Recent HHS Leadership Changes That Impact Public Health

April 20, 2026 | Catherine Murphy

Over the last 16 months, the Trump Administration has championed the Make America Healthy Again (MAHA) agenda within HHS — with Secretary Robert F. Kennedy, Jr., leading the department. He was confirmed by the Senate and sworn in on Feb. 13, 2025, and has since worked to implement sweeping changes in the department and MAHA priorities (e.g., addressing chronic disease and childhood allergies, removing specific food dyes, and increasing transparency within the agency).

Significant changes within HHS over this period include the termination of 10,000+ employees via Reductions in Force and more departures via voluntary separation incentives. This has left many agencies and offices to adjust and impacted how state and territorial health departments collaborate with partners at HHS agencies like CDC. Alongside these major ongoing changes (and more proposed) to the department are the appointments and alterations to HHS leadership by President Trump.

CDC Director

CDC has seen a handful of changes during the first year of the Trump Administration. Its director leads the agency and directs public health priorities like disease prevention, outbreak control, and health threat defense.

In July 2025, Susan Monarez was confirmed as CDC director but removed a month later due to disagreements with the Administration over vaccine policy. Soon after, she appeared before the Senate Health, Education, Labor & Pensions (HELP) Committee to testify about events around her termination. The lack of CDC leadership was a source of concern for the public health community, as leaders cited the importance of evidence-based decision-making from the agency and sound leadership to respond to ongoing health threats and emergencies.

Following the departure of Monarez, Jim O’Neill, deputy secretary of HHS, was appointed acting director of CDC. In February 2026, however, he was removed from the role amid his departure from HHS to be nominated as the director of the National Science Foundation. Meanwhile, department restructuring elevated Chris Klomp to chief counselor, in charge of all HHS operations. While HHS searches for a new CDC director, Jay Bhattacharya, director of NIH, is performing delegable duties.

Federal law dictates that Senate-confirmed positions, including CDC director, have acting replacements for a maximum of 210 days — a deadline that passed on March 25. The agency says that they are actively looking for a replacement.

Advisory Committee on Immunization Practices

CDC’s Advisory Committee on Immunization Practices (ACIP) is a group of up to 19 voting members — independent medical and public health experts — who make recommendations on vaccines, which become CDC policy once adopted by its director. Recommendations bear on immunization schedules, the Vaccines for Children program, and clinical decision-making, and have downstream effects on whether insurance providers cover vaccines and the context in which they can be administered (i.e., pharmacy vs. office visit). ACIP has also seen considerable change under this Administration:

• In June 2025, HHS removed all 17, Biden-appointed members of ACIP. In a press release, the department noted the goal to “reestablish public confidence in vaccine science.” This move garnered bipartisan response from Congressional leaders, especially those on the Senate HELP Committee, who specifically questioned Secretary Kennedy on his potential revisions to CDC’s vaccine recommendations during his confirmation hearing.
• In January 2026, HHS announced an overhaul of the childhood vaccine schedule outside of the ACIP recommendation process. The announcement included changes to recommendations for hepatitis A, rotavirus, influenza vaccines, and more.
• In March 2026, a federal judge placed a stay on all of Secretary Kennedy’s appointments to ACIP, the panel's recommendations, and the 2026 schedule change.

Surgeon General

Finally, the U.S. Surgeon General role, which advises the public on health and leads the Commissioned Corps of the U.S. Public Health Service, has been marked by ongoing shifts. In May 2025, after withdrawing his nomination for Janet Nesheiwat, President Trump announced Casey Means, MD, as his new nominee for the position. Means is a doctor and wellness influencer who advocates for MAHA priorities, including finding ways to reduce rates of chronic disease. Several members of the Senate HELP Committee have stalled her confirmation, citing concerns around Means’ statements on vaccine safety. Means appeared before the committee in February 2026.

Public Health Impacts

The flux within HHS — a side effect of the administration’s desired changes within the department — has had ongoing impacts on the process for issuing public health guidance, approving and altering vaccine recommendations, and more. Congress remains interested in understanding the impact of reforms occurring within HHS, including in hearings centered around agencies and nominees. ASTHO will continue to track changes within HHS as well as responses from legislators, and work to be a resource to Congress on best practices for public health.