Surgeon general nominee faces sharp questions about vaccines, birth
control and qualifications
[February 26, 2026]
By ALI SWENSON
NEW YORK (AP) — Wellness influencer, author and entrepreneur Dr. Casey
Means on Wednesday shared a vision for addressing the root causes of
chronic disease instead of feeding into “reactive sick care” during her
confirmation hearing to become the nation's next surgeon general.
“Our nation is angry, exhausted and hurting,” the 38-year-old said in
Washington before the Senate health committee Wednesday. “If we’re
addressing shared root causes, we’re going to be able to stop the
whack-a-mole medicine that’s not working for us.”
It's a message that dovetails with that of Means' ally, Health Secretary
Robert F. Kennedy Jr., and his “Make America Healthy Again” movement. It
also has some bipartisan support, with many Democrats and Republicans
agreeing that the rise in chronic disease is a problem that needs
solving.
But Means also faced tough questions from senators about topics that
have become divisive in recent years, such as vaccines and hormonal
birth control, as well as about her qualifications and potential
conflicts. The Stanford-educated physician’s disillusionment with
traditional medicine drove her to a career in which she has promoted
various products, at times without disclosing how she could benefit
financially. She has no government experience, and her license to
practice as a physician is not currently active.
“I have very serious questions about the ability of Dr. Means to be the
kind of surgeon general this country needs,” Vermont independent Sen.
Bernie Sanders, the ranking member of the Senate health committee, said
Wednesday.
Next, the committee will consider whether to advance Means' nomination,
in which case it would go to a vote in the full Senate.
Senators grill Means on vaccines
As the nation’s doctor, the surgeon general is a leader for Americans on
public health issues. If confirmed, Means could issue advisories that
warn of public health threats. She also would be tasked with promoting
Kennedy's sprawling MAHA agenda, which calls for removing food
additives, rooting out conflicts of interest and promoting healthier
eating.
Surgeons general also have sometimes used the office to advocate on
issues related to vaccination — though the office has no role in
creating vaccine policy. While Means has largely steered clear of
Kennedy’s debunked views on vaccines, senators from both parties grilled
her on how she would approach the issue if confirmed.
Sen. Bill Cassidy, the Louisiana Republican who chairs the Senate health
committee, asked Means whether she would advise Americans to vaccinate
against flu and measles amid outbreaks across the U.S. She didn't make
that commitment, instead emphasizing the importance of informed consent
between patients and doctors.
Cassidy, a doctor himself, then asked Means if she accepts evidence that
shows vaccines don’t cause autism.
“I do accept that evidence,” she said, referring to the research. “I
also think that science is never settled.”
Means said she looked forward to seeing the results of a federal effort
to study environmental contributors to autism. The National Institutes
of Health is funding such research, and it’s not clear when those
findings will be made public.
Means also was asked about concerns she has raised about the birth dose
of the hepatitis B vaccine, which the U.S. Centers for Disease Control
and Prevention stopped recommending for all children in a move
criticized by scientific and medical groups nationwide. She said she
supports the CDC's approach to the birth dose, but that promoting
universal vaccination against the disease “at some point in childhood”
was worthwhile.
Senators scrutinize Means' past comments on birth control,
psychedelics
Washington Democratic Sen. Patty Murray asked Means to address her past
comments that birth control pills were being prescribed “like candy” and
showed a “disrespect of things that create life.”
Means said she thinks oral contraceptives should be available to all
women, but raised concerns about what she called “horrifying side
effects” that can occur in certain populations.
“Doctors do not have enough time for a thorough informed consent
conversation,” she said.
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Dr. Casey Means takes her seat at the start of a Senate Health,
Education Labor and Pension Committee confirmation hearing for U.S.
Surgeon General on Capitol Hill Wednesday, Feb. 25, 2026, in
Washington. (AP Photo/Tom Brenner)
 According to the American College of
Obstetricians & Gynecologists, hormonal birth control methods such
as the pill, patch or ring are safe for most people but are
associated with a small increased risk of deep vein thrombosis,
heart attack and stroke. The risk is higher in some people, such as
smokers older than 35 or those who have multiple cardiovascular
disease risk factors.
Sen. Susan Collins, a Republican from Maine, noted that Means had
touted the therapeutic use of psychedelic mushrooms in her book and
tried them herself.
“What I would say as a private citizen is in many cases different
than what I’d say as a public health official,” Means replied,
adding she wouldn’t recommend psychedelics for the public.
Means isn't a traditional candidate for the role
During the hearing, Means said her goal is to “get more whole,
healthy foods on American plates.” It's a worldview she developed
during her unconventional path in the medical field.
After graduating from Stanford University with a doctor of medicine
degree, Means dropped out of her surgical residency program at
Oregon Health and Science University in 2018. She later cited her
belief that the health care system was broken and exploitative as
the reason for her withdrawal.
Means then turned to alternative approaches to address what she has
described as widespread metabolic dysfunction driven largely by poor
nutrition and an overabundance of ultraprocessed foods.
Because she had completed enough postgraduate training to obtain a
medical license, she did so and started her own functional medicine
practice in Oregon, which later closed. She co-founded Levels, a
nutrition-, sleep- and exercise-tracking app that can give users
insights from blood tests and continuous glucose monitoring.
Financial disclosures show she made hundreds of thousands of dollars
promoting wellness products, including specialty basil seed
supplements, teas and elixirs, probiotic products and a prepared
meal delivery service. An Associated Press investigation found that
while recommending these products, she at times failed to disclose
that she could profit or benefit from the sales.
Senators on Wednesday questioned Means about some of those cases.
She said the claims were incorrect, and that she takes conflicts of
interest seriously.
In an ethics filing, Means said that if she is confirmed, she will
resign from her Levels position and forfeit or divest stock options
and stock in the company. She also pledged to stop working for Rupa,
a specialty lab work company for which she developed an online
course. While she may continue receiving royalty payments from her
book “Good Energy,” she will not promote it, the filing said.
The filing also noted she will “not acquire any direct financial
interest in entities listed on the Food and Drug Administration’s
prohibited holdings list.”
At least two previous surgeons general have publicly suggested Means
is not fit for the job.
Last May, former Bush administration surgeon general Dr. Rich
Carmona wrote that Means' professional qualifications “raise
significant concerns.” Later that month, President Donald Trump's
first-term surgeon general, Dr. Jerome Adams, wrote on social media
that the surgeon general's traditional leadership of the U.S. Public
Health Service Commissioned Corps requires a medical license.
Means is seeking to join an administration for which her brother,
Calley Means, already works. As a senior adviser to the U.S.
Department of Health and Human Services, he has helped promote the
Republican administration's warnings about ultraprocessed foods.
___
Associated Press writers Laura Ungar in Louisville, Kentucky and
Nicholas Riccardi in Denver contributed to this report.
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