Casey Means, President Trump’s nominee for surgeon general, currently lacks the necessary votes for confirmation following a contentious hearing. At least two Senate Republicans — Sens. Susan Collins of Maine and Lisa Murkowski of Alaska — have not committed to confirming Means.
Vaccines were a central topic during the hearing, where Sen. Bill Cassidy (R-LA), chair of the Senate health committee, pressed Means on her positions.
“I think it’s very important as a physician, and to rebuild trust in public health, to make sure patients are encouraged to have informed consent with their doctor before getting any medication,” Means stated.
She added, “I believe vaccines save lives. I believe they are an important part of public health. I also do not want to not encourage patients to have a conversation with their doctor.”
Means emphasized that “informed consent is going to be part of building trust in public health.”
Winning approval from the Health, Education, Labor and Pensions Committee — which is split 12 Republicans to 11 Democrats — is almost certainly required for confirmation. A single Republican vote against Means could derail her nomination.
The Republican-controlled Senate has confirmed very few of Trump’s nominees. However, one early pick was withdrawn: former Florida GOP Rep. Dave Weldon, who led the White House’s effort to name him as CDC director after Murkowski and Collins raised vaccine concerns.
The surgeon general is the nation’s top doctor and a high-profile public health spokesperson.
Last year, the Senate confirmed Robert F. Kennedy Jr. to lead the Health and Human Services Department despite his vaccine skepticism. The Finance Committee approved him on a party-line vote.
Murkowski stated it was too soon to decide whether she supports Means’ confirmation, noting, “These issues are important to me. Last year when the secretary was going through his confirmations, he made certain assurances about vaccines that in fairness I am not seeing have been kept.”
Cassidy also questioned Means on mifepristone, measles vaccinations, and autism links. When asked whether she would advise Americans to vaccinate against flu and measles amid outbreaks, Means did not commit to a public vaccination recommendation, instead stressing informed consent.
Regarding vaccines and autism, Means acknowledged the evidence but added, “I also think that science is never settled.”
Means expressed interest in federal research on environmental factors contributing to autism, noting the National Institutes of Health is funding such studies.
She was also questioned about her past comments regarding the hepatitis B vaccine birth dose, which the CDC stopped recommending for all children. Means said she supports the CDC’s approach but emphasized universal vaccination “at some point in childhood” remains important.
Additionally, Washington Democratic Sen. Patty Murray asked Means to address her previous remarks that birth control pills were prescribed “like candy” and showed a “disrespect of things that create life.”
Means stated oral contraceptives should be available to all women but raised concerns about “horrifying side effects” in certain populations, saying, “Doctors do not have enough time for a thorough informed consent conversation.”