Filling CDC, Surgeon General Roles Proves Challenging for Biden Administration

Vaccine skepticism from HHS Secretary Kennedy hampers efforts to install permanent public health leadership.

Apr. 3, 2026 at 6:44am

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A dimly lit, cinematic painting of an empty government office space, with desks and chairs arranged in a sterile, bureaucratic manner. The room is bathed in warm, diagonal sunlight, creating deep shadows that convey a sense of uncertainty and vacancy.The prolonged absence of permanent public health leadership at the CDC and Surgeon General's office leaves the country vulnerable to disease outbreaks and other serious threats.Atlanta Today

The Biden administration has struggled to fill key public health roles at the Centers for Disease Control and Prevention (CDC) and the Office of the Surgeon General, leaving the country vulnerable to public health threats. The CDC has been without a permanent director for nearly seven months since the previous director was fired by Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., who has pushed an anti-vaccine agenda. The surgeon general post has also remained vacant for nearly a year after President Trump's nominee, Dr. Casey Means, faced skepticism from lawmakers over her views on vaccines. Former HHS officials warn the lack of permanent leadership at these agencies is undermining the government's ability to respond to disease outbreaks and provide real-time public health guidance.

Why it matters

The absence of permanent leadership at the CDC and the surgeon general's office comes at a critical time, with the country facing ongoing public health challenges like a surge in measles cases and a recent E. coli outbreak. Without a CDC director who can make key decisions like adopting vaccine recommendations, the government's ability to protect public health is severely constrained. The controversy over the surgeon general nomination also highlights the tensions between the administration's public health priorities and the anti-vaccine views of HHS Secretary Kennedy.

The details

The CDC has been without a permanent director since August 2025, when President Biden's first nominee, Susan Monarez, was fired by Secretary Kennedy after just 28 days in the role. Since then, the agency has been led by a series of acting directors, including most recently Dr. Jay Bhattacharya of the National Institutes of Health (NIH). However, Bhattacharya's authority has been limited since the CDC director's 210-day statutory limit for temporary leadership expired last week. The surgeon general post has also remained vacant since President Trump nominated Dr. Casey Means nearly 11 months ago, but her confirmation has stalled in the Senate amid concerns over her views on vaccines.

  • In August 2025, President Biden's CDC director nominee Susan Monarez was fired by HHS Secretary Kennedy after just 28 days in the role.
  • In February 2026, Dr. Jay Bhattacharya of the NIH became the CDC's acting director.
  • Last week, the CDC director's 210-day statutory limit for temporary leadership expired.

The players

Robert F. Kennedy Jr.

The current Health and Human Services (HHS) Secretary, who has pushed an anti-vaccine agenda that has constrained the administration's efforts to fill key public health roles.

Susan Monarez

President Biden's first nominee for CDC director, who was fired by Secretary Kennedy after just 28 days in the role.

Dr. Jay Bhattacharya

The current acting director of the CDC, who has been limited in his authority since the 210-day statutory limit for temporary leadership expired last week.

Dr. Casey Means

President Trump's nominee for Surgeon General, whose confirmation has stalled in the Senate amid concerns over her views on vaccines.

Dr. Jerome Adams

The former Surgeon General under the Trump administration, who argues the lack of permanent leadership at the CDC and Surgeon General's office is undermining the government's ability to respond to public health threats.

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What they’re saying

“The absence of a full-time CDC director creates dangerous gaps in authority and makes Americans less safe. The director is responsible for leading the response to disease outbreaks, final vaccine recommendations, interacting with states, localities, Congress, and international partners, and providing strategic direction.”

— Tom Frieden, Former CDC Director under the Obama administration

“We are much less able to respond to outbreaks like measles when they occur without a CDC director able to say on a moment's notice, 'Yes, send 10 officers to Texas right now to help respond to this measles outbreak.' When you don't have a director, you lose surveillance, you lose response, and you lose real-time guidance, and that hurts America's health.”

— Dr. Jerome Adams, Former Surgeon General under the Trump administration

What’s next

The White House has reportedly tasked HHS Chief Counselor Chris Klomp with leading the search for a new CDC director, and Klomp said last month that a few finalist candidates had been identified. However, no nomination has been announced yet. The status of Dr. Casey Means' nomination for Surgeon General also remains unclear, with the Senate health committee chair indicating he has 'no comment' on her confirmation.

The takeaway

The Biden administration's struggle to fill key public health roles at the CDC and Surgeon General's office highlights the challenges posed by HHS Secretary Kennedy's anti-vaccine agenda. The lack of permanent leadership at these agencies is undermining the government's ability to respond to public health threats and provide real-time guidance, leaving the country vulnerable during a time of ongoing health crises.