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President Donald Trump said Thursday he is withdrawing Dr. Casey Means’ stalled nomination for surgeon general and nominating radiologist Dr. Nicole Saphier instead, after Means’ path forward in the Senate stalled over questions about her medical background and her views on vaccines.
Trump made the announcement in a social media post, saying he would nominate Saphier and calling her “a STAR physician who has spent her career guiding women facing breast cancer through their diagnosis and treatment.” Health Secretary Robert F. Kennedy Jr. also endorsed the new pick, calling Saphier “a long-time warrior for the MAHA movement.”
The change comes as Means’ confirmation effort ran into resistance inside the Senate health committee and failed to move forward. In an interview Thursday, Means said her nomination fell apart after a “yearlong smear campaign against me,” which she said was part of a broader effort to impugn the MAHA movement and its focus on reforming food and healthcare. Means said she will continue to “help with progress on this movement how I can.”
Means’ withdrawal followed tense exchanges during her confirmation process with lawmakers from both parties, raising doubts about whether she could secure enough votes to advance out of the Senate health committee. The AP reported that Means said she believed Lisa Murkowski was not going to vote for her and that Susan Collins had serious reservations.
AP previously reported that Trump nominated Means last May as an attempt to bring a close Kennedy ally into the role of the nation’s doctor. Means, who is described as 38 and Stanford-educated, promoted ideas aligned with the MAHA movement, including a view that Americans are overmedicalized and that diet and lifestyle changes should be central to efforts to reduce chronic disease.
The nomination also faced scrutiny about Means’ experience. The AP reported that Means did not finish her surgical residency program and does not currently have an active medical license, and that senators also raised questions about possible conflicts. During her confirmation process in February, senators grilled Means about Kennedy’s effort to pull back vaccine recommendations, and the AP described contentious moments as Means tried to navigate between support for vaccines and the view that decisions should be made by patients and their doctors.
In her confirmation hearing, Means was repeatedly asked about the birth dose of the hepatitis B vaccine. The AP reported that the U.S. Centers for Disease Control and Prevention stopped recommending that birth dose for all children late last year, a change the AP said was criticized by scientific and medical groups and currently blocked in a lawsuit. Means said she questioned the birth-dose recommendation and had posted on social media in 2024 that giving the vaccine to newborns whose parents did not have hepatitis B was “absolute insanity.”
Trump’s new nominee, Saphier, is the director of breast imaging at Memorial Sloan Kettering Monmouth, according to the institution’s profile. The AP reported that the profile says she has a doctor of medicine degree from Ross University School of Medicine in Barbados and fellowships at the Mayo Clinic. Like Means, the AP reported that Saphier has questioned whether every child needs the hepatitis B vaccine at birth.
The AP reported that Saphier said in a September podcast that she “doesn’t necessarily think it’s necessary” for newborns if, for example, the mother recently tested negative for hepatitis B, the family lives a low-risk lifestyle, and there is no hepatitis B-positive person living in the home. The report also said Saphier questioned COVID booster requirements and argued on a radio show in September that they were not always rooted in evidence.
Saphier has also been portrayed by the MAHA movement. The AP reported that she used the phrase “Make America Healthy Again” before Kennedy popularized it, and that it was the title of a book she wrote in 2020 that criticized government handling of health care and the Affordable Care Act.
Even so, the AP said Saphier has at least once diverged from Trump’s medical messaging. The report described that in 2024 Trump advised pregnant women “Don’t take Tylenol,” and that Saphier said the advice should be framed with nuance—saying women generally are advised to take acetaminophen only under medical supervision, at the lowest effective dose when necessary, and that untreated fever or severe pain also can pose serious risks to mothers and babies. The AP said Saphier wrote in an email to the AP that “For decades, women have endured a paternalistic tone in medicine,” and that the president’s Tylenol comments were “a prime example,” adding that advising moderation was sound but delivering it “in a patronizing, simplistic way was not.” The AP reported that Saphier later described a press conference as “full of hyperbole” and “really painful to watch.”
Means is Trump’s second surgeon general nominee in his second term whose nomination has been withdrawn. The AP said Trump withdrew his first nominee for the post, Fox News medical contributor Janette Nesheiwat, after questions arose about her academic credentials.
In Thursday’s announcement, Trump also criticized what he described as GOP Sen. Bill Cassidy’s “intransigence and political games,” the AP reported, describing Cassidy as the chair of the Senate health committee. The AP reported that Cassidy is facing reelection and interrogated Means about vaccines during her hearing; the AP said Cassidy did not respond to a request for comment. The AP also reported that Means’ brother, Calley Means, blamed Cassidy in a social media post and that Kennedy later accused Cassidy of doing “the dirty work” for “entrenched interests” seeking to stall the MAHA movement.
With Trump now attempting to fill the surgeon general post a third time, Saphier’s confirmation path will likely again hinge on whether she can secure enough votes in the Senate health committee amid ongoing scrutiny of both qualifications and vaccine-related views.