Trump pulls Casey Means' stalled surgeon general nomination. New pick is
radiologist Nicole Saphier
[May 01, 2026]
By ALI SWENSON and MEG KINNARD
WASHINGTON (AP) — 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.” Health Secretary
Robert F. Kennedy Jr. complimented the nomination, calling Saphier “a
long-time warrior for the MAHA movement.”
But at least in one instance, she hasn't been in lockstep with Trump's
thoughts on health policy, telling The Associated Press in September
that his cautions about pregnant women taking Tylenol were
oversimplistic and “patronizing.”
Means' withdrawal came after her tense exchanges with lawmakers of both
parties threw into question whether she could secure enough votes to
advance out of the Senate health committee.
In an interview Thursday, Means said her nomination fell apart after a
“yearlong smear campaign against me,” which she said was a larger effort
to impugn the MAHA movement and its focus on reforming food and
healthcare.
She said she will continue to “help with progress on this movement how I
can.”
Means pitched ideas popular with MAHA
In nominating Means last May, Trump sought to hire a close Kennedy ally
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 effort to
pull back 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
and currently blocked during a lawsuit. 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.”
Means' nomination had languished since the late February confirmation
hearing, even as activists from the MAHA movement orchestrated a push to
support her bid by surging phone calls to Republican senators Lisa
Murkowski of Alaska and Susan Collins of Maine. They had both indicated
reservations with the pick.
Means told The Associated Press her understanding was that Murkowski
wasn't going to vote for her, and Collins had serious reservations.
“I think there was some talking past each other,” Means said of her
conversations with the senators, noting they seemed focused on vaccines
when she “wasn't coming in with any agenda to impact the vaccine
conversation.”
In post Thursday, Trump called Means “a strong MAHA Warrior” and also
criticized the “intransigence and political games” from GOP Sen. Bill
Cassidy of Louisiana, the chair of the Senate health committee, who is
facing a tough reelection this year and who interrogated Means about
vaccines during the hearing.
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President Donald Trump speaks to reporters as he meets with NASA's
Artemis II astronauts Victor Glover, Christina Koch, Reid Wiseman
and Jeremy Hansen in the Oval Office of the White House, Wednesday,
April 29, 2026, in Washington. (AP Photo/Matt Rourke)
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. Kennedy later piled on with his
own post claiming Cassidy “did the dirty work for entrenched interests
seeking to stall the MAHA movement.” 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 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.
Like Means, Saphier 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.
Saphier used the phrase “Make America Healthy Again” years before
Kennedy popularized it. It was the title of a book she wrote in 2020
that criticized government handling of health care and the Affordable
Care Act.
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 AP 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."
Saphier did not respond to a request for comment.
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Kinnard reported from Columbia, S.C.
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