On November 25, 2025, the Centers for Disease Control and Prevention (CDC) took a dramatic turn in its leadership, appointing Dr. Ralph Abraham, Louisiana’s outspoken former Surgeon General and a prominent vaccine skeptic, as its new principal deputy director. The appointment, confirmed by the Department of Health and Human Services (HHS) and first reported through an internal CDC database, has sent shockwaves through the public health community and reignited fierce debates over the future of vaccine policy in the United States.
Dr. Abraham’s elevation to the CDC’s second-in-command arrives at a particularly turbulent moment. The agency has been without a permanent director since August, when Dr. Susan Monarez was removed from her post. Jim O’Neill, a former Silicon Valley investor with no medical degree, currently serves as acting director. With Abraham’s appointment, the CDC’s top medical authority is now a figure whose views on vaccines and public health diverge sharply from longstanding scientific consensus.
Abraham’s background is as unconventional as his new role. Before entering medicine, he spent a decade as a veterinarian, then practiced family medicine in rural Louisiana. He served three terms in Congress from 2015 to 2021, and was appointed Louisiana’s first Surgeon General in 2024 under Republican Governor Jeff Landry. However, questions have swirled around Abraham’s medical credentials; while licensed to practice medicine in Louisiana, he does not appear to be board-certified in family medicine, according to a search of the American Board of Family Medicine’s website, as reported by NBC News.
His tenure as Louisiana’s top health official has been marked by controversy. In February 2025, just hours after Robert F. Kennedy Jr. was sworn in as HHS Secretary, Abraham issued an internal memo instructing the Louisiana Department of Health to halt all promotion of mass vaccination events. The memo, obtained by the Associated Press, directed the department to “no longer promote mass vaccination” through media campaigns, even as the state faced the worst whooping cough outbreak in 35 years. Abraham’s approach was clear: “Government should admit the limitations of its role in people’s lives and pull back its tentacles from the practice of medicine,” he wrote earlier this year, as quoted by the Washington Post. “Restoring this trust requires returning medical decisions to the doctor-patient relationship, where informed, personalized care is guided by compassion and expertise rather than blanket government mandates.”
His stance on vaccines goes well beyond administrative policy. Abraham has repeatedly questioned the safety of COVID-19 vaccines, once describing them as “dangerous.” In September 2024, he told the Shreveport Times that he “sees Covid vaccine injuries every day,” though he did not specify the nature of those injuries. He has also voiced support for investigating the debunked link between vaccines and autism, a position that alarms many in the medical field. During the pandemic, Abraham advocated for the use of ivermectin as a COVID treatment, prescribing it more than nearly any other Louisiana physician in 2021, despite evidence that it is ineffective against the virus, as documented by MedPage Today.
Abraham’s time as surgeon general was further marred by the state’s delayed response to a deadly whooping cough outbreak. In late 2024 and into 2025, Louisiana saw 387 cases and two infant deaths from the disease. Infants are not eligible for their first pertussis vaccine until two months of age, but can gain protection if their mothers are immunized during pregnancy. Abraham’s department waited three months after the infant deaths before issuing an official alert to physicians and the public, a delay sharply criticized by public health experts. Dr. Nirav Shah, former CDC principal deputy director under the Biden administration, called Abraham’s appointment “atrocious,” telling NPR, “Dr. Abraham’s record shows that when an emergency in public health materializes, his instinct is to sweep it under the rug.”
Abraham is not just a critic of vaccines. He has supported bills to ban fluoride in public water systems and expand access to ivermectin for COVID treatment—positions that place him at odds with mainstream medical science. The fluoride bill failed, but the ivermectin bill passed. He has also promoted leucovorin as a promising treatment for some children with autism, despite limited evidence supporting its widespread use.
The political backdrop to Abraham’s appointment is impossible to ignore. He is a vocal supporter of HHS Secretary Robert F. Kennedy Jr., whose own skepticism of vaccines has shaped the current direction of U.S. health agencies. Kennedy has removed pro-vaccine members from federal advisory boards and cut funding to vaccine research programs, moves that have deepened divides within the public health establishment. Abraham’s critics argue that his appointment gives Kennedy’s vaccine-skeptical agenda a “scientific gloss.” Dr. Shah warned, “He gives Secretary Kennedy some scientific and medical cover for their odious and unscientific beliefs.” Anne Schuchat, who served as CDC principal deputy director from 2015 to 2021, described the move as “scary,” adding, “We know that vaccinations are saving lives and protecting health and preventing outbreaks, and ideology should not outweigh the evidence.”
Not everyone in Louisiana politics agrees with Abraham’s approach. Senator Bill Cassidy, a physician and pro-vaccination advocate, has sparred publicly with Abraham over vaccine policy. When Abraham canceled the state’s mass vaccination program, Cassidy warned that “anything that undermines the understanding, the correct understanding, the absolute scientifically based understanding that vaccines are safe and that, if you don’t take them, you’re putting your child or yourself in greater danger, anything that undermines that message is a problem.”
Abraham’s appointment also carries personal resonance for Louisiana’s political community. After Abraham left Congress in 2021, his chief of staff, Luke Letlow, was elected to his seat but died from COVID-19 before being sworn in, at a time when vaccines were not yet widely available. Letlow’s widow, Julia Letlow, subsequently won the seat. In 2021, she told CBS News, “I would’ve given anything – I would’ve given everything – for that shot to be available for us. Looking back now, and for someone to turn it away, it’s heartbreaking to me.”
For now, Abraham’s start date at the CDC remains unannounced, and Louisiana Governor Jeff Landry has yet to name a successor for the state’s surgeon general post. But with Abraham’s rise, the CDC’s leadership is now firmly in the hands of figures who have questioned or opposed some of the foundational tools of modern public health. Whether this signals a lasting shift in U.S. vaccine policy—or a new era of controversy for the CDC—remains to be seen. What’s certain is that the nation’s approach to public health leadership is facing its most consequential test in decades.
