President Donald Trump's nominee for surgeon general, Dr. Casey Means, defended her views on vaccines, autism, and public health in a Senate confirmation hearing Wednesday, but her responses underscored the steep challenges she faces in winning support from Democrats.
Means, a physician aligned with the Make America Healthy Again movement, sought to frame her approach as focused on chronic disease and patient empowerment rather than vaccine skepticism.
In her opening statement before the Senate Health, Education, Labor, and Pensions Committee, she said, "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 added, "Diabetes, representing cellular-energy collapse, is draining our human potential."
Democrats pressed Means on vaccines and autism, long contentious issues in public health debates and scrutinized, given MAHA's criticism of pharmaceutical companies and elements of the federal health establishment.
Asked whether she would recommend that mothers vaccinate their children against measles, Means declined to give a direct endorsement.
"I'm not an individual's doctor, and every individual needs to talk to their doctor before putting medication in their body," she said.
In response to questioning from Sen. Bernie Sanders, I-Vt., Means acknowledged the scientific evidence but emphasized uncertainty.
"I do accept that evidence. I also think that science has never settled," she said, adding that she supports Health and Human Services Secretary Robert F. Kennedy Jr.'s effort to examine "all environmental factors that could be contributing to autism."
She maintained, however, that "vaccines are not part of my core message."
Means also said she believes that "vaccines save lives," but again stopped short of explicitly encouraging mothers to vaccinate their children against measles and influenza in an exchange with committee Chair Bill Cassidy, R-La., a physician.
On autism, Means said, "We do not know as a medical community what causes autism. The science is never settled," a formulation likely to draw scrutiny from Democrats who cite extensive research that has found no causal link between vaccines and autism.
Beyond vaccines, Means signaled more conventional positions on other health issues.
"I absolutely think that oral contraception should be widely accessible," she said when asked about birth control pills.
At the same time, she emphasized physician guidance: "I believe especially when it comes to oral contraceptives, we need to have patients having a conversation with their doctor about risks and benefits."
Means' nomination comes amid heightened partisan tensions over public health policy since the COVID-19 pandemic.
Democrats have repeatedly criticized MAHA and Kennedy's past statements about vaccines, and several have indicated they are wary of nominees perceived as sympathetic to revisiting settled vaccine science.
With Republicans narrowly controlling the Senate, Means can afford few defections if Democrats remain unified in opposition.
The committee has not scheduled a vote on her nomination.
James Morley III ✉
James Morley III is a writer with more than two decades of experience in entertainment, travel, technology, and science and nature.
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