President Donald Trump on Thursday announced his latest pick for surgeon general, Nicole Saphier, putting an end to Casey Means’s nomination process that had stretched nearly a year.
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The choice of Saphier – a longtime Fox News contributor and radiologist at Memorial Sloan Kettering Cancer Center – represents Trump’s third attempt to fill the job of the nation’s top doctor, after first nominating and then withdrawing Janette Nesheiwat last year.
The role of surgeon general, which offers a prominent bully pulpit but limited influence over policy, has been ensnared by broader fights over vaccines, public health and Health Secretary Robert F. Kennedy Jr.’s Make America Healthy Again movement. Kennedy, the founder of an anti-vaccine group, has a long history of disparaging vaccines and has attempted to upend the public health system.
The shift is the latest shake-up in Kennedy’s health department. In recent months, Kennedy has largely stopped publicly talking about vaccines as polling suggests vaccine skepticism carries political risks. Earlier this year, his top aides were restructured, and his new nominee to lead the Centers for Disease Control and Prevention has expressed support for vaccines. Meanwhile, Saphier has been openly critical of Kennedy on social media.
Trump on Truth Social called Saphier “an INCREDIBLE COMMUNICATOR, who makes complicated health issues more easily understood by all Americans.” Saphier has previously interviewed Trump for Fox News and wrote a 2021 book that blamed anti-Trump sentiment for undermining the coronavirus response.
Saphier was among several high-profile figures who claimed in 2022 that the CDC would mandate that schoolchildren receive coronavirus vaccines. But the claim was wrong: The CDC cannot mandate that schoolchildren receive vaccines, a decision left up to states and jurisdictions. Saphier did not immediately respond to a request for comment.
A health products entrepreneur and popular online personality who left the medical establishment in her final year of residency, Means had seen her nomination stall as some Republicans questioned her stance on vaccines, her medical credentials and her pushes against the medical establishment. Means appeared before the Senate Health, Education, Labor and Pensions Committee in February after an earlier hearing was postponed after she went into labor.
“Casey will continue to fight for MAHA on the many important Health issues facing our Country, such as the rising childhood disease epidemic, increased autism rates, poor nutrition, over-medicalization, and researching the root causes of infertility, and many other difficult medical problems,” Trump wrote on his Truth Social platform.
In an interview with The Washington Post, Means praised the leadership of Trump and Kennedy, whom she credited with invigorating a new movement around health with MAHA. She pointed to a win Thursday by the movement in eliminating from a farm bill potential liability protections for pesticide companies.
“The decision about me and my nomination came down to three senators, three disgruntled senators, so I don’t think it represents the bigger picture of what’s happening with the movement, which is overall very positive,” she said.
Means said the White House pulled the nomination because of “that act of aggression against this movement” by the senators blocking her nomination.
“My message is about empowerment and about fixing broken health care incentives that are keeping us sick, and the establishment did not want to hear this from the nominee for the nation’s doctor,” she said. “Many in the establishment want to keep the status quo exactly as it is.”
‘A system that protects itself’
Trump also attacked Sen. Bill Cassidy (R-Louisiana), the chairman of the Senate Health Committee, saying that Cassidy had stood in the way of Means’s confirmation. “Hopefully all of the Great Republican People of Louisiana, which I won, BIG, three times, will be voting Bill Cassidy OUT OF OFFICE in the upcoming Republican Primary!” Trump wrote.
The White House and Cassidy’s office did not immediately respond to a request for comment.
The MAHA movement had pushed hard for Means’s nomination, with its political advocacy arm sending emails rallying supporters to call senators and complaining that Cassidy, as well as Republican Sens. Lisa Murkowski (Alaska) and Susan Collins (Maine), had held up the process. Key figures have encouraged supporters to press holdout senators.
Vani Hari, an activist and Kennedy ally who also writes under the name the Food Babe, said that Means represents “the kind of disruption that entrenched interests in Washington are unwilling to tolerate.”
“We’re seeing a system that protects itself,” she said. “A system that says it wants change but recoils the moment real change shows up.”
Trump has endorsed one of Cassidy’s primary opponents, Rep. Julia Letlow (R-Louisiana), who along with other members of Congress had praised Means during Kennedy’s appearances on the Hill this month.
“Casey Means is the most articulate, eloquent and erudite evangelist for the MAHA movement,” Kennedy said in response to Letlow during the hearings.
Means’s brother, Calley, a top White House health adviser who helped Means write the book considered the bible of the MAHA movement, posted on social media that he is “so proud of Casey, and the way she conducted herself during this process.”
He went on to accuse Cassidy of delaying Means’s nomination and smearing her, saying he “demanded” to schedule her initial hearing on her due date.
“Bill Cassidy is a mindless avatar for his donors and a blind defender of the status quo system that is profiting from American sickness.”
Means had come under fire by some lawmakers and Jerome Adams, Trump’s surgeon general in his first term, for the status of her medical license. She currently has a medical license in Oregon that she voluntarily placed in inactive status, according to the Oregon state medical board, meaning she cannot practice medicine in the state.
In her confirmation hearings, she did not explicitly recommend all Americans receive the measles and flu shots – a stance many public health experts said was previously unimaginable for the nation’s top doctor.
She instead said that all patients should speak with their physicians and that vaccines save lives.
Saphier has criticized the administration
Saphier joined Fox News as a contributor in 2018, “breaking down the latest medical news across all platforms,” according to a biography posted on the website Thursday. The page was taken down after Trump’s announcement. A Fox News spokesperson said Thursday afternoon that her contributor contract had been terminated.
Saphier has been critical of the administration. After Trump’s controversial proclamation last fall that Tylenol was linked to autism, Saphier said on Fox News Radio that the news conference was “very messy.” She said she had hoped for a more tempered tone for public health officials after the pandemic. While she applauded the administration for digging into the causes of autism, she said, there was “no new evidence” to prove a causation between Tylenol and autism.
Saphier, who has limited public access to her X account, has criticized Kennedy’s actions. The Post reviewed copies of her tweets, which were archived by the National Conference on Citizenship.
A federal judge temporarily blocked the Trump administration in March from implementing Kennedy’s sweeping changes to the childhood immunization schedule, siding with major medical organizations that argued Kennedy unlawfully altered vaccine policy and improperly reconstituted a federal vaccine advisory panel. After the ruling, she wrote: “The CDC vaccine schedule is in limbo, the status of ACIP up in the air and no clear path forward. The system needed reform, but not chaos. The pendulum swung too far in the overhaul. Time for a measured reset, with transparency and data driven guidance.”
Saphier also appeared to critique Means, who has advocated for the use of continuous glucose monitors as part of her past work with the company Levels.
Saphier posted on X in August: “I fully support RFK Jr.’s mission to make America healthier, as I did write the book about MAHA before it was a household name-but with ‘Operation Gold Rush’ and others centered on glucose/health monitors, I cringe knowing members of his appointed inner circle profit from them.”
Aaron Schaffer and Lena H. Sun contributed to this report.
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