Casey Means, Trump's surgeon general nominee and RFK ally, grilled on vaccines in Senate confirmation hearing

Means was pressed by both a Democratic and a Republican senator on the committee about her past criticism of the use of the Hepatitis B vaccine for newborns. Means has criticized the blanket use of the vaccine for babies, both on social media and on a podcast with Tucker Carlson, saying Hepatitis B is contracted through sexual disease and drug use.

But Sen. Lisa Murkowski, an Alaska Republican, said the disease is far more transmissible than sexual contact, and is also being transmitted through ordinary community contact. 

"In Western Alaska, where we see Hep B as endemic, we find that it's being spread through mosquitos bites where a child is itching an arm, ordinary household, community contact," Murkowski said. "Whether it's sharing food, toothbrushes, and minor injuries. And so this is where, this is where many in my state are looking at this and saying, 'We have been able to turn the corner on this.' We're no longer seeing children with liver cancer, with this liver disease. And it is because the Hepatitis B vaccine has been made available to them at birth. My hope is that as you are communicating the value of childhood vaccines, that demonstrated, positive results of vaccines just like this would be communicated and not just, 'Everybody needs to consult with their doctor.'"

Democratic Sen. Angela Alsobrooks of Maryland brought up a past tweet in which she said Means suggested vaccinating newborns with the Hepatitis B vaccine is a crime. Means said she "supports vaccines" and the tweet was taken "out of context." 

Means said this administration is continually studying the vaccine schedule. 

"I think there's a nuanced conversation that American families are looking to have about shared clinical decisionmaking with their doctors about specific vaccines that their children may not be as seriously at risk for," she said. 

Cassidy asked Means, "Do you agree with the need for universal Hepatitis B immunization?"

"I think right now any parent in America can walk into their pediatrician's office and get access to the Hepatitis B vaccine for their child if they want it," she said. Cassidy repeatedly asked her if she sees universal Hepatitis B vaccination as a goal. Eventually, Means said vaccination at some point in childhood would be a good goal.

Sen. Lisa Blunt Rochester asked Means if she would refuse to conduct a study with serious ethical issues even if the administration of Kennedy pressured her to do so. 

Means said she's a "strong-willed person" who has no problem having a direct conversation about ethical concerns with anyone. Means said protecting patients and children is her top priority.

"And also, I do not believe that the secretary or anyone in the administration would ask me to do anything unethical," she said. 

Means reaffirmed that she isn't currently able to prescribe medications, insisting the path she's decided to pursue as a doctor doesn't require seeing patients. She does have a medical license that's "voluntarily placed on inactive status because I'm not actively seeing patients at this time."

Means said she has no plans to seek to activate her license with the Oregon medical board, when asked by Sen. Andy Kim of New Jersey. 

"I do not plan to reactivate, because I'm not going to be seeing patients in this role," she said. 

Means said her decision to be placed on inactive status has been a source of "severe misinformation by the media."

Sen. Susan Collins, a Maine Republican, focused on a passage in Means' book "Good Energy" where she wrote about trying psychedelic mushrooms for therapeutic purposes in 2021. Collins said she was "concerned" by the mention of illicit drugs and asked Means if she would advise those substances to the American people. 

Means said that what she "would say as a private citizen is in many cases different from what I would say as a public health official," and said that while she believes the science on psychedelic therapy is "still emerging," she would not currently recommend it to the American public. 

"I do believe that there is exciting work being done in this area that needs to continue," Means said. 

Sen. Jon Husted, an Ohio Republican, asked Means about her views on pesticides, which are used to keep bugs and other pests from destroying crops. Means has called pesticides toxic, and in her newsletter said a person's health "can be transformed" by reducing exposure to them. Kennedy has also criticized the use of pesticides, though he sought to reassure American farmers after releasing a report that blamed the chemicals for children's health conditions. 

But last week, Mr. Trump signed an executive order boosting the use of glyphosate, the active ingredient in Roundup. 

Means said the use of pesticides is a "very complex issue" and said that she believed farmers "are in an impossible situation right now, where we have developed an agriculture system that is dependent on chemicals that are toxic to have an affordable food supply." Husted said that not using pesticides could reduce crop yields by up to 50% and cause supply issues and raised prices. 

Means said that "changing anything overnight would be devastating to the American farmer and the American consumer," but that the Trump administration "is committed to understanding what's in our food and how it's affecting our body and how cumulative exposures to various chemicals in our environment is affecting us." Pesticides and insecticides are among the factors that need to be investigated, Means said. She said she hoped they can eventually be removed from the food supply without crisis. 

