Trump’s Surgeon General Pick Is Taking Heat From Both Advocates And Opponents Of Vaccines

Casey Means, President Donald Trump’s pick for surgeon general, has achieved an unlikely feat: uniting vaccine skeptics and mainstream medical advocates against her nomination.

Activists in both camps are now urging senators to vote her down.

After Means’ confirmation hearing last week Kayla Hancock, a vaccine proponent and director of the liberal health care advocacy group Protect Our Care’s Public Health Watch project said Means is “too damn dangerous to be Surgeon General.” At the same time, physician and prominent vaccine skeptic Mary Talley Bowden pointed to Means’ statements touting vaccines as “life-saving” as a “cop-out.”

Means is likely to need every Republican on the Senate’s health committee behind her to advance to a confirmation vote. But some GOP lawmakers are reassessing what having an avowed vaccine skeptic at the top of the health department Robert F. Kennedy Jr. has wrought and aren’t sure they want to empower another department leader with an equivocal position on immunization.

“These issues are important to me,” said Sen. Lisa Murkowski (R-Alaska), who’s undecided on how to vote. Murkowski said last week she needed more clarity on Means’ position on vaccines. Means would serve as America’s top doctor and report to Assistant Secretary for Health Brian Christine if confirmed. Surgeons general typically use the office to promote good health practices.

Trump tapped Means after pulling his first choice, former Fox News contributor Janette Nesheiwat, after news reports said Nesheiwat had misstated her academic and medical credentials. There’s been no one in the role during Trump’s second term.

Means came to fame promoting healthy living and alternative therapies in a book and on social media, and told senators last week that vaccines weren’t a “core” part of her platform. As a result, anti-vaccine activists like Bowden suspect she’s not one of them, even though Means has Kennedy’s backing.

Means declined to comment for this story.

Public health advocates point to Means’ muddled responses on vaccines — at the hearing she repeatedly stated they save lives but declined to say she’d use her bully pulpit to promote them — as reason for senators to vote no. The advocates say they have no reason to think she’ll do anything but promote Kennedy’s efforts to shift public thinking about vaccines, from civic responsibility to free choice.

Kennedy has reduced the number of diseases the government recommends children receive immunizations for from 17 to 11, which could have a ripple effect on what shots schools require. Schools are, for most Americans, the only place that requires proof of vaccination and states control those rules.

The irony is that Means also has run afoul of anti-vaccine activists who group her and her brother, Kennedy adviser Calley Means, as rivals for power inside the health department. They see the Meanses as more focused on food and not as much on culling the vaccine schedule.

"Vaccines, especially the Covid ones, have been at the heart of public health policy for years, and downplaying them as not core to her message shows she's out of touch with the real crises we're facing,” Bowden told POLITICO.

An otolaryngologist who leads a group called Americans for Health Freedom, Bowden has advocated for years for Covid shots to be pulled from the market.

After Trump picked Means for the job last May, Mike Adams, a vaccine skeptic who runs the website Natural News, called her “an impostor” and “a plant, airdropped into the movement to change the narrative so you don’t talk about vaccines.”

While most Republicans on the Health, Education, Labor and Pensions Committee support Means, she’ll need all of their votes if Democrats are united in opposition. Besides Murkowski, Susan Collins of Maine has said she’s undecided. Bill Cassidy, the Louisiana Republican and the panel’s chair, has repeatedly declined to comment.

Means has emerged as a leading voice in Kennedy’s Make America Healthy Again movement. The Stanford University medical school graduate has promoted controversial health practices, such as drinking raw milk, to her newsletter subscribers. Her book, Good Energy: The Surprising Connection Between Metabolism and Limitless Health, co-authored with her brother, was a bestseller. Like Kennedy, it focuses on calling out the root causes of disease in food and lifestyle. She also co-founded Levels, a health-tech company that uses glucose monitoring to track blood sugar.

At the confirmation hearing Means said vaccines weren’t a part of her platform, but she has publicly criticized vaccine recommendations. In 2024, she called giving the hepatitis B birth dose to children born to parents who don’t have the virus “absolute insanity.”

