Casey Means, Donald Trump’s controversial nominee for US surgeon general, appeared before the Senate health committee on Wednesday for a two‑hour hearing in which she defended her medical credentials, side-stepped direct questions on vaccine guidance, and blamed the country’s chronic‑disease burden on “ultra‑processed foods, industrial chemical exposure, lack of physical activity, chronic stress and loneliness, and over‑medicalization”.
As the nation’s prospective top doctor, Means would be responsible for communicating federal public‑health guidance. In her opening remarks, she said Americans were “angry, exhausted and hurting from preventable diseases” and called for a “great national healing”. Her hearing was postponed in October, after she went into labor hours before she was scheduled to testify.
Democrats on the committee quickly expressed their concerns about Means’s ability to push back against the health secretary Robert F Kennedy Jr’s misinformation about the safety and efficacy of vaccines, which public health experts says is endangering the wellbeing of the American public.
“I have very serious questions about the ability of Dr Means to be the kind of surgeon general this country needs,” said Senator Bernie Sanders, the committee’s ranking member.
Although Means, 38, graduated from Stanford School of Medicine, she did not complete her head and neck surgical residency at Oregon Health and Science University, is not board-certified, and does not have an active medical license. Her scientific experience is mainly focused around her work as a wellness influencer, and a leader within the Make America Healthy Again (Maha) space – which has become the key pillar of the Trump administration’s health policy.
Means declined to give a simple yes-or-no answer when the committee chair and former physician, the Republican Bill Cassidy, pressed her on whether, as surgeon general, she would encourage parents to vaccinate their children with routine shots such as the measles, mumps and rubella (MMR) vaccine.
“I’m supportive of vaccination. I do believe that each patient, mother, parent, needs to have a conversation with their pediatrician about any medication they’re putting in their body and their children’s bodies,” Means said.
Means’s comments come as measles outbreaks continue across the country, with South Carolina experiencing the worst measles outbreak in more than 30 years amid declining childhood immunization rates. In response, Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services (CMS), urged Americans to “take the vaccine, please” earlier this month. In an interview with CNN, Oz issued a rare plea from the Trump administration to insist upon inoculation. “Not all illnesses are equally dangerous and not all people are equally susceptible to those illnesses,” he said. “But measles is one you should get your vaccine.”
Means repeated her stance for patient “autonomy” when it comes to the hepatitis B vaccine for children. As Cassidy, a liver specialist who has treaded the disease “for decades”, asked the surgeon general nominee for a clear answer as to whether she believes that universal immunization is an important goal – Means said it was an “important recommendation” at “some time” in childhood.
“I think the administration questions whether this vaccine is necessary for all children on the first day of life [sic],” she added. The Centers for Disease Control and Prevention (CDC) recently scrapped a longstanding recommendation that all US newborns receive the hepatitis B vaccine.
In a tense back‑and‑forth with the Democratic senator Tim Kaine, Means also declined to say whether she agreed with Kennedy’s past claim that there is no evidence the flu vaccine prevents hospitalization. Instead, she repeated that she supported CDC guidance on influenza vaccination, and ultimately acknowledged only that the shot could prevent severe illness “at a population level”.
While Means insisted that anti-vaccine rhetoric “has never been a part” of her message and said she was “not here to complicate the issue on vaccines”, she repeatedly sidestepped direct questions from lawmakers about whether vaccines cause autism – a theory long discredited by the scientific community and promoted by Kennedy.
“The reality is that we have an autism crisis that’s increasing, and this is devastating to many families, and we do not know as a medical community what causes autism,” she said, while acknowledging that there is an overwhelming body of evidence refuting claims that vaccines cause the condition. “I also think that science is never settled, and I think that the effort to look at comprehensive, cumulative exposures into what is causing autism is important.”
Throughout her career, Means has spurned the medical establishment, noting that she dropped out of her residency because she grew “disillusioned with traditional healthcare”, which, she claims, focuses on diagnoses and prescriptions instead of diet and lifestyle.
