Louisiana Surgeon General Ralph Abraham named CDC principal deputy amid vaccine trust concerns

Ralph Abraham, Louisiana’s surgeon general, has been appointed principal deputy director of the CDC at a time when the agency has no permanent director. Prior to the appointment, The Washington Post confirmed with the Department of Health and Human Services (HHS), the deputy secretary Jim O’Neill served as acting CDC director. Abraham’s start date has not been announced.

The principal deputy director role sits within the CDC’s “Immediate Office of the Director and Leadership,” but the agency provides little detail on the job’s responsibilities, leaving some questions about the balance between scientific authority and political influence, according to the CDC’s website. The Post reports the deputy director is heavily involved in running the agency and shaping public health policy at a national level.

Abraham’s appointment has raised concerns among public health experts because of his past record on vaccines. Once first bumped to surgeon general in 2024, he faced criticism for instructing health officials to stop promoting vaccines, including flu shots and instead focusing on personal choice. He has also promoted research into the link between vaccines and autism and supported making ivermectin, a medication not approved for COVID-19, available over the counter.

In a February letter on vaccines, Abraham argued that government agencies should avoid promoting “pharmaceutical products” when the manufacturers are protected against lawsuits for harm. The Post shared an excerpt from the letter where Abraham wrote, “It is understood that the products pushed will benefit some and cause harm to others, but public health pushes them anyway with a one-size-fits-all, collectivist mentality whose main objective is maximal compliance.”

In addition, his appointment comes after former CDC principal deputy director Susan Monarez was “forced to resign” in August 2025. According to many news outlets, HHS Health Secretary Robert F. Kennedy Jr., demanded that she fire top leaders and accept vaccine recommendations aligned with his administration.

Abraham’s new role comes amid broader concerns about vaccine trust and public health in the U.S. Nearly half of state and local public health employees left their positions between 2017 and 2021, creating gaps in expertise and institutional knowledge.

At the same time, the public’s confidence in vaccines and health authorities has fluctuated. Political controversies, misinformation and conflicting messages during COVID have contributed to a decline in trust, especially toward federal agencies like the CDC, according to the World Health Organization (WHO).

Globally, the WHO warns that vaccine misinformation is a growing threat. Kate O’Brien, director of the Department of Immunization, Vaccines and Biologicals at WHO, said in September 2025 that vaccines have saved over 150 million lives in the past 50 years, but misinformation risks reversing decades of progress. She noted that coverage for essential vaccines is falling in some communities, including for measles, and that once false claims spread, people tend to continue to believe them even after being shown the facts.

At the state level, Abraham’s history reflects how public health roles can intersect with politics. Louisiana’s surgeon general position was created in 2024, following similar moves in states including Florida, California and Michigan.

However, public health experts have expressed skepticism about Abraham’s ability to lead at a national level.

Debra Houry, a former principal deputy director of the CDC, told The Post that Abraham “checks a couple of boxes” because he is a physician and has health department experience but added that “it appears he does not always follow science or data to make decisions given his handling of the whooping cough outbreak in Louisiana and prescribing ivermectin during COVID.”

Abraham now steps into a leadership role at a pivotal time for public health, as trust in vaccines and health authorities remains fragile, and political pressure continues to shape health policy.