The Centers for Disease Control and Prevention dropped the universal recommendation in December even though it has coincided with a significant drop in childhood cases in recent decades. The CDC now recommends the shot only when a newborn’s mother has tested positive for the virus or has not been tested.

Cassidy condemned the decision at the time.

During her testimony, Means advocated for shared clinical decision-making and informed consent — where parents and providers weigh the risks and benefits of vaccines. She also said she supports the CDC’s vaccine guidance.

“I believe [vaccines are] a key part of our public health strategy,” she said. “I also believe that this administration is committed to making sure we have the safest vaccine schedule in the world and that we are continually studying the vaccine schedule, vaccine injuries, making sure we're eradicating conflicts of interest in vaccine research and doing gold standard science on vaccines.”

But Means’ stance was far too relaxed for Bowden. “I would absolutely prioritize someone who has the backbone to call for pulling unsafe Covid vaccines off the market,” she told POLITICO.

Last fall, the Texas Medical Board reprimanded Bowden for attempting in 2021 to treat a Covid patient with ivermectin, an anti-parasitic drug the FDA has said isn’t effective against Covid-19 and could be harmful if taken in large doses. Bowden has since sued in retaliation.

Bowden urged senators to vote against Means’ confirmation and Trump to withdraw her nomination in a social media post last week. Several other anti-vaccine advocates made similar demands.

“#NoMeansNo,” wrote Craig Wax, a physician and Covid shot skeptic who Kennedy has endorsed.

Despite the backlash, the White House is sticking by Means — and is pushing senators to do so as well.

“Dr. Casey Means’s elite academic credentials, research background, and advocacy on America’s chronic disease epidemic will make her a critical asset for President Trump’s push to Make America Healthy Again,” White House spokesperson Kush Desai said in a statement to POLITICO.

“The Administration continues to have productive conversations with the Senate to advance Dr. Means as our next surgeon general, and the White House looks forward to her swift confirmation,” he added.

Vaccine skeptics with ties to Kennedy are also throwing their support behind her.

Del Bigtree, an anti-vaccine advocate and former communications director for Kennedy during the secretary’s 2024 presidential bid, told POLITICO senators are trying to make Means “carry an issue that’s not hers” by grilling her on vaccines.

"I hope that these senators, if they block her, are remembered for being the ones that stood with the status quo, where the surgeon generals are only involved in poisoning kids, not in making them healthier,” he said.

Some public health experts who back the use of vaccines think Means’ equivocal responses during her confirmation hearing followed Kennedy’s playbook.When he was seeking confirmation as health secretary last year, Kennedy played down some of his previous vaccine skepticism to gain senators’ votes.

“We've seen nominees of this administration come before this committee and completely mislead them,” said Peter Lurie, a physician who leads the Center for Science in the Public Interest, a Washington-based nonprofit watchdog. Means is the latest example of it, he said.

“She's in a terribly difficult spot: She has to toe the line that somehow reassures the people who favor vaccines, but that does not offend her sponsor, the secretary,” Lurie said.

Some Republican senators’ reluctance to back her shows the administration is starting to pay a price for embracing vaccine skepticism, Lurie argued.

“It’s a change from the last time around, where the secretary, whose positions on vaccines were clearer than hers, still managed to get through,” he said.

But Angela Rasmussen, an American virologist who works at the University of Saskatchewan’s Vaccine and Infectious Disease Organization in Canada, sees Means’ responses on vaccines as an attempt to obscure her previous anti-vaccine positions. Rasmussen, who is part of the Save America Movement, a group fighting against Trump, pointed to Means’ tweets on the hepatitis B vaccine and a poem she posted on her website last year.

“I’d bury research, seal the locks,/ Then line you up for seventy-three shots,” says the poem, in a nod to a vaccine skeptics’ allegation that federal health agencies hid research showing a link between autism and vaccines.

“I’d cancel critical thinking, stop dissenters with bots,/ Then jab your kids without a second thought,” the poem continues.