President Donald Trump on Thursday nominated Erica Schwartz to serve as director of the Centers for Disease Control and Prevention, concluding a monthslong effort to choose a permanent leader of the embattled health agency. 

Schwartz, who will have to be confirmed by the Senate, would take over the role as Health and Human Services Secretary Robert F. Kennedy Jr. oversees a string of controversial health policy changes at the agency, including an overhaul of childhood vaccine recommendations.

Schwartz served as deputy surgeon general during the first Trump administration, where she played a major role in the U.S. response to the Covid-19 pandemic. She spent more than 20 year in uniform, including as rear admiral and chief medical officer of the Coast Guard.

Dr. Jay Bhattacharya had been acting director of the CDC — a title that expired last month under federal law. That law, called the Vacancies Act, limits the amount of time an acting officer can serve in place of a Senate-confirmed official to 210 days. 

Late last month marked 210 days since the most recent CDC director, Dr. Susan Monarez, was fired. 

She has so far been the only person to serve as a confirmed CDC director during Trump’s second term, holding the role for under a month last summer. In congressional testimony in September, Monarez said she was fired after refusing Kennedy’s demands to approve vaccine recommendations she believed lacked scientific support.

It is unclear how Schwartz’s views on vaccines or other key public health policies compare with Kennedy’s.

Also on Thursday, Trump said he chose Sean Slovenski as deputy CDC director and chief operating officer, and Jennifer Shuford as deputy CDC director and chief medical officer. Shuford, as head of the Texas Department of State Health Services, led the state’s response to a massive measles outbreak last year, and credited vaccination and testing in declaring it over.

Schwartz’s nomination comes after a tumultuous several months for the agency, which is reeling from the leadership upheaval, plummeting morale, significant staff turnover and controversial changes to U.S. vaccine policy. Ahead of leadership departures last year, staff members were shaken by a gunman’s attack on the CDC’s Atlanta headquarters on Aug. 8. 

Last month, a judge blocked a critical vaccine panel’s efforts to overhaul U.S. immunization policy. That includes an effort to reduce the number of recommended childhood shots from 17 to 11.

Trust in federal health agencies has plummeted during Kennedy’s tenure as Health and Human Services secretary, according to a February poll from health policy research group KFF, with declines across the political spectrum.