Trump administration officials believe they have found a prescription to fix the Centers for Disease Control and Prevention: a four-person team to lead an agency charged with advising Americans on navigating health challenges but has seen a precipitous decline in public trust.
The move comes amid questions about whether the CDC will continue to implement Health and Human Services Secretary Robert F. Kennedy Jr.’s vaccine agenda or back away ahead of the midterm elections, with many voters opposed to Kennedy’s efforts to roll back vaccine policies.
Kennedy and his deputies have recommended that President Donald Trump nominate Erica Schwartz, a former deputy U.S. surgeon general, to lead the Atlanta-based CDC. The decision remained in front of Trump as of Wednesday afternoon.
Officials have also assembled three other senior officials, including a former Walmart health executive, Texas’s current health commissioner and the No. 2 leader of the Food and Drug Administration to round out Schwartz’s planned leadership team.
Trump officials concluded that the CDC had diverted from its original mission of preventing disease and responding to outbreaks, with the agency’s operational challenges and messaging struggles exposed during the coronavirus response, according to four people with knowledge of the administration’s CDC review and staff selection process who spoke on the condition of anonymity to share internal deliberations. The CDC’s past leaders have offered similar diagnoses: Robert Redfield, Trump’s first-term director of the agency, has been a public critic of the CDC’s pace and decision-making; Rochelle Walensky, who led the agency during the Biden administration, also sought to overhaul the CDC before she left the government.
Many public health experts — including some of the candidates that the administration approached to become the CDC’s next leader — believe that Trump’s own actions deeply damaged an organization long considered to be the world’s premier public health agency. A few candidates for CDC director asked for the authority to hire and fire staff and operate with greater independence from Kennedy; they were ultimately not selected, according to three people familiar with the process who spoke on the condition of anonymity to share internal deliberations.
Under Kennedy, the federal government has cut the number of shots routinely recommended to children and directed the CDC to update its website to contradict its longtime guidance that vaccines don’t cause autism, moves that medical and public health experts say conflict with long-standing scientific evidence.
Officials with knowledge of the selection process said that Schwartz — if picked by Trump and confirmed by the Senate — would get a free hand to run the CDC with little interference, assuming she proves up to the task.
“The goal is for her to come in and run her agency,” said one official who spoke on the condition of anonymity to discuss internal operations, pointing to Mehmet Oz, who oversees the Centers for Medicare and Medicaid Services, as a model leader.
After the Trump administration’s initial moves to dramatically shake up the CDC, internal considerations about the agency have changed in recent months amid controversies over Kennedy-directed vaccine changes, said a former senior HHS official who served in Trump’s first term and then in the Biden administration, speaking on the condition of anonymity to discuss personnel decisions. That shift is “increasing the urgency of filling the CDC director role after recent failed attempts,” the former official said. “Doing so will require a capable leader — she is far more qualified than previous nominees — and a willingness to stop sidelining the CDC and let it get back to its job.”
Some experts, including Jeffrey Klausner, an infectious-disease physician and informal adviser to Kennedy, say the underlying politics may be shifting too.
“People recognize that the majority of Americans want safe and effective vaccines, and the politics of anti-vax don’t work,” Klausner said.
Schwartz did not respond to requests for comment.
The White House said in a statement: “Given we have not made any announcements regarding the next CDC director, this all seems quite premature.”
HHS spokesman Andrew Nixon said in a statement: “Secretary Kennedy is committed to the Trump administration’s objective of restoring the CDC to its original mission of fighting infectious disease and reestablishing it as the world’s most trusted guardian of public health.”
Whoever takes the CDC job will inherit legal battles related to Kennedy’s vaccine changes, a growing measles outbreak — with more than 1,700 cases reported this year — and a workforce shaken by months of upheaval.
While the selections have drawn praise from public health experts and former officials, some former CDC officials said the real test will be whether the agency’s scientific work is insulated from political influence. Political appointees with ties to Children’s Health Defense, the anti-vaccine group Kennedy founded, or hold similar views, are still working at or advising HHS.
Debra Houry, the CDC’s former chief medical officer, said she would view the changes as more than window dressing only if political appointees stop presenting partial data at the agency’s federal vaccine advisory panel and allow accurate information to guide clinical recommendations — rather than leaving a confused public to turn elsewhere for guidance.
Houry praised political appointees Jerome Adams, who served as surgeon general, and Brett Giroir, an assistant secretary for health, for their responses during the pandemic under the first Trump administration. Houry was one of three senior officials to resign last summer to protest the ouster of then-CDC Director Susan Monarez, who left after clashing with Kennedy over vaccine policy.
Demetre Daskalakis, who oversaw the CDC’s center on immunizations and respiratory diseases and also resigned in August over Monarez’s departure, said the challenges run deeper than any leadership reshuffle.
“I don’t think there can be a successful executive team at CDC with the level of HHS animus toward public health,” he said.
During the search, candidates with more traditional public health backgrounds sought promises of autonomy to lead the agency and keep science insulated from political influence, according to three people with knowledge of the candidate search who spoke on the condition of anonymity to share internal discussions.
