Dr. Casey Means appeared before the Senate on Wednesday in a long-awaited hearing to discuss her highly scrutinized nomination for surgeon general.
Means faced tough questions from members of the Senate Health, Education, Labor and Pensions Committee about her stances on vaccines, contraception and antidepressant use during pregnancy. She often avoided direct answers, instead echoing refrains from Health Secretary Robert F. Kennedy Jr. and other top health officials.
Sens. Bill Cassidy, R-La., and Bernie Sanders, I-Vt., both grilled Means about whether she believed that vaccines cause autism, as Kennedy has claimed.
Means said that vaccines save lives and that “anti-vaccine rhetoric has never been a part of my message.” However, she declined to rule out vaccines as a contributor to autism, despite decades of evidence that has not shown a link.
“We do not know as a medical community what causes autism,” Means said. “Until we have a clear understanding of why kids are developing this at higher rates, I think we should not leave any stones unturned.”
Scientists largely attribute the rise in autism cases to advances in diagnostic capabilities and greater understanding and awareness of autism spectrum disorder. Genes and environmental factors are likely contributors as well.
Means also hesitated when asked several times by Sen. Tim Kaine, D-Va., if the flu vaccine prevents serious disease, hospitalizations or death.
“Doctor, this is an easy one,” Kaine said.
Means replied: “I support the CDC guidance on the flu vaccine.”
In a highly controversial move, Kennedy altered the Centers for Disease Control and Prevention’s childhood vaccine guidance in January. Instead of a universal recommendation for flu shots, the CDC now recommends shared clinical decision-making between patients and doctors.
Means, a popular wellness influencer, was a campaign adviser during Kennedy’s presidential bid and an architect of his “Make America Healthy Again” agenda. Her brother, Calley Means, is a Kennedy ally and senior adviser to the Department of Health and Human Services.
Like Kennedy, Means has gained popularity in wellness circles because of her messages about outsize corporate influence in the food and pharmaceutical industries. She has often expressed skepticism of traditional medicine, writing on her website that hormonal birth control has “horrifying health risks” and that the “total burden” of the vaccine schedule — before Kennedy overhauled it — is “causing health declines in vulnerable children.” (Neither claim is substantiated by scientific evidence. Routine childhood shots are backed by decades of safety data, and serious complications from hormonal birth control are rare.)
Sen. Patty Murray, D-Wash., pressed Means on Wednesday about her prior comments on birth control.
Means said some of the “horrifying” side effects she was referring to include blood clots and stroke among women who have clotting disorders, are smokers or have obesity.
“I absolutely believe these medications should be accessible to all women,” she said, adding that “all medications have risks and benefits.”
Where antidepressant use during pregnancy is concerned, Means reiterated that there are benefits and risks and said patients should have a nuanced conversation with their doctors. (Some Food and Drug Administration officials have questioned whether pregnant women should stay on the medications, despite the American College of Obstetricians and Gynecologists’ recommendation to do so.)
If confirmed to the role, Means would be an outlier among surgeons general: She does not hold an active medical license (her license lapsed in January 2024) and she did not complete her medical residency (she graduated from Stanford University School of Medicine but left a surgical residency program at Oregon Health and Science University in 2018, just months before she was due to complete it).
As a result, many medical professionals have questioned whether Means is qualified to become America’s top doctor with the authority to issue health warnings and advisories for the entire country.
