Trump Withdraws Nomination of Casey Means for Surgeon General

WASHINGTON -- President Donald Trump has withdrawn the nomination of Dr. Casey Means, his pick for surgeon general, whose confirmation was stalled amid opposition, including from some Republicans, over her views on vaccines and her unconventional approach to medicine.

In a social media post Thursday, Trump announced a new nominee: Dr. Nicole B. Saphier, a radiologist who has a wellness podcast and has appeared frequently on Fox News. She is the director of breast imaging at MSK Monmouth in New Jersey, a branch of Memorial Sloan Kettering Cancer Center in New York City.

Trump described Saphier as "a STAR physician who has spent her career guiding women facing breast cancer" and "an INCREDIBLE COMMUNICATOR, who makes complicated health issues more easily understood by all Americans."

Unlike Means, Saphier, 44, does not appear to be a hero in Health Secretary Robert F. Kennedy Jr.'s Make America Healthy Again movement, whose leaders view her as too conventional. She has praised vaccines as lifesaving and has at times criticized Kennedy as an ineffective messenger. She has also been critical of Means.

But she has also embraced some of the tenets of the secretary's agenda. She rejects vaccine mandates and wants the childhood vaccine schedule to be flexible enough to allow some parents to delay giving infants their shots. Kennedy called her "a longtime warrior for the MAHA movement" in a social media post Thursday.

"Can we change the timeline?" Saphier asked during a 2025 podcast. "Does every single child need all of these vaccines? Because the reality is not all vaccines are created equal; lumping them together just completely erases the science."

Years before Kennedy popularized the "Make America Healthy Again" slogan, Saphier published a book under that name. She is also the author of a book called "Panic Attack: Playing Politics With Science in the Fight Against COVID-19," which railed against some lockdown measures pushed by Democratic lawmakers. She has also slammed the Centers for Disease Control and Prevention for its management of the COVID pandemic and said in particular that the agency has misrepresented the risk of COVID to children.

Trump's decision to withdraw Means' nomination was unexpected, but perhaps inevitable. Three Republican health committee members -- Sens. Bill Cassidy of Louisiana, the chair, Susan Collins of Maine and Lisa Murkowski of Alaska -- refused to say whether they would vote for her.

In another social media post Thursday, Trump assailed Cassidy who, he said, "stood in the way of Robert F. Kennedy Jr.'s Nominee, Casey Means, for the important position of U.S. Surgeon General." (Kennedy does not make nominations; the president does.) Kennedy, who called Means "one of the MAHA movement's most powerful evangelists," accused Cassidy of doing "the dirty work for entrenched interests."

A spokesperson for Cassidy did not respond to a request for comment.

Saphier's chances of being confirmed are difficult to predict. Her views on vaccination appear, in certain respects, similar to those of Means; both have said vaccines save lives, and both have said parents need to make vaccination decisions alongside their doctors. But unlike Means, who did not emphasize her views on vaccines, Saphier has hit the issue head-on.

"We have to be very clear here: When vaccination rates go down, preventable diseases come back," Saphier said recently on her "Wellness Unmasked" podcast. "That's not political. That's epidemiology; that's reality. And at the same time, Americans are also making something else clear. They want transparency. They want choice, and they want to make decisions alongside their doctors -- not to be told what to do by shifting policies or unclear messaging, and those two things can actually coexist."

She went on: "Bottom line is this: Vaccine is one of the most effective tools we have to prevent serious illness. That's true, but if we continue to send mixed signals, we risk losing the public's trust entirely, and once that is gone, it's very hard to get back."

Saphier had a somewhat unconventional path into medicine. She became pregnant when she was 17 and has spoken about her experience as a teenage mother. (She has since had two more children.) She went to medical school at Ross University in Barbados and has also embraced alternative medicine, saying she lives her life combining Western medicine with "Eastern techniques" and "natural remedies."

She describes herself as a part-time farmer on her Instagram account and sells a line of supplements called DropRx, including herbal tinctures for stress relief and focus.

Saphier is Trump's third surgeon general nominee. His first was Dr. Janette Nesheiwat, a former Fox News contributor. But her nomination was withdrawn in May 2025 after Laura Loomer, a right-wing influencer who is close to the president, opposed her. Loomer also opposed the nomination of Means.

Had she been confirmed, Means, a "functional medicine" physician and wellness influencer whose brother Calley Means is a top Kennedy adviser, would have been a highly unconventional surgeon general. While she is a licensed physician and a graduate of a top-notch medical school, Stanford University, her license is on "inactive" status in Oregon. She is also a vocal critic of the medical establishment.

In addition to being grilled on vaccines, Means faced sharp questions from Collins about her experimentation with psychedelic therapy after the death of her mother. After Means testified that "Americans are ready to hear about spirituality as it pertains to medicine," Collins said she understood spirituality, but added, "It's the link to illicit drugs that I'm having a hard time with."

In an interview Thursday after Trump's announcement, Means said she would continue to be an advocate for the issues she is passionate about. She also praised Trump, who has angered many MAHA influencers over a recent executive order aimed at ramping up production of the weedkiller glyphosate, which some scientists have linked to cancer.

"There is a really positive cultural movement happening right now where people are asking the government to help them get healthy and help them stand up against corporate interests that are making us sick, and the government has said, yes, we'll help you," Means said.

"I genuinely believe in my heart that the Trump administration is trying to figure out how to move the balls forward," she added. "Yes, there are some setbacks, but there are some huge wins, and the way that culture has moved forward in the past year is monumental."

Indeed, Thursday was a day for MAHA wins and losses. Just days after MAHA activists and politicians from both parties rallied outside the Supreme Court to protest the administration's stance on glyphosate, the House stripped the farm bill of a provision that would have prevented states from warning consumers about the dangers of pesticides. Movement leaders celebrated.

Less than two hours later, Trump announced he was withdrawing Means' nomination.

"After the glyphosate executive order fiasco, this feels like yet another gut punch to MAHA voters," Alex Clark, a wellness podcaster who works for the right-wing advocacy group Turning Point USA, said in a text message.

Clark was among a number of MAHA leaders who met recently with the president and his aides, and told them that the confirmation of Means was important to them. Means also attended.

"Political games killed her nomination, and no Democrat was willing to fight for her because they didn't want to endorse a Trump nominee," said Vani Hari, another MAHA leader. "It's so toxic."

Hari called Saphier "rather establishment." Clark called her "terrifyingly pro-vaccine." Dr. Robert Malone, another ally of Kennedy, said Saphier was "moderate MAHA."

Now it will be up to Cassidy, the health committee chair, to set a schedule for Saphier's confirmation hearing. He has yet to schedule a hearing for another Trump health nominee, Dr. Erica Schwartz, his pick to lead the CDC.

But Cassidy may be otherwise occupied, and has little incentive to take steps to please the Trump administration. He is facing a tough primary opponent in his reelection campaign in Louisiana. Trump, who is angry that Cassidy voted to convict him after he was impeached in 2021, has endorsed Cassidy's opponent.

This article originally appeared in The New York Times.

Copyright 2026 The New York Times Company

This story was originally published April 30, 2026 at 12:09 PM.