The Centers for Disease Control and Prevention (CDC) has appointed Dr. Ralph Abraham as the principal deputy director, a position that places him as the second-highest ranking official within the agency. This appointment, confirmed by the CDC, follows Dr. Abraham’s controversial tenure as the surgeon general of Louisiana, where he directed the state’s health department to cease promoting vaccinations. The announcement of his new role was not formally made public, initially being reported by Inside Medicine through an internal email.
Dr. Abraham’s directive in Louisiana involved a significant shift in the state’s public health messaging regarding vaccinations. He ordered that the state stop using media and health fairs to advocate for vaccines, instead advising that patients should discuss the risks and benefits of vaccination with their healthcare providers. In a memo outlining this policy change, he emphasized that “vaccines should be treated with nuance,” highlighting the distinction between seasonal vaccinations and childhood immunizations, which he noted are crucial for ensuring immunity in children.
This appointment occurs against the backdrop of evolving language on the CDC’s website, which recently stated, “The claim ‘vaccines do not cause autism’ is not an evidence-based claim because studies have not ruled out the possibility that infant vaccines cause autism.” This shift in messaging aligns with Dr. Abraham’s approach during his time in Louisiana, where he has not explicitly opposed vaccinations but has significantly altered the promotion of them.
Dr. Abraham, a former Republican congressman and physician, has previously expressed gratitude to President Trump and Health and Human Services Secretary Robert F. Kennedy Jr. for their leadership in public health matters. In September 2025, he thanked them for their “common sense approach” regarding warnings to pregnant women against taking Tylenol. His public health strategies have included controversial stances such as promoting the use of hydroxychloroquine during the Covid-19 pandemic and being among the highest prescribers of ivermectin in Louisiana, a drug that garnered attention as an alternative treatment for Covid among some conservative circles.
The timing of Dr. Abraham’s appointment is notable, as the CDC has been without a permanent director since the ousting of former director Susan Monarez in August. Monarez’s departure followed a tumultuous relationship with Secretary Kennedy. Currently, Jim O’Neill serves as the acting director of the CDC while the agency navigates this leadership transition.
As the CDC continues to address public health challenges, Dr. Abraham’s new role may influence vaccination policies and public health initiatives moving forward. His previous actions and statements will likely remain under scrutiny as he assumes responsibilities that could shape vaccination strategies across the United States.
