In a development that roils Washington’s latest health leadership nomination fight, former President Donald Trump has pulled the nomination of Casey Means for U.S. Surgeon General after the controversial pick failed to secure the minimum Senate support required for confirmation.
Trump made the announcement of the withdrawal Thursday via his social media platform Truth Social, adding that he would instead nominate Nicole Saphier, a cancer radiologist and regular contributor to conservative media outlet Fox News, for the role that leads the U.S. Public Health Service.
Means, a Stanford-trained physician, entrepreneur and prominent online health influencer, faced fierce cross-partisan skepticism from lawmakers throughout the nomination process largely over her history of controversial statements on vaccine safety. Critically, Means does not hold an active medical license to practice in any U.S. state, a detail that amplified concerns about her suitability to lead the nation’s top public health agency.
Means’ nomination stalled out immediately after her February Senate confirmation hearing, where she declined to answer a direct question on whether infants should receive routine childhood vaccines, and refused to reject the long-debunked conspiracy theory that links routine childhood vaccines to autism. While she told lawmakers at the hearing that she agrees “vaccines save lives” and are a core component of infectious disease public health strategy, she repeatedly emphasized prioritizing patient autonomy over public health guidelines throughout her testimony.
Policy analysts also connected Means’ nomination to the wider vaccine skepticism that has gained traction in conservative politics, noting that Means was widely viewed as an ideological ally of Health Secretary Robert Kennedy Jr., who has faced widespread alarm from lawmakers across both parties over his own long history of anti-vaccine activism.
In his Thursday Truth Social post, Trump did not blame his own party’s internal divisions for the failed nomination, and instead placed full blame on Louisiana Republican Senator Bill Cassidy, a trained physician who led opposition to Means’ confirmation. Trump lambasted Cassidy for what he called “intransigence and political games” that blocked Means’ path to confirmation, and explicitly called on Louisiana voters to remove Cassidy from office in the next election cycle.
Turning to his new pick, Trump offered glowing praise for Saphier, framing her as a highly qualified, public-facing leader on cancer care. “She is a STAR physician who has spent her career guiding women facing breast cancer through their diagnosis and treatment while tirelessly advocating to increase early cancer detection and prevention, while at the same time working with men and women on all other forms of cancer diagnoses and treatments,” Trump wrote. He added that Saphier is “also an INCREDIBLE COMMUNICATOR, who makes complicated health issues more easily understood by all Americans.”
Saphier currently practices radiology at Memorial Sloan Kettering Cancer Center Monmouth. Beyond her clinical work, she has a high public profile: she published the 2020 book *Make America Healthy Again: How Bad Behavior and Big Government Caused a Trillion-Dollar Crisis*, and hosts a popular wellness-focused podcast titled *Wellness Unmasked*.
This nomination marks the third time Trump has put forward a candidate for surgeon general, the top role overseeing the 6,000-person U.S. Public Health Service. His first pick, Janette Nesheiwat, another former Fox News contributor and physician, withdrew from consideration after facing criticism from a senior Trump administration adviser over her public positions on COVID-19 policy and questions raised about her professional credentials.