The Senate on Wednesday confirmed Dr. Erica Schwartz to lead the Centers for Disease Control and Prevention, making her the health agency’s first permanent director in roughly a year.

The 51-44 vote was largely split along party lines, with Republicans in favor and Democrats against, though Sen. Tim Kaine, D-Va., voted with Republicans. Kaine said last month that he regretted voting against the previous CDC director Susan Monarez and had apologized to her.

Schwartz served as deputy surgeon general during President Donald Trump’s first term; before that, she was a Navy physician and chief medical officer in the Coast Guard.

A series of acting directors have led the CDC since August 2025, when Health Secretary Robert F. Kennedy Jr. fired Monarez after 29 days in the role. Until Wednesday, that was the only period in Trump’s second term when the CDC had a permanent director. Trump initially picked Dr. Dave Weldon, a former Republican congressman, for the role in 2024, but pulled the nomination after it became clear that Weldon did not have enough support. Weldon faced scrutiny at the time over past comments about vaccines.

Schwartz takes over from Jay Bhattacharya, who has helmed the agency since February while also directing the National Institutes of Health. Federal law required the Trump administration to nominate a permanent director in March, but Schwartz’s nomination came a month after the deadline.

As CDC director, Schwartz will oversee the country’s public health response, including approving vaccine recommendations and helping contain disease outbreaks. She will inherit a measles crisis — the U.S. has recorded its highest number of cases in 35 years — and a growing outbreak of cyclosporiasis, a parasitic infection that has been linked to shredded iceberg lettuce. Schwartz will also have to contend with rising rates of vaccine hesitancy, which some experts say Kennedy’s rhetoric and policies have exacerbated.

Though Schwartz was widely seen as a conventional pick for CDC director, some public health experts said she didn’t do enough at a Senate hearing last month to distance herself from some of Kennedy’s more controversial stances. Schwartz said at the hearing, for example, that vaccines are safe and effective, but she said she was unaware of some of Kennedy’s vaccine policy changes and dodged questions about whether she supported them.

Sen. Bill Cassidy, R-La., who chairs the Health, Education, Labor and Pensions Committee and is a doctor, accused Schwartz during her appearance of evading answers to his questions about whether she would challenge Kennedy if he tried to undermine science.

“We need a CDC director that will actually stand up to crazy, stupid things being said that undermine faith in immunization,” Cassidy said.

Cassidy agreed to support Schwartz’s nomination last month, he said, after speaking with her again and talking to those “who served with her and know her well.”

“I am confident that she knows what she is doing and will stand against those who do not,” he said at a HELP committee meeting July 23.

Cassidy added that “as a sign of good faith,” the Department of Health and Human Services recently modified a CDC webpage about vaccines and autism. Since November, the page has claimed that studies haven’t ruled out a link between childhood vaccines and autism, ignoring decades of research that shows no association. That claim has not been removed, but the page now also says that scientists have not identified the root causes of autism.

The National Public Health Coalition, an advocacy group of former CDC employees that has been critical of Kennedy, said in a statement last month that it would not support Schwartz’s nomination based on her performance at the hearing.

“The public needed to hear clear commitments about how she would protect CDC guidance from political pressure. Too often, her stated commitments were incomplete, vague, or missing,” the group said.

Emily Hilliard, an HHS spokesperson, told NBC News last month that Schwartz’s “record speaks for itself.”

“Claiming that Dr. Schwartz was evasive because she declined to speculate on policy decisions outside the scope of her nomination is simply political theater,” she said in a statement.

Kennedy, who has a history of anti-vaccine activism, altered the childhood immunization schedule in January to recommend fewer universal shots to all children. (A federal judge blocked the change in March.) Last year, he fired the members of the CDC’s vaccine advisory panel and replaced them with a group of his choosing, many of whom are skeptical of Covid shots. Monarez testified before Congress last year that Kennedy ousted her for refusing to blindly approve guidance from that panel.

Schwartz said at the hearing last month that Kennedy would never ask her to commit in advance to approve particular vaccine recommendations.

“As CDC director, my sacred responsibility is to provide the American people with public health guidance that is clear, honest and evidence-based,” she said. “I will never betray the science.”