"Eventually, we are going to need to move towards a more sustainable way of growing our food that decreases our reliance on toxic chemicals that are hurting human health," Means said. She said those changes would need to be made thoughtfully, with "full respect for American farmers," but that "at the end of the day, we need to understand how these chemicals are affecting our bodies." 

Means will not directly regulate pesticides as surgeon general, but Husted noted that her views will directly impact consumers. 

Republican Sen. John Husted asked Means about the connection between smart phones and children's mental well being, and asked her if she would recommend banning cellphones in America's schools, as some individual schools have done across the country. 

"Do you believe that smart phones and social media are negatively impacting the health of America's children?" Husted asked. "What age should a child have access to a smartphone and social media? And would you recommend banning smartphones in America's schools?"

Means said smart phones are negatively affecting children's health. But she said she didn't have an answer to the question of age for accessing a cellphone. 

She said schools, parents, communities and the government need to exercise an "abundance of caution" when approaching smartphones in schools, but made no recommendations. Husted didn't press her to answer the question. 

Democratic Sen. Chris Murphy of Connecticut, following on Baldwin's questions, pressed Means on the times she has benefitted financially from medical companies whose products she promoted. 

Murphy asked if she's familiar with Federal Trade Commission policy requiring people recommending products online to disclose their financial connection to those companies. 

Means said she is familiar. Murphy noted a "pending complaint" about her alleged failure to comply with that rule. Murphy said Means "routinely" violated this policy, and insisted that in the "majority" of her posts on social media, she failed to disclose her connection. 

"That's false," Means said. 

Murphy claimed Means had received partnership fees for a prenatal vitamin when Means posted on social media that she was simply a "fan."

"It's incorrect and it's a false representation," Means said of Murphy's assertions, insisting she's worked with the Office of Government Ethics to be in full compliance. 

"I take it very seriously," Means said. "Before, during and after, if I'm in office, I will be in full compliance with the Office of Government Ethics." 

Murphy disagreed. 

"This seems systemic," Murphy said. "It seems that in the majority of instances in which you were, as a medical professional, recommending a product, you were hiding the fact that you had a financial partnership. You seem to be in regular, willful violation of the FTC rules."

"I don't think that's true," Murphy said, adding that if a failure to disclose "inadvertently" has happened, she would rectify the situation. 

Sen. Tammy Baldwin, a Democratic senator from Wisconsin, noted that Means says she wants to root out conflicts of interest in federal agencies, while she has received money for promoting health companies and supplements. 

Baldwin said Means has promoted a lab testing company that, before she began promoting their tests, agreed to pay $43 million to resolve allegations that it had billed for medically unnecessary lab tests and violated the False Claims Act. Means said she "was not familiar with that settlement" when she promoted the company's products. 

Baldwin said it "does not inspire confidence that you're here to make Americans healthy when you accept money to promote a company who's had to pay a settlement because of violating the False Claims Act."

Baldwin also noted Means has promoted a range of supplements, including those that claim to promote longevity and detoxification. Baldwin said that, according to information provided to the committee, Means has made at least $325,000 from promoting supplements since the beginning of 2024. 

Baldwin asked if she believes most Americans can afford the supplements and glucose monitoring products Means has promoted, such as a "full membership" for health products amounting to $1,500 a year. Baldwin asked if spending that much is one of her solutions to the nation's health problems. 

"I certainly don't think every American needs to be wearing a glucose monitor," Means said. 

"My work on using entrepreneurship as a tool to bring and study new tools that can help us understand our blood sugar better, I am very proud of," she added.

Sen. Patty Murray, a Washington Democrat, pushed Means about her previous comments that Americans "use birth control like candy." Murray noted that there are 18 FDA-approved contraceptive methods, both hormonal and non-hormonal, and "there are decades of evidence showing that every one of these birth control methods is safe and effective."

Although Means said "I believe these medications should be accessible to all women," she said "doctors do not have enough time for thorough, informed consent conversations."

"Some of the horrifying side effects of birth control that I have mentioned include blood clots and stroke risk in women who have clotting disorders who are smokers, who have obesity," Means said. 

Means said her previous comments were taken out of context, saying she is speaking about "particular women" who she believes are not giving informed consent due to "their medical history, their lifestyle exposures and their family history." 

"We prescribe a huge amount of hormonal contraceptives and I do not believe most of those conversations have informed consent because of the pressures their doctors are under because of our broken health care system," Means said.

Murray noted that these answers are different from what she has said before. 

