Health Secretary Robert F. Kennedy Jr.’s influence looms over the White House’s stalled effort to appoint a new CDC director, with officials struggling to balance his Make America Healthy Again agenda against bipartisan vaccine skepticism. Federal law requires a replacement for acting director Dr. Jay Bhattacharya by midnight Wednesday, but internal disagreements and Senate confirmation hurdles have left the agency without a permanent leader for nearly 200 days.

The search for a nominee who aligns with Trump’s health priorities while avoiding Kennedy’s divisive vaccine views—such as opposition to mandatory childhood shots—has narrowed to a shortlist of candidates, including staunch vaccine advocates, according to sources.