https://www.cidrap.umn.edu/childhoo...r-faces-first-major-test-she-even-begins-work
New CDC director faces first major test before she even begins work
Liz Szabo, MA
Today at 9:41 a.m.
Childhood Vaccines
Public Health
But the biggest test for the CDC’s new director, Erica Schwartz, MD, MPH, JD, has arrived before her first day on the job.
Schwartz, who has been confirmed but not sworn in, will have to decide how to respond to President Donald Trump’s executive order, issued August 10, calling for children to receive fewer life-saving immunizations.
The executive order is the Trump administration’s second attempt this year to slash the number of vaccines children receive. An earlier policy change announced by the acting CDC director in January, which would have slashed the number of recommended immunizations, has been blocked by a federal judge.
A litmus test
The CDC director typically signs off on vaccine recommendations, which are usually written by an independent panel of experts after reviewing medical evidence.
The CDC’s first Senate-confirmed director, Susan Monarez, PhD, was fired after less than one month on the job for refusing to rubber-stamp vaccine policies from Health and Human Services Secretary Robert F. Kennedy Jr.
The agency has since been without a permanent director.
Public health advocates say they’re waiting to see whether Schwartz will defend the current immunization schedule, which protects children against 18 potentially life-threatening diseases, or if she will agree to recommend only the 11 vaccines endorsed by Trump’s order.
“Now that she’s confirmed, what is she going to do about this executive order that is politically motivated and not science-based?” asked Bruce Gellin, MD, MPH, who led the Department of Health and Human Services National Vaccine Program Office from 2002 to 2017.
“How she handles this will be a litmus test for how her tenure goes as a CDC director,” Gellin said.
Questions about where Schwartz stands
At Schwartz’s confirmation hearing, she testified that she supports vaccines and “will never betray the science.”
Schwartz told the Senate committee that her “first priority will be restoring trust in public health through radical transparency and unwavering scientific integrity. As CDC director, my sacred responsibility is to provide the American people with public health guidance that is clear, honest, and evidence-based.”
How she handles this will be a litmus test for how her tenure goes as a CDC director.
At the hearing, Senator Bernie Sanders, a Vermont Independent, asked Schwartz if she would be willing to defy orders from Kennedy that went against science or could harm public health.
When Schwartz replied, “I do not believe that the president or the secretary would ever do what you just mentioned,” several senators accused her of being evasive.
Trump’s executive order gives Schwartz a chance to answer Sanders’ question.
Executive orders from the president are akin to an all-staff memo from a company CEO. While they are binding for administration employees, they carry no legal weight for those outside the federal government, including doctors, states and medical organizations. New York state health officials have already said they will not change their vaccine policy.
“If she signs on to change the vaccine schedule based on an executive order, then you know her path,” said Demetre Daskalakis, MD, MPH, who led the CDC’s National Center for Immunization and Respiratory Diseases until resigning almost a year ago. “She will reveal herself.”
Addressing Schwartz, Gellin added, “Here's your chance to prove what your priorities are.”
If Schwartz refuses to comply with Trump’s executive order, “she could set the record for the shortest tenure of a Senate-confirmed CDC director.”
She has to decide beforehand which lines she can and can't cross.
Public health advocates are urging Schwartz to defend vaccines.
“The position of director of the CDC isn't about the the job; it's about protecting the health of Americans,” said Daskalakis, now the chief medical officer at Callen-Lorde Community Health Center in New York. “If given the choice between standing up for science and your job, you need to stand up for science.”
“If I were her, I would decline the directorship,” Daskalakis said. “I would be like, ‘I'm sorry you created this executive order that circumvents the scientific process at CDC. I'm not able to accept this role.’”
A thinner, traumatized CDC
Many CDC employees feel traumatized today, Daskalakis said.
Trump issued the executive order just two days after the anniversary of a deadly attack on the CDC’s Atlanta headquarters.
The position of director of the CDC isn't about the the job; it's about protecting the health of Americans.
On August 8, 2025, a gunman fired 500 rounds into CDC offices, killing a security guard before being fatally shot by police. The gunman blamed the COVID-19 vaccine for his medical problems.
The CDC has lost one quarter of its staff since President Trump took office, leaving the agency with fewer resources to respond to the largest measles epidemic in 35 years and a record-setting outbreak of food poisoning due to the Cyclospora parasite, as well as international crises such as the Ebola outbreak in central Africa.
President Trump’s proposed budget would slash the agency’s budget next year by 40%.
The need to lead with science
Schwartz’s response to the executive order could further demoralize CDC staff, Gellin said.
If public health employees “don't think their leader is going to be backing the science, then the morale is not going to improve,” Gellin said. “If their leader doesn't lead with the science, then why would America trust the CDC to be science-based?”
When Debra Houry, MD, MPH, was at the CDC, she thought carefully about what would be the “red line that you cannot cross,” and encouraged the leaders she supervised to do the same.
Schwartz “has to figure this out for herself,” said Houry, who resigned as the CDC’s chief medical officer after Monarez was fired.
“She has to decide beforehand which lines she can and can't cross,” Houry said. “When you're in the middle of something, it's much harder to navigate, and the lines become fuzzier.”
In a column for Medpage Today, former CDC director Mandy Cohen, MD, MPH, wrote that the “CDC's scientific credibility isn't director Schwartz's to spend. It belongs to the American people, and protecting it is a duty of the job.”
In the column, published four days before Trump’s executive order, Cohen wrote, “I hope she's never put in this position.”
