What the Surgeon General Nominee Said on Vaccines, Autism, and Psychedelics

Surgeon General nominee Dr. Casey Means appeared before a Senate panel on Feb. 25 and indicated broad alignment with top Trump administration health officials on vaccines, food, and farming.

During a hearing in Washington, Means, 38, answered questions from members of the Health Committee as they consider whether to advance her nomination to the full Senate.

The hearing was delayed from October 2025, when Means went into labor shortly before she was due to appear.

Here’s what Means said on Wednesday.

Top Priorities

In her opening statement, Means said her top priorities include improving Americans’ health, noting that many Americans suffer from chronic diseases such as diabetes.

Means said that there is a need to address what she called the drivers of the public health crisis, including ultra-processed foods, exposure to industrial chemicals, rising loneliness, and a lack of physical activity.

The new dietary guidelines issued by health officials will help by giving Americans in prison, schools, and other venues healthier meals, Means said.

She said later that many of the chronic diseases have the same root causes, and that she wants to update the health care system to treat those causes.

“If we’re addressing shared root causes, we’re going to be able to stop the whack-a-mole medicine that is not working for us and that is so costly,” she said.

Sen. Roger Marshall (R-Kan.) said Means “brings a forward-thinking vision focused on prevention, innovation, and patient empowerment” and was “poised to shift us from reactive sick care to proactive health care, emphasizing metabolic health, to truly make America healthy again.”

Support for Vaccines, Informed Consent

Sen. Bill Cassidy (R-La.), the committee’s chairman, was among the senators questioning Means on vaccines. Cassidy voted to confirm Health Secretary Robert F. Kennedy Jr., but has criticized vaccine-related moves, including downgrading recommendations for some vaccines for children in January.

Cassidy asked Means to endorse vaccines for measles amid an outbreak in South Carolina, and influenza after the new vaccine schedule stopped broadly recommending flu shots.

“I believe vaccines save lives. I believe they’re an important part of public health,” Means said. “I also do not want to not encourage patients to not have a conversation with their doctor. I think it’s incredibly important. And informed consent is going to be a big part of building trust in public health.”

The updated schedule also stopped recommending hepatitis B vaccination shortly after birth to children whose mothers tested negative for the disease.

“The idea of giving a newborn the hepatitis B vaccine … if the baby is born to parents *without hepatitis B* is absolute insanity and should make every American pause and question the health care system’s mandates,” Means said on X in 2024.

Cassidy multiple times asked Means to endorse specific vaccines, including the hepatitis B shot. He asked her if she supported every child receiving the hepatitis B vaccine at some point before they become adults. She said yes.

Possible Vaccine-Autism Connection

Means also said that it is good the Trump administration is funding research into the causes of autism, including vaccines.

“We have an autism crisis that is increasing, and this is devastating to many families,” Means said. “We do not know as a medical community what causes autism. The administration has just committed a huge amount of funding to looking at environmental factors that could be contributing to autism. Until we have a clear understanding about why kids are developing this at higher rates, we should not leave any stones unturned.”

The rates of autism have increased from one in 150 children in 2002 to one in 31 children in 2022, according to federal data released in 2025.

Kennedy has pledged to uncover what factors are contributing to the spike.

The Autism Science Foundation, among other groups, says vaccines do not cause autism, pointing to studies such as a 2019 paper that analyzed children in Denmark. Other researchers have said there are signs supporting a possible association, and some people paid by the federal vaccine injury court have received compensation for autism-related claims.

Cassidy said that ample evidence shows no association. Sen. Markwayne Mullin (R-Okla.) told Means she was right to want to look at an array of possible causes of autism.

Psychedelics

Means in a 2024 book said that people should consider therapy facilitated by psychedelic products, many of which are not legal outside of studies. “Strong scientific evidence suggests that this psychedelic therapy can be one of the most meaningful experiences of life for some people, as they have been for me,” she wrote at the time.

Sen. Susan Collins (R-Maine) asked if Means stands by what she wrote.

“I believe what I would say as a private citizen is in many cases different from what I would say as a public health official,” Means said.

“When it comes to psychedelic therapy for mental health issues, I think the science is still emerging, so it would not be a recommendation to the American people to do that,” she said soon after.

Means said that there are various efforts to study psychedelics, and that she supports that research.

The surgeon general—known as America’s doctor—is part of the Department of Health and Human Services, which is led by Kennedy, and is in charge of the 6,000 officers in the U.S. Public Health Service Commissioned Corps.

