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Trump pulls Casey Means' stalled surgeon general nomination, announces new pick

Dr. Casey Means testifies during a Senate Health, Education Labor and Pension Committee confirmation hearing for U.S. Surgeon General on Capitol Hill, Feb. 25, in Washington.
Tom Brenner
/
AP
Dr. Casey Means testifies during a Senate Health, Education Labor and Pension Committee confirmation hearing for U.S. Surgeon General on Capitol Hill, Feb. 25, in Washington.

Updated April 30, 2026 at 4:24 PM EDT

WASHINGTON — President Donald Trump said Thursday he's nominating radiologist and former Fox News Channel contributor Dr. Nicole Saphier for surgeon general after Dr. Casey Means' path forward stalled in the Senate over questions about her experience and her stance on vaccines.

In a social media post, Trump said he would nominate Saphier, whom he called "a STAR physician who has spent her career guiding women facing breast cancer through their diagnosis and treatment."

Saphier is director of breast imaging at Memorial Sloan Kettering Monmouth, according to her profile on the New York-based institution's website. She has a doctor of medicine degree from Ross University School of Medicine in Barbados along with fellowships at the Mayo Clinic, the profile said.

The withdrawal came after tense exchanges between Means and lawmakers of both parties threw into question whether she could secure enough votes to advance out of the Senate health committee.

Her nomination had languished since her confirmation hearing in late February, even as activists from the Make America Healthy Again movement orchestrated a push to support her bid by surging phone calls to Republican Sens. Lisa Murkowski of Alaska and Susan Collins of Maine. They had both indicated reservations with the pick.

Means pitches ideas popular with MAHA

In nominating Means last May, Trump sought to hire a close ally of Health Secretary Robert F. Kennedy Jr. as the nation's doctor. The 38-year-old Means, a Stanford-educated physician who became disillusioned with the health care system and pivoted to a career as an author and entrepreneur, promotes ideas popular with the MAHA movement, including that Americans are overmedicalized and that diet and lifestyle changes should be at the center of efforts to end widespread chronic disease.

But Means, who did not finish her surgical residency program and doesn't currently have an active medical license, also had faced scrutiny for her lack of experience and potential conflicts. On top of those concerns, senators grilled her in February about Kennedy's wide-ranging pullback of vaccine recommendations — leading to some contentious moments as Means toed the line between support for vaccines and calling them a decision best made by patients and their doctors.

In her confirmation hearing, Means was repeatedly asked about the birth dose of the hepatitis B vaccine, which the U.S. Centers for Disease Control and Prevention stopped recommending for all children late last year in a move criticized by scientific and medical groups nationwide. Means has raised doubts about the birth dose, posting on social media in 2024 that giving the vaccine to a newborn whose parents don't have hepatitis B was "absolute insanity."

In another post earlier Thursday, Trump called Means "a strong MAHA Warrior" and also criticized the "intransigence and political games" from GOP Sen. Bill Cassidy of Louisiana, who is facing a tough reelection this year and who interrogated Means about vaccines during the hearing.

Means' brother, Calley Means, a health adviser to the Trump administration, blamed Cassidy in a social media post, claiming his "constant delay tactics" sank the nomination because he didn't bring Means' nomination to a committee vote. Cassidy didn't respond to a request for comment.

Now Trump will try to fill the post a third time

Means is the second U.S. surgeon general pick whose nomination has been withdrawn in Trump's second term. Trump withdrew his first nominee, Fox News medical contributor Janette Nesheiwat, after questions were raised about her academic credentials.

Saphier, like Means, has questioned whether every child needs to get the hepatitis B vaccine at birth.

"I don't necessarily think it's necessary," she said on a podcast in September. "My opinion is if a woman recently tested negative for hepatitis B and they're living a low-risk lifestyle, no IV drug use, not a sex worker, they don't have a hepatitis B positive person living in the home, then the newborn probably doesn't need this vaccine and we can have a conversation about whether or not they should get the vaccine later in life."

She also has criticized COVID vaccine booster requirements, arguing on a radio show in September that they were not always rooted in evidence.

In at least one case, Saphier has diverted from Trump's medical messaging. Last year, as Trump advised pregnant women, "Don't take Tylenol" — promoting unproven and in some cases discredited ties between the medication, vaccines and autism — Saphier said that while pregnant women generally are advised to take acetaminophen only under medical supervision, when necessary and at the lowest effective dose, equally important was that untreated fever or severe pain can also pose serious risks to mothers and babies. She noted that part was missing from Trump's message, delivered at a press conference with top U.S. health officials.

"For decades, women have endured a paternalistic tone in medicine. We've moved past dismissing symptoms as 'hysteria,'" Saphier wrote in an email to The Associated Press at the time. "The President's recent comments on Tylenol in pregnancy are a prime example. Advising moderation was sound; delivering it in a patronizing, simplistic way was not." On a podcast at the time, Saphier said the press conference was "full of hyperbole" and "really painful to watch

Means and Saphier did not respond to requests for comment. The U.S. Department of Health and Human Services referred inquiries to the White House.

Copyright 2026 NPR

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