Surgeon general nominee Casey Means grilled on vaccines, pesticides in hearing

After over a year without a surgeon general, the Senate Health Committee is grilling Casey Means on vaccinations, her business entanglements, and past comments on pesticides, as they weigh whether she should serve as the nation’s top doctor.

Means wrote the book considered the bible of the Make America Healthy Again movement with her brother, Calley Means, a Trump administration official. As surgeon general, she could amplify many of her messages around healthy eating and exercise, although she has faced criticism for some of her ties to wellness products.

Means is drawing fire and praise from both sides of the aisle, reflecting the MAHA coalition’s crosscutting appeal. Her messages on food found favor with both sides, while Democrats and the panel’s GOP chair probed her views on vaccinations and a Republican senator raised questions on how her stance on pesticides could impact American farmers.

Means highlighted the nation’s chronic illness rates and a path to how she hopes to change them in her opening remarks.

“Public health leaders must address the evidence-based, modifiable drivers of chronic diseases which include ultra-processed foods, industrial chemical exposure, lack of physical activity, chronic stress and loneliness, and overmedicalization,” Means said. “As surgeon general, I would call on every American and the Public Health Service to join in a great national healing — one that halts preventable chronic disease, makes healthy living the easiest choice, honors the body’s connection to the environment, and puts America back on the road towards wholeness and health.”

Her initial confirmation hearing was delayed after she gave birth in the fall. This hearing is also a referendum on the controversial moves of her political patron, Health Secretary Robert F. Kennedy Jr., who has overhauled federal vaccine guidelines and upended the public health system. Means, like Kennedy, has publicly questioned the number of vaccines included in the childhood vaccine schedule, as well as the hepatitis B shot. Public health experts say the vaccine schedule is safe and effective.

At the beginning of the hearing, Chairman Bill Cassidy (R., La.) cautioned that as the nation’s top doctor, Means would have a responsibility to fight back against the vaccine skepticism rising across the country “at a time when so many, for whatever reason, sow distrust and confusion.”

Sen. Bernie Sanders (Ind., Vt.), the panel’s ranking minority-party member, went further, accusing Trump and Kennedy of spreading misinformation on vaccines and pleading with Means to take a stand against them.

Cassidy later peppered Means with questions around immunizations, pointing to children who have died of vaccine-preventable disease. Means emphasized that while she supports vaccines, she believes parents and patients must speak to their physicians. She also refused to explicitly say vaccines do not cause autism when pressed, instead saying that no stones should be left unturned in the search for the causes of autism. As health secretary, Kennedy instructed the Centers for Disease Control and Prevention to remove from its website the long-settled scientific conclusion that vaccines do not cause autism.

In his questioning, Sanders started by pointing out the overlap between his and Means’s interest in fighting against ultra-processed food, before pivoting to further press Means on the scientific community’s determination that vaccines don’t cause autism.

“Anti-vaccine rhetoric has never been a part of my message,” Means said, adding that the nation should study when children are getting many medications.

A Washington Post examination last year found that Means had made over half a million dollars from partnerships with companies that her financial forms described as selling “diagnostic testing,” “herbal remedies and wellness products,” and “teas, supplements, and elixirs” from 2024 into the summer of 2025, according to her financial disclosures. Legal and advertising experts told the Post last fall that they were concerned about whether Means clearly disclosed her ties to some brands.

Sen. Tammy Baldwin (D., Wis.) grilled Means on some of her connections to wellness products: “It seems to me that you’ve spent your career sort of making money off the flaws” in the healthcare system.

Sen. Chris Murphy (D., Conn.) said he was concerned that Means was in “willful violation” of Federal Trade Commission rules, recommending products without telling followers she was sponsored by such products.

Means pushed back on the allegations and said she “would rectify that immediately” if it has inadvertently happened.

“I take conflicts of interest incredibly seriously,” Means said.

While many Republicans spoke highly of Means’s approach to improving American diets and fighting chronic disease, some others did not hold back in their questioning of her past remarks on psilocybin, pesticides, and other items.

Pesticides are a hot-button issue among the MAHA movement after Trump issued an executive order protecting a key ingredient in a weed killer.

She wrote in a newsletter sent in 2024: “How can we help bring a pesticide-free world to fruition? It starts with each of us prioritizing eating organic food as much as possible and standing firmly against buying or serving food sprayed with pesticides.”

Sen. Jon Husted (R., Ohio) stressed that he has heard questions from Ohio farmers about her comments on pesticides, calling them critical for the food supply and farmers’ stability.

Means called her thoughts on pesticides a core belief that was important to understand the impact pesticides could be having on Americans’ bodies, but noted she understood change could not happen overnight to destabilize the farming ecosystem.

Means also got in a testy exchange with Sen. Patty Murray (D., Wash.) over birth control, with Means stressing that it’s important to highlight the possible risks including stroke for women. Means has a history of disparaging birth control, which has been under fire from wellness and right-wing influencers.

Secretary Kennedy has championed Means’s nomination.

“She has an extraordinary capacity to communicate to the American public. That is the function of the surgeon general,” Kennedy said at an event Monday, saying Means would be a medical and “moral” authority for the public and he hoped she would be confirmed very soon.Means’ credentials — attending Stanford for her undergraduate education and medical school, racking up academic honors, writing scientific papers and working on research at top institutions — came up in the hearing.

Means left her medical residency over seven years ago and has encouraged Americans to ask questions of their doctors — positions Kennedy has said led to her nomination.

Means, a physician, has a medical license in Oregon that she voluntarily placed in inactive status, according to the state medical board, which means she cannot practice medicine in Oregon as of the beginning of 2024. Sen. Andy Kim (D., N.J.) raised concerns about Means’s medical license. Means pushed back on him by noting she practiced medicine and sees her background as “a feature, it’s not a bug.

MAHA supporters have lauded her for challenging the medical mainstream.

Public health experts have raised questions about some of her advice. In her book Good Energy, Means writes that “the ability to prevent and reverse” a variety of ailments, including infertility and Alzheimer’s, “is under your control and simpler than you think.”

Medical experts have said that while there is significant evidence that diet and exercise can lower the risk of some chronic conditions and slow the progression of diseases, Means overstates the science when she says it can reverse many of them.