New CDC director faces first major test before she even begins work
Liz Szabo, MA
Today at 9:41 a.m.
Childhood Vaccines
Public Health
All leaders of the Centers for Disease Control and Prevention (CDC) face tough challenges.But the biggest test for the CDC’s new director, Erica Schwartz, MD, MPH, JD, has arrived before her first day on the job.
Schwartz, who has been confirmed but not sworn in, will have to decide how to respond to President Donald Trump’s executive order, issued August 10, calling for children to receive fewer life-saving immunizations.
The executive order is the Trump administration’s second attempt this year to slash the number of vaccines children receive. An earlier policy change announced by the acting CDC director in January, which would have slashed the number of recommended immunizations, has been blocked by a federal judge.
A litmus test
The CDC director typically signs off on vaccine recommendations, which are usually written by an independent panel of experts after reviewing medical evidence.
The CDC’s first Senate-confirmed director, Susan Monarez, PhD, was fired after less than one month on the job for refusing to rubber-stamp vaccine policies from Health and Human Services Secretary Robert F. Kennedy Jr.
The agency has since been without a permanent director.
Public health advocates say they’re waiting to see whether Schwartz will defend the current immunization schedule, which protects children against 18 potentially life-threatening diseases, or if she will agree to recommend only the 11 vaccines endorsed by Trump’s order.
“Now that she’s confirmed, what is she going to do about this executive order that is politically motivated and not science-based?” asked Bruce Gellin, MD, MPH, who led the Department of Health and Human Services National Vaccine Program Office from 2002 to 2017.
“How she handles this will be a litmus test for how her tenure goes as a CDC director,” Gellin said.
Questions about where Schwartz stands
At Schwartz’s confirmation hearing, she testified that she supports vaccines and “will never betray the science.”
Schwartz told the Senate committee that her “first priority will be restoring trust in public health through radical transparency and unwavering scientific integrity. As CDC director, my sacred responsibility is to provide the American people with public health guidance that is clear, honest, and evidence-based.”
How she handles this will be a litmus test for how her tenure goes as a CDC director.
At the hearing, Senator Bernie Sanders, a Vermont Independent, asked Schwartz if she would be willing to defy orders from Kennedy that went against science or could harm public health.
When Schwartz replied, “I do not believe that the president or the secretary would ever do what you just mentioned,” several senators accused her of being evasive.
Trump’s executive order gives Schwartz a chance to answer Sanders’ question.
Executive orders from the president are akin to an all-staff memo from a company CEO. While they are binding for administration employees, they carry no legal weight for those outside the federal government, including doctors, states and medical organizations. New York state health officials have already said they will not change their vaccine policy.
“If she signs on to change the vaccine schedule based on an executive order, then you know her path,” said Demetre Daskalakis, MD, MPH, who led the CDC’s National Center for Immunization and Respiratory Diseases until resigning almost a year ago. “She will reveal herself.”
Addressing Schwartz, Gellin added, “Here's your chance to prove what your priorities are.”
If Schwartz refuses to comply with Trump’s executive order, “she could set the record for the shortest tenure of a Senate-confirmed CDC director.”
She has to decide beforehand which lines she can and can't cross.
Public health advocates are urging Schwartz to defend vaccines.
“The position of director of the CDC isn't about the the job; it's about protecting the health of Americans,” said Daskalakis, now the chief medical officer at Callen-Lorde Community Health Center in New York. “If given the choice between standing up for science and your job, you need to stand up for science.”
“If I were her, I would decline the directorship,” Daskalakis said. “I would be like, ‘I'm sorry you created this executive order that circumvents the scientific process at CDC. I'm not able to accept this role.’”
A thinner, traumatized CDC
Many CDC employees feel traumatized today, Daskalakis said.
Trump issued the executive order just two days after the anniversary of a deadly attack on the CDC’s Atlanta headquarters.
The position of director of the CDC isn't about the the job; it's about protecting the health of Americans.
On August 8, 2025, a gunman fired 500 rounds into CDC offices, killing a security guard before being fatally shot by police. The gunman blamed the COVID-19 vaccine for his medical problems.
The CDC has lost one quarter of its staff since President Trump took office, leaving the agency with fewer resources to respond to the largest measles epidemic in 35 years and a record-setting outbreak of food poisoning due to the Cyclospora parasite, as well as international crises such as the Ebola outbreak in central Africa.
President Trump’s proposed budget would slash the agency’s budget next year by 40%.
The need to lead with science
Schwartz’s response to the executive order could further demoralize CDC staff, Gellin said.
If public health employees “don't think their leader is going to be backing the science, then the morale is not going to improve,” Gellin said. “If their leader doesn't lead with the science, then why would America trust the CDC to be science-based?”
When Debra Houry, MD, MPH, was at the CDC, she thought carefully about what would be the “red line that you cannot cross,” and encouraged the leaders she supervised to do the same.
Schwartz “has to figure this out for herself,” said Houry, who resigned as the CDC’s chief medical officer after Monarez was fired.
“She has to decide beforehand which lines she can and can't cross,” Houry said. “When you're in the middle of something, it's much harder to navigate, and the lines become fuzzier.”
In a column for Medpage Today, former CDC director Mandy Cohen, MD, MPH, wrote that the “CDC's scientific credibility isn't director Schwartz's to spend. It belongs to the American people, and protecting it is a duty of the job.”
In the column, published four days before Trump’s executive order, Cohen wrote, “I hope she's never put in this position.”