Casey Means faces Senate grilling on vaccines, conflicts, and qualifications

CMCasey Means is 38 years old, holds a Stanford University medical degree, and co-authored a 2024 book called Good Energy about metabolism, chronic disease, and nutrition. She built a significant public following through podcast appearances and her brother Calley Means, who served as an adviser to Health Secretary Robert F. Kennedy Jr.

Means does not hold an active medical license. She dropped out of her surgical residency at 🌲Oregon Health and Science University in 2018, citing disillusionment with the health care system. She practiced briefly in Oregon, later closed that practice, and has pledged that if confirmed, she would not reactivate her license.

The HELP Committee hearing on Feb. 25 lasted more than two hours. Committee Chair Sen. BCBill Cassidy — himself a physician — had to push Means three times before she clearly endorsed the MMR vaccine. He noted that two children died of measles in the United States last year as he pressed her. She ultimately said: I am absolutely supportive of the measles vaccine, and I do believe vaccines save lives.

On the flu vaccine, Means gave a more evasive answer. When Sen. Tim Kaine asked directly whether she believed the flu vaccine prevents serious disease and hospitalization or death in children, she began answering I believe that all patients should talk to their doctor — a deflection that left the scientific question unanswered. The flu vaccine's effectiveness at reducing pediatric hospitalization and death is established in peer-reviewed literature.

Means runs Levels, a company that sells continuous glucose monitors, supplements, and nutrition tracking software. Before the hearing, she pledged to resign from the company and stop working as a supplement-promoting influencer if confirmed. Sen. Chris Murphy cited a watchdog group's allegation that she violated FTC disclosure rules by promoting a prenatal vitamin brand without disclosing a financial relationship with the manufacturer.

Sen. SCSusan Collins asked Means about her book's discussion of the therapeutic use of psychedelic mushrooms and her personal use of them. Means said what I would say as a private citizen is in many cases different than what I'd say as a public health official and added she would not recommend psychedelics for the public.

Means' nomination is closely tied to Health Secretary Robert F. Kennedy Jr.'s Make America Healthy Again movement, which emphasizes ultra-processed foods, environmental toxins, and lifestyle factors as root causes of chronic disease. Her brother Calley Means served as a Kennedy adviser. Her public messaging on nutrition and root causes closely mirrors Kennedy's platform.

The Surgeon General is nominated by the president and confirmed by the Senate. The position carries no regulatory authority — the Surgeon General cannot issue binding rules or mandates. The office's primary power is communicative: publishing advisories, speaking to media, and shaping public health norms. That communicative role makes vaccine hesitancy or hedging by the Surgeon General potentially consequential for public behavior.