Will the Senate learn from its mistakes on Trump’s surgeon general nomination?

President Trump has nominated for surgeon general Casey Means — a wellness influencer, founder of a company that offers exercise tracking and diet coaching and a close associate of Health and Human Services Secretary Robert F. Kennedy Jr.

Means has received bipartisan praise for her campaigns against ultra-processed food, inflammatory proteins and fat, excessive sugar, and seed oils as major causes of metabolic dysfunction, obesity and chronic disease. She is also known for advocating locally grown, organic foods.

That said, Means’s recent testimony at her confirmation hearing provides abundant evidence that confirming her as the government’s leading spokesperson on public health would reinforce the administration’s use of conspiracy theories instead of scientific research to set priorities and polices — and to make many more Americans sick again.  

Responding to questions about flu, measles and Hepatitis B vaccines, Means ducked, dodged, and dissembled. “We’re continually studying the vaccine injuries,” she emphasized, “making sure we’re eradicating conflicts of interest in vaccine research.” Note that she has boasted on social media of having “spoken out against the current culture of vaccines.”

When Sen. Tim Kaine (D-Va.) asked if she agreed with Kennedy that there is no evidence flu vaccines prevent hospitalization and deaths among children, she replied that vaccines save lives at “the population level,” whatever that means. She then indicated that she hadn’t seen Kennedy’s statement and advised parents to consult with their physicians.

With a measles outbreak in South Carolina hitting unvaccinated children especially hard, Means declined to assure Sen. Bill Cassidy (R-La.), a physician, that she would encourage mothers to make certain their children were vaccinated against the disease.

Pressed by Sen. Angela Alsobrooks (D-Md.) about a social media post in which she had declared “The hepatitis B vaccine at birth is a crime,” Means replied, “That is not a full tweet.” But the full context doesn’t add anything — she did not elaborate on her claim in the rest of the post. 

In another exchange with Cassidy, she said Hepatitis B vaccines were available to the public and that parents should “have autonomy over the issue.” Cassidy pointed out that they already have autonomy before she would concede that a shot “at some time in their youth” would be “an important recommendation.”

Means also suggested that a Hepatitis B shot is unnecessary at birth because the disease is contracted through sexual contact and drug use, leading Sen. Lisa Murkowski (R-Alaska) to explain that it is often transmitted through shared food, toothbrushes and blood from minor injuries to family members. Vaccinations at birth, added Murkowski, have “made a remarkable difference” in her state.

Asked about claims that vaccines cause autism, Means acknowledged that no reputable studies have found a connection. But she added, “We do not know as a medical community what causes autism and we should not leave any stone unturned,” because “science is never settled.” She waved aside Sen. Susan Collins’s (R-Maine) concerns about her use of illicit psychedelic mushrooms, and her apparent endorsement of them in her book, “Good Energy.” “I believe what I would say as a private citizen is in many cases different than what I would say as a public health official,” Means said.

Means has claimed that birth control pills “show a disrespect for things that create life,” are prescribed “like candy” and may cause “horrifying side effects.” She has also alleged that “at the highest levels of our medical institutions there are conflicts of interest and corruption that are actually making the science we’re getting not as accurate and not as clean as we’d want it.” 

In her view, the pharmaceutical industry, doctors and regulators profit by keeping Americans sick. According to an investigation by the Associated Press, however, Means has not always informed consumers of the hundreds of thousands of dollars she has made promoting basil seed supplements, teas and elixirs, probiotic products and prepared meal delivery services.  

Once a harsh critic of pesticides, Means, like RFK Jr., has changed her tune since February. That was when Trump issued an executive order, in the name of national security, to increase domestic production of the potentially harmful herbicide glyphosate and sided with Bayer in a case before the Supreme Court that could make it more difficult to sue pesticide makers whose products cause cancer. Pesticide restrictions, Means told the committee, “would be devastating for the American farmer and the American consumer.”

To these policy-related objections, critics add that Means lacks the qualifications to be surgeon general. A graduate of Stanford University College of Medicine, she did not complete her residency and does not have an active license to practice medicine.

To confirm her, despite her evisceration of vaccine protocols, would “undermine every argument they’ve made about merit, standards, and making DEI shortcuts,” says Jerome Adams, surgeon general in the first Trump administration.

Cassidy, Collins and Murkowski, it is worth noting, all voted to confirm RFK Jr. as HHS secretary, despite reservations over his views on vaccines and evidence-based science. We know how that turned out. This time, one can only hope they will heed the old saying, “Fool me once, shame on you. Fool me twice, shame on me.” 

Glenn C. Altschuler is the Thomas and Dorothy Litwin Emeritus Professor of American Studies at Cornell University. David Wippman is emeritus president of Hamilton College.

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