Dr. Erica Schwartz, who appeared before the Senate Health, Education, Labor and Pensions Committee in July, was confirmed Wednesday as CDC director.

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The U.S. Senate confirmed Dr. Erica Schwartz as director of the Centers for Disease Control and Prevention, nearly a year after the last permanent director was fired in a dispute over vaccine policy with Health Secretary Robert F. Kennedy Jr.

The vote on Schwartz’s nomination was 51-44 in favor.

She will take command of a public health agency that has lost thousands of employees in the second Trump administration amid layoffs, resignations and leadership shakeups.

The CDC is currently responding to surges in measles cases, cyclosporiasis outbreaks and an Ebola outbreak in the Democratic Republic of the Congo and Uganda.

In a July confirmation hearing, Sen. Bill Cassidy led some Republicans in hard questions about vaccines and whether she would support their use if pressured by Kennedy.

Cassidy ultimately voted to advance her nomination out of the Health, Education, Labor and Pensions Committee after she allayed his concerns. He also voted in favor of confirmation.

“After speaking with Dr. Schwartz again after the hearing, reviewing the transcript and speaking to those who served with her and know her well, I’m confident that she knows what she is doing and will stand against those who do not,” Cassidy said on July 23.

Sen. Bernie Sanders, an independent from Vermont and ranking member on the health committee, voted against her advancement out of committee and against her nomination on the Senate floor Wednesday.

While Sanders said he was impressed by Schwartz’s credentials and service, he did not think she was prepared to stand up to Kennedy’s false statements on vaccines and other health topics.

“I think the American people are owed better than what President Trump has nominated,” Sanders said on July 30.

Dr. Demetre Daskalakis, a former CDC official who resigned last August, said Schwartz has her work cut out for her. “I really wish her luck in her new role,” he told NPR . “But I would also say, it’s not about the job, it’s about the public health mission. And that needs to be her focus.”