During her remarks before lawmakers, she praised Trump and Kennedy for inviting “a mature, candid, grand conversation about how our medical education and fixing perverse incentives can pull us back from the brink”.
In 2024, Means co-authored a book, Good Energy, with her older brother Calley, an entrepreneur who currently serves as one of Kennedy’s close advisers and has also railed against the US medical establishment. The siblings argue in their book that metabolic health is the key to reversing chronic illness, a framing that critics say verges into pseudoscience. “Many doctors are doing the wrong things, pushing pills and interventions when an ultra-aggressive stance on diet and behavior would do far more for the patient in front of them,” Means writes in the book.
The prospective surgeon general also co‑founded Levels, a health tracking company built around continuous glucose monitoring, as part of her belief that people need real‑time data to understand what’s driving their symptoms.
In the past, Means has trodden lightly when it comes to the efficacy of vaccines, but is aligned with the health secretary’s routine skepticism of the number of vaccines children are recommended.
“I also find it perplexing that people are often shamed for asking any questions about the 70+ injected medications going into their children’s bodies before the age of 18,” she wrote on her website.
Earlier this year, the Trump administration announced it would slash routine vaccine recommendations during childhood from 17 to 11 jabs, a move that public health experts said would erode trust in inoculations and allow infectious diseases to spread.
During the hearing, some Democrats on the health committee probed Means about apparent inconsistencies in her disclosures of compensation for promoting wellness products on social media and in her widely read newsletter. “It seems that in the majority of instances in which you, as a medical professional, were recommending a product, you were hiding the fact that you had a financial partnership. You seem to be in regular, willful violation of FTC [Federal Trade Commission] rules,” Senator Chris Murphy told her.
Means insisted she had worked “diligently” with the US Office of Government Ethics to address any potential conflicts. “If it inadvertently has happened, I would rectify that immediately,” she said.
In October, Senators Elizabeth Warren and Andy Kim wrote to Means seeking clarification about possible conflicts of interest tied to her former clients and employers. They did not receive a response.
Means’s nomination has received significant backlash from the US scientific community. Former surgeon general Richard Carmona, who served under George W Bush, told the Guardian that Means’s nomination was a “disgrace” to the future of America’s public health system. “She has no significant public health background experience. She has no scalable leadership experience,” he said.
On Wednesday, Means batted away questions about her inactive medical license, stressing that it was “voluntarily placed on inactive status” because she is not currently seeing patients. She added that she had no plans to reactivate it, noting that the surgeon general does not provide individual clinical care.
However, the surgeon general also oversees the US Public Health Service Commissioned Corps, a uniformed service of more than 6,000 public‑health officers, and the role requires “maintaining active and unrestricted licenses and certifications”.
Under Kennedy’s leadership, the Department of Health and Human Services (HHS) has been beset with chaos. Grants have been terminated, there has been a mass exodus of officials from key agencies, and anti-vaccine loyalists have been installed to the advisory committee on immunization practices (ACIP). Cassidy, the Louisiana Republican who ultimately cast the deciding vote to confirm Kennedy as Trump’s health secretary last year, did so despite expressing concern about Kennedy’s anti‑vaccine record. Kennedy assured him during the confirmation process that he would not interfere with the make-up of the ACIP. He has since reversed course, reshaping the department and sidelining career public‑health experts.
Means is Trump’s second nominee for the surgeon general position. Last year he put forward Dr Janette Nesheiwat, but withdrew her name before her Senate confirmation hearing amid criticism from the right and reports of misleading medical credentials.
Carmona said that his optimism that lawmakers will push back against Means’s credentials was “muted”.
“We see too much ideology and not enough science,” he said. “You’re putting an untrained person in the position … at a time when we probably need a real leader more than ever because of the mis- and disinformation that’s out there.”
Disclaimer : This story is auto aggregated by a computer programme and has not been created or edited by DOWNTHENEWS. Publisher: theguardian.com
