Dr. Ralph Lee Abraham, the Louisiana surgeon general who halted his state’s vaccine promotion campaigns and delayed warning the public about a deadly whooping cough outbreak, has quietly been installed as the second-highest official at the Centers for Disease Control and Prevention. The Department of Health and Human Services did not announce this appointment. The news was first spotted by Dr. Jeremy Faust, who runs the Substack called Inside Medicine.
Abraham, a 70-year-old former Republican congressman who served three terms representing Louisiana’s 5th congressional district, started in his new role as principal deputy director on November 23, according to the agency’s internal database. The HHS has since confirmed Abraham’s appointment.
The selection aligns the CDC’s senior leadership with the views of Health Secretary Robert F. Kennedy Jr., a longtime vaccine skeptic. Abraham has promoted discredited COVID-19 treatments including ivermectin and hydroxychloroquine, and, according to Faust, Abraham was the seventh-highest prescriber of ivermectin among Louisiana’s roughly 12,000 practicing physicians in 2021, personally accounting for 1.1% of the state’s prescriptions for the anti-parasitic drug. Clinical studies had already demonstrated ivermectin’s ineffectiveness against COVID-19 by that time.
In September, Abraham told the Shreveport Times he believes the COVID vaccine is “dangerous” and does not recommend it to his own patients. At a state legislative meeting last September, he claimed: “I see, now, vaccine injury every day of my practice” from COVID vaccines, though he did not specify the nature of these injuries. The claim contradicts extensive research showing COVID vaccines significantly reduce hospitalizations and deaths.
Abraham’s record as Louisiana’s top health official has drawn sharp criticism. In February, he ordered the Louisiana Department of Health to cease promoting mass vaccination—a decision announced the same day Kennedy was confirmed as HHS secretary. Under his leadership, the state’s health department delayed for months before alerting physicians and the public about a whooping cough outbreak that killed two infants, the state’s first pertussis-related deaths since 2018.
Dr. Georges Benjamin, executive director of the American Public Health Association, said the delayed response was atypical. “Particularly for these childhood diseases, we usually jump all over these,” Benjamin told NPR. “These are preventable diseases and preventable deaths.”
CDC agenda
Dr. Nirav Shah, who served as CDC principal deputy director for two years before resigning earlier this year, told the New York Times that Abraham is “unqualified” for the position. “My jaw hit the ground” upon hearing of the appointment, Shah said, adding that a significant aspect of the role involves emergency response. He described the delayed notification about the pertussis deaths as “not just unacceptable, it’s shameful.”
As a congressman, Abraham consistently advocated for repealing the Affordable Care Act. “You should come to my practice in Mangham on a daily basis and I can show you the debacle of the ObamaCare law, if we can even call it that,” he said during a 2014 congressional debate. “As a practicing physician, right now, it’s not working and it’s even dangerous.”
Notably, as NBC News points out, there is no evidence Abraham is board-certified in family medicine, despite being described as a “family medicine physician” on official Louisiana state websites. The American Board of Family Medicine’s online database does not list him as certified, and the Louisiana State Board of Medical Examiners identifies him only as a general practitioner. Abraham practiced veterinary medicine for a decade before obtaining his medical degree from the LSU School of Medicine in 1994.
The appointment carries structural significance for the administration’s health agenda. The CDC currently lacks a permanent director; acting director Jim O’Neill, a former biotech executive without medical credentials, was installed in August after Kennedy fired his predecessor. Under the Federal Vacancies Reform Act, acting directors can serve only 210 days—a clock that expires in late March unless a permanent nominee is named. As principal deputy director, however, Abraham can serve indefinitely without Senate confirmation, potentially giving Kennedy and the White House sustained influence over the agency’s vaccine policies.
Senator Bill Cassidy of Louisiana, the Republican chairman of the Senate Health Committee and a physician, has clashed publicly with Abraham over vaccine policy. In February, Cassidy criticized Abraham’s decision to halt mass vaccination campaigns, saying: “Removing these resources from parents is not a stand for parents’ rights. It is making health care less convenient and available for Louisianans who are very busy.”
For this story, Fortune used generative AI to help with an initial draft. An editor verified the accuracy of the information before publishing.
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