Continuing on the thread about vaccines and autism, Sen. Bernie Sanders, the committee's ranking member, said Means' answers were "political and not to the point."

The American Medical Association, Sanders said, insists an abundance of studies shows "no link" between vaccines and autism. That's in contrast to Kennedy's past statements.

Sanders said "it is" an issue that so many children are being diagnosed with autism, but said, "we don't want conspiracy theories" to determine public health. 

"Absolutely, I 100% agree with you," Means interjected. "And also, as a biomedical researcher and physician, I am not going to sit here and say that we should not study something in the future." 

Sanders said the "overwhelming" evidence shows vaccines don't cause autism. 

Means said anti-vaccine rhetoric has never been a part of her message. 

When Cassidy asked Means if she believed there was a connection between vaccines and autism, she did not give a clear answer. Since Kennedy took office, federal websites have been updated to include false claims about autism and vaccines. 

"I'm a physician. The reality is we have an autism crisis that is increasing and this is devastating to many families," Means said. "We do not know, as a medical community, what causes autism." 

Means highlighted the Trump administration's funding of studies looking at environmental factors. Means said that she accepted evidence that showed vaccines did not cause autism but that "science is never settled." 

More than once, Cassidy, the Republican chairman who is also a physician, asked Means if she would encourage women to vaccinate their children with the MMR vaccine against measles. 

"Tragically, next question, we've had two children die from measles in West Texas," Cassidy said. "We've now had an outbreak of like a thousand children almost in South Carolina area. You're a mom. We're on the verge of losing our measles elimination status. Would you encourage other mothers to have their children vaccinated against measles with the MMR vaccine?"

Means said she believes vaccines "save lives." But she stopped short of saying she would encourage mothers to vaccine their children, when pressed. 

"I'm supportive of vaccination," she said. "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, their children's body."

In her opening statement, Means focused much of her attention on tackling chronic diseases by addressing what she said are some of their root causes. 

"Our nation is angry, exhausted and hurting from preventable diseases," she said. 

Means blamed America's chronic disease epidemic on ultra-processed food, industrial chemical exposure, lack of physical activity, chronic stress, loneliness and "overmedicalization." 

"I believe that every American shares a core yearning to thrive and help their families thrive, but we are asking people to make healthy choices in environments that are squarely structured against them," she said. 

Means blasted what she called conflicts of interest in federal health agencies, and praised the president and Kennedy for their interest in addressing chronic disease issues. 

She also defended her credentials, saying she has treated thousands of patients, has run her own medical practice and co-founded a health technology company to help patients address blood sugar dysregulation. 

The committee will take a 15-minute break at 11 a.m. so Means can care for her baby boy, who was born on the day she was supposed to have her confirmation hearing in October. 

"And by the way, congratulations on your baby," Chairman Bill Cassidy said as he opened the hearing. "It gives you a great perspective on life, and I trust all is well."

Means is an author and has built a large following online by writing about health and wellness, often focusing on metabolic health. In her newsletter "Good Energy," she has criticized both the food and health care industries. A wishlist for the administration she published in 2024 included praise for Kennedy and a list of priorities including the reformation of "burdensome food regulations" and an investigation of the childhood vaccine schedule.

Means and her brother also wrote the book "Good Energy," where they said their mother had "simply been prescribed pills" after being diagnosed with pancreatic cancer instead of being "set on a path of curiosity about how these conditions are connected and how the root cause can be reversed." Pancreatic cancer is one of the deadliest forms of cancer, and their mother died of the disease in 2021. Another chapter of the book is titled "Trust Yourself, Not Your Doctor." 

Means is also the co-founder of Levels, a health app that can connect to glucose monitors.

 The surgeon general is considered the "Nation's Doctor," according to the U.S. Department of Health and Human Services. Their job includes giving Americans "the best scientific information available on how to improve their health and reduce their risk of illness and injury" by issuing advisories, calls to action and reports.

The surgeon general also oversees 6,000 members of the U.S. Public Health Service Commissioned Corps, another part of HHS. 

Once confirmed by the Senate, the surgeon general serves a four-year term of office.

Means is a medical doctor, but she does not currently have a license to treat patients. 

Means attended the Stanford School of Medicine and graduated in 2024 as a distinguished scholar, according to the university. She went on to begin a residency in head and neck surgery, but departed the program without completing it and is not a surgeon. 

Means was granted a full medical license in Oregon in 2018, according to online records, and opened a functional medicine practice called Means Health. She has also worked in biomedical research. 

Her license has been "inactive" since 2024, according to online records. On her website, Means said the status change was voluntary because she "was not actively seeing patients."