Casey Means, MD, appeared before the Senate Health, Education, Labor and Pensions Committee on Feb. 25 as she seeks to become the nation’s surgeon general, fielding questions about vaccines and her clinical background.
Dr. Means, a wellness influencer, author and entrepreneur, was nominated by President Donald Trump in May, and her October confirmation hearing was postponed after she went into labor the day it was scheduled.
If confirmed, Dr. Means would oversee the U.S. Public Health Service Commissioned Corps, a group of more than 6,000 uniformed public health officers. The role is often referred to as the nation’s top doctor.
Here are four takeaways from the nearly three-hour hearing:
1. Stance on vaccines
While questioned about her stance on vaccines by Sen. Bill Cassidy, MD, a Republican who serves as chairman of the Senate HELP Committee, Dr. Means said she believes vaccines save lives and supports the measles vaccine. The discussion came as South Carolina is facing the largest measles outbreak in the nation since the virus was declared eliminated in 2000, with more than 970 cases confirmed since October. Medical experts have said measles-related hospitalizations in the state may be significantly higher than the reported 2% hospitalization rate.
Dr. Means did not say whether she would encourage parents to vaccinate their children. Instead, she emphasized informed consent and urged individuals to speak with their physicians before taking medications.
“I believe vaccines save lives. I believe they’re an important part of public health,” Dr. Means said. “I also do not want to not encourage patients to have a conversation with their doctor. I think it’s incredibly important. Informed consent is going to be part of building trust in public health.”
Dr. Means also cited rising autism rates in the U.S. and said it is important to study all of the environmental factors that could be contributing. Sen. Bernie Sanders, an independent from Vermont, referenced the American Medical Association’s statement that “an abundance of evidence from decades of scientific studies shows no link between vaccines and autism.”
“Until we have a clear understanding of why kids are developing this at higher rates, I think we should not leave any stones unturned,” Dr. Means said.
2. Questions about clinical experience
Dr. Means was also questioned about her inactive medical license. Although she graduated from Stanford (Calif.) University School of Medicine in 2014 and spent four years as a resident physician, she left residency in her fifth year “to focus on the real root causes of why Americans are so sick,” she wrote in her LinkedIn profile. Dr. Means said during the hearing she does not plan to reactivate her license if confirmed. She said it has not expired and was voluntarily deactivated because she does not see patients, according to Spectrum News.
3. Prevention-first approach to chronic disease
Dr. Means framed her approach to medicine by saying “the root of the word healing means to return to wholeness.” She emphasized shifting away from what she described as a “reactive sick care” model toward prevention and addressing the root causes of chronic disease.
The prevention-focused message comes as healthcare costs rank as Americans’ top economic concern, according to a recent KFF Health Tracking Poll, and as national health spending climbed 7.2% in 2024 to $5.3 trillion, or 18% of GDP, according to CMS.
Dr. Means aligned her message with HHS Secretary Robert F. Kennedy Jr.’s “Make America Healthy Again” agenda, echoing its focus on chronic disease reduction, food policy and prevention-based care.
4. Questions on hormonal birth control
Dr. Means faced questions about her past remarks on hormonal birth control. In prior podcast appearances and online commentary, she has questioned aspects of hormonal contraception, according to NPR.
During the hearing, she said oral contraception should be widely accessible but emphasized that patients should discuss risks and benefits with their physicians.
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