Kennedy told reporters in an unrelated press conference this week that “we’ve been waiting a long time for Dr. Means to come on board” and that “she has an extraordinary capacity to communicate to the American people.”

Inactive License

Means graduated from Stanford Medical School in 2014. She has drawn scrutiny for not completing her surgical residency.

She decided to drop out before finishing because she “grew increasingly disillusioned with the reactive ‘sick care’ model she encountered” and wanted “to explore the intersection of holistic health and surgery,” according to her website.

Means obtained a medical license and had her own practice in Portland, Oregon, before joining the company Levels, which provides blood testing and other medical services. The license was voluntarily listed as inactive on Jan. 1, 2024, because, according to Means, she no longer sees patients.

Sen. Andy Kim (D-N.J.) wondered if Means would look to reactivate the license if she is confirmed, pointing to how members of the Public Health Service Commissioned Corps are expected to have active licenses.

“I do not plan to reactivate, because I’m not going to see patients in this role,” Means said. “It would not make sense to do that.”

She said that Department of Health and Human Services has found her qualified for the surgeon general position and that her experience gives her the ability to communicate public health information.

Kim said lacking the license could undermine Means’ credibility if she becomes the surgeon general.

Product Promotion

Means has a popular newsletter on health, and some 845,000 followers on Instagram.

She has used her newsletter and social media to promote products, including supplements from a company called WeNatal. Federal Trade Commission (FTC) policy requires influencers to disclose any relationships to brands they’re promoting.

Sen. Chris Murphy (D-Conn.) said that according to financial documents Means submitted to the committee, she began receiving money from WeNatal in the spring of 2024, but later that year, in a video she posted, Means said that she did not have a financial relationship with the company.

Means said that was not true.

Murphy then listed more examples he said showed false representations, including a lack of disclosure of payments from another firm, Genova Diagnostics, in seven out of nine posts.

“This seems systemic,” Murphy said. “It seems that in the majority of instances in which you were as a medical professional recommending a product, you were hiding the fact that you had a financial partnership.”

Means maintained that the allegations were not true. “And if it inadvertently has happened, I would rectify that immediately,” she said.

Means also said she takes conflicts of interest seriously and worked with the Office of Government Ethics on how to comply with federal law.

“I have the evidence she regularly violates FTC policy by recommending products and not disclosing her financial affiliation, and it’s not believable to me that she has no idea that she has been systematically violating its policy,” Murphy told reporters after the hearing.

Open to Confrontation

Some senators raised comments from administration officials, prompting Means to say that she would be open to expressing concern to officials if she took issue with things they said.

“I certainly have absolutely no issue having very frank conversations with anyone in the administration if I believe their comments are misguided in some way or not fully informed,” she said. “That’s not a conversation I would have publicly first. I would have a private and direct conversation if I felt patients were at risk.”

Sen. Lisa Blunt Rochester (D-Del.) brought up a trial that U.S. authorities approved for funding that would test the hepatitis B vaccine in the west African nation of Guinea-Bissau by having some babies not receive a birth dose—the current standard in the country, but set to change soon.

Means said that she was not familiar with the trial but indicated that it sounded unethical.

The trial is being reviewed by officials in Guinea-Bissau, the country’s health minister said in January.

“I would not hesitate to have direct, private conversations with anyone about ethical concerns, and also I do not believe that the secretary or anyone in the administration would ask me to do anything unethical,” Means added later.

Regenerative Farming

Means in her newsletter in 2024 noted that the World Health Organization has said glyphosate, an ingredient in some pesticides, damages DNA and probably causes cancer. The Environmental Protection Agency says it can be used safely.

Trump on Feb. 18 signed an order designating the domestic production of glyphosate a national defense issue, and granting immunity to manufacturers.

Kennedy, who had spoken out strongly against glyphosate in the past, said that glyphosate is toxic but that the agricultural system depends on that and other chemicals. Means offered a similar defense.

“We must as a country move away from using toxic inputs in our food supply and we must study these chemicals more to understand their effects. I’m very gravely concerned about the health impacts of these chemicals,” Means said. “Our food system is dependent currently on these chemicals. There is a good faith movement towards moving our food system towards regenerative agriculture and precision application of pesticides. I believe in good faith that is happening in the administration.”

Sen. Edward Markey (D-Mass.) responded: “I’m disappointed to see you back away from your efforts.”

Means said that she was not backing away from the issue.

Nathan Worcester contributed to this report.