clearing the way for a full Senate vote on a permanent director the agency has gone without for all but roughly one month of President Donald Trump's second term.

Every Republican on the committee backed Schwartz, joined by Sen. Tim Kaine (D-Virginia). The rest of the Democratic caucus, including ranking member Bernie Sanders (I-Vermont), voted against her. Trump nominated Schwartz in April, his third pick for the job in less than two years, and the objection Thursday was the one that dominated her confirmation hearing two weeks ago: whether she would refuse an order from Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. that ran against the evidence.

The practical stake for primary care practices sits downstream of that question. The CDC director signs off on recommendations from the Advisory Committee on Immunization Practices, and those recommendations determine which vaccines commercial plans must cover without cost sharing and what is available through the Vaccines for Children program. Kennedy fired all 17 sitting ACIP members last year and replaced them with his own appointees, then revised the childhood immunization schedule. Whoever holds the director's job decides whether the panel's output becomes CDC policy.

Cassidy's reversal

Schwartz appeared to be in trouble after the hearing, where committee Chairman Bill Cassidy, M.D. (R-Louisiana), a gastroenterologist who has repeatedly broken with Kennedy on vaccine policy, pressed her several ways on political interference and got a version of the same answer each time. She would follow the science, she said, and did not believe the secretary would ask her to do otherwise.

Cassidy announced his support a week later, tying it to revisions HHS made to the CDC's vaccines and autism webpage. He said he was "confident that she knows what she is doing and will stand against those who do not." The page still stops short of the agency's longstanding position, now saying scientists have not identified the root causes of autism. There is no scientific evidence that vaccines cause autism.

The committee also advanced Sean Kaufman, M.P.H., for assistant secretary for preparedness and response on a 12-11 party-line vote, with Cassidy providing the deciding vote after criticizing Kaufman's past comments on the hepatitis B birth dose and mRNA vaccines. Cassidy said he had secured assurances from senior HHS officials that Kaufman would have no role in vaccine policy, along with personnel changes and expanded oversight. "I've received these reassurances," Cassidy said. "If they are not held, they will be future leverage points for this committee over future appointees."

The agency she would inherit

Schwartz, a retired rear admiral in the U.S. Public Health Service Commissioned Corps who served as deputy surgeon general in the first Trump administration and as chief medical officer of the U.S. Coast Guard, holds medical and law degrees and a master's in public health. She would take over an agency that has lost more than 3,000 employees since early 2025, upward of a quarter of its workforce, and has been run on an acting basis by National Institutes of Health Director Jay Bhattacharya, M.D., since Susan Monarez, Ph.D., was fired less than a month into her tenure.

She would also inherit the worst measles year since 1991. The CDC counted 2,318 confirmed cases as of July 23, already past the 2,289 recorded in all of 2025, with 93% occurring among people who were unvaccinated or whose status was unknown. Childhood vaccination rates have slipped below the 95% coverage needed to interrupt transmission, and international health officials meet in November to determine whether the United States has lost its measles elimination status.

The full Senate is not expected to take up either nomination before the August recess, which puts a final confirmation vote as late as September.