Dr. Casey Means faced pointed questioning Wednesday over vaccines, birth control, financial conflicts and her qualifications to serve as surgeon general. The Senate Health Committee will now decide whether to send her nomination to the full Senate.
Means, a Stanford-trained physician and wellness entrepreneur aligned with Health Secretary Robert F. Kennedy Jr., was repeatedly pressed on how she would use the surgeon general’s platform, particularly on vaccines.
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Vaccine stance draws bipartisan scrutiny
Chairman Bill Cassidy, a Republican and physician, told Means that the nation’s top doctor must counter vaccine skepticism. He asked directly whether she accepts the scientific consensus that vaccines do not cause autism.
“I do accept that evidence,” Means replied. “I also think that science has never settled.”
She pointed to federal funding for research into environmental contributors to autism, saying “we should not leave any stones unturned.”
Cassidy and other senators sought a clear endorsement of routine immunization, including measles and flu shots. Means said she believes vaccines save lives but stopped short of urging universal vaccination, returning instead to the importance of informed conversations between parents and physicians.
Sen. Tim Kaine, D-Va., asked whether she believes the flu vaccine reduces hospitalizations and deaths in children. Means ultimately said she supports CDC guidance and believes the flu shot works “at the population level.”
She also addressed past criticism of the hepatitis B birth dose, calling vaccination “at some time in childhood” a “worthy goal,” while noting that some parents question whether the shot is necessary on the first day of life.
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Birth control, psychedelics and pesticides
Sen. Patty Murray, D-Wash., confronted Means over prior statements describing hormonal birth control as being used “like candy.”
“You also claimed, contrary to established science, that hormonal birth control has, quote, horrifying health risks for women,” Murray said.
“I’m curious if you are aware of what the side effects of hormonal contraception are,” Means asked in response.
Murray replied that she was curious if Means, as Surgeon General, is “going to tell the truth to the American people.”
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The Surgeon General’s office was established in 1871 for the Marine Hospital Service, which later became the U.S. Public Health Service in 1912.
Means said oral contraceptives should remain available but argued physicians often lack time for thorough informed consent conversations.
Republican Sen. Susan Collins raised Means’s past discussion of psilocybin and her personal use of psychedelic mushrooms, described in her book. Means said what she wrote as a private citizen differs from what she would recommend in public office and stated she would not advise the public to use psychedelics.
Other Republicans questioned her past criticism of pesticides. Means said she remains concerned about health effects but acknowledged that agriculture depends on those products and that change cannot happen overnight.
Financial disclosures and medical license
Democrats focused on Means’s financial ties to wellness products. A Washington Post review reported she earned more than $500,000 from partnerships with companies selling diagnostic testing, supplements and related products.
Sen. Chris Murphy, D-Conn., cited a complaint alleging she failed to disclose financial relationships in some online endorsements. Means rejected the allegation and said she would correct any inadvertent errors. “I take conflicts of interest incredibly seriously,” she said.
In ethics filings, Means pledged to resign from her role at the health app company Levels and divest related holdings if confirmed. She also committed to ending work with other health-related ventures.
Lawmakers questioned her inactive Oregon medical license. Means left her surgical residency more than seven years ago and voluntarily placed her license on inactive status, which means she cannot currently practice medicine in that state. She said her path outside traditional clinical practice is “a feature, it’s not a bug.”
Former surgeons general have publicly criticized her nomination, arguing that the leader of the U.S. Public Health Service should hold an active license.
The surgeon general position has been vacant for more than a year. The committee will vote on whether to advance Means’s nomination to the full Senate.