One person contacted about the job did not get a follow-up inquiry after they said they wanted direct access to the president and full hiring and firing authority, similar to that of Oz.
“For whatever reason, CMS has been insulated from the radical changes that the rest of HHS has experienced,” said the person, who spoke on the condition of anonymity to share internal discussions, referring to the CDC, the FDA and the National Institutes of Health.
Leadership turbulence
Trump officials also determined that the problems at the CDC ran deeper than any single leader could address.
Sean Slovenski, a former Walmart executive, is the intended pick to serve in a chief operating officer role; he has operational experience after working at Walmart, the world’s largest private employer. Jennifer Shuford, an infectious-disease physician who is Texas’s health commissioner, has credibility with GOP officials after leading the health department of the nation’s largest state led by Republicans. She would serve in a senior medical role. Sara Brenner, a senior FDA official who served as the agency’s acting commissioner at the start of Trump’s second term, would also move over to the CDC.
Brenner would be expected to work out of Washington, while the other officials would be based in Atlanta.
The selections of Schwartz, Slovenski, Shuford and Brenner came after a roughly six-week process of canvassing candidates, people familiar with the process said. Some candidates, like Joseph Marine, a Johns Hopkins cardiologist, were championed by the Make America Healthy Again advocates. Others, like former Kentucky governor Ernie Fletcher and Mississippi State Health Department chief Daniel Edney, were seen as more traditional public health choices.
The process also reflects the influence of Chris Klomp, a longtime health care entrepreneur whom the White House elevated to be chief counselor of the HHS. Klomp drew on his business-world experience to assemble a team intended to bring different capabilities, skill sets and constituencies, said three people familiar with the selections. Kennedy signed off on Klomp’s selections.
Trump could still opt for another CDC leader, officials said, potentially forcing them to reopen the search process.
Schwartz, a longtime government employee and health care leader, is well-regarded in public health circles. She left government in early 2021 after the incoming Biden administration told her that she would not be selected to serve as acting U.S. surgeon general. In recent months, she has posted videos to Instagram focused on preventing chronic conditions, hyping private Medicare plans and touting the benefits of walking amid MAHA’s focus on addressing chronic diseases.
The selection of Schwartz, a longtime Navy officer and a retired rear admiral in the Commissioned Corps of the U.S. Public Health Service, would mark the third time the administration has tried to put a permanent director in place at the nation’s leading public health agency — an unusually turbulent stretch for an institution responsible for tracking outbreaks, guiding vaccine policy and responding to public health emergencies. The CDC has been without a permanent director for all but 29 days since Trump took office in January 2025.
Midterms, MAHA and morale
As the midterm elections loom and Republicans seek to maintain control of the House and Senate, Trump administration officials have recently downplayed their push to overhaul vaccine policy and instead touted their work on nutrition and drug pricing. Vaccine messaging is seen as too polarizing, officials have said, as some Republicans — including Trump’s chief pollster — warn that skepticism toward vaccine requirements is “politically risky.”
Under Kennedy, the CDC enacted the most sweeping and controversial reduction to the childhood vaccine schedule in decades. Public health and medical experts warned the changes, announced in January, could weaken protections against deadly vaccine-preventable diseases. Kennedy defended the move as protecting children and rebuilding trust in public health, yet he has rarely mentioned vaccines in recent podcast interviews and a national tour to highlight his MAHA initiatives.
Administration officials view MAHA as a key part of a winning midterm coalition, but the movement led by Kennedy comprises varied — and at times competing — priorities focused on pushing healthier foods, tighter regulations over pesticides and eliminating vaccine mandates.
Those tensions have already surfaced in decisions around vaccine policy and advisory panels.
A federal judge last month ruled that members of Kennedy’s handpicked vaccine advisory panel — the Advisory Committee on Immunization Practices — had been improperly appointed, citing a rushed process and lack of expertise. Kennedy had dismissed the panel’s 17 members in June and replaced them with new appointees, several of whom have expressed skepticism about vaccines. The judge also blocked the Trump administration from implementing Kennedy’s sweeping changes to the childhood immunization schedule.
In addition to managing politics, the new CDC leader will have to manage a workforce depleted by departures and, according to current and former officials, shaken by a workplace shooting and political pressures.
Layoffs, resignations and retirements have hollowed out expertise, leaving many programs led by interim officials, while the director’s office is staffed by more than a dozen political appointees, few with medical backgrounds, according to current and former officials.
At an all-hands meeting last month with Jay Bhattacharya, the NIH director who is overseeing the CDC during the search for a permanent agency director, employees voiced frustration recalling an attack at the CDC’s Atlanta headquarters last summer by a gunman who appeared to distrust the coronavirus vaccine.
“We still have bullet holes from the terrorist attack,” one employee said to sustained applause, according to a video obtained by The Washington Post.
“We’re missing a lot of trust in our leadership. … What are you planning to do to rebuild our trust in all of you?” another employee asked, to even longer applause.
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