Casey Means Surgeon General Hearing: Vaccines, Pesticides and Ethics
Dr. Casey Means speaking on stage at a conference in Las Vegas
Photo: Instagram / @drcaseyskitchen · Oct 24, 2024
Public Health · U.S. Policy

Casey Means Faces Senate: Vaccines, Pesticides and Conflicts Questioned in Surgeon General Bid

On February 25, 2026, Dr. Casey Means, a Stanford‑trained doctor and wellness entrepreneur linked to the Make America Healthy Again agenda, answered Senate HELP Committee questions on vaccines, chronic disease, pesticides and ethics during her U.S. Surgeon General confirmation hearing.

📅 February 25, 2026 ⏱ Approx. 6 min read 🏛 Senate HELP Committee
Dr. Casey Means is Donald Trump’s nominee for U.S. Surgeon General. She trained at Stanford University School of Medicine and later co‑founded Levels, a company that pairs continuous glucose monitors with a mobile app. On February 25, 2026, the U.S. Senate Committee on Health, Education, Labor and Pensions held a confirmation hearing on her nomination, as listed on the official Senate HELP Committee hearings page. Senators focused on her positions on childhood vaccines, glyphosate and other pesticides, hormonal birth control, the abortion pill mifepristone, her inactive medical license, and financial relationships with health‑related companies.
Casey Means on stage discussing prevention-focused health
2.5 hrs
Approximate length of Senate HELP hearing
6,000
Public Health Service officers the Surgeon General leads
$43M
Genova Diagnostics DOJ settlement (2020)
17 → 11
CDC childhood vaccines after recent schedule cuts
~90%
Pediatric flu deaths in 2024–25 among not fully vaccinated children (CDC)
Interactive Explorer

Tap a Topic from the Hearing to See What Was Said

Vaccines: Support Stated, Details Left to “Shared Decision‑Making”

Senators from both parties asked Means about vaccines, including the childhood schedule, influenza shots and a possible vaccine–autism link. In exchanges with Sen. Tim Kaine, she said she believes “vaccines save lives” and called them “a key part of any infectious‑disease public health strategy,” but did not give a simple “yes” when asked whether flu vaccination reduces hospitalization and death in children.

On autism, she said she accepts evidence that vaccines do not cause autism but repeated that “science is never settled” and said she wants further study as autism diagnoses rise. By contrast, the American Medical Association and the American Academy of Pediatrics state that decades of studies have not found a causal link between vaccines and autism.

CDC data on flu deaths and vaccination
  • A CDC analysis of the 2024–25 flu season found that among 208 pediatric decedents with known vaccination status who were eligible, 89% had not been fully vaccinated against influenza (MMWR 2024–25 pediatric flu deaths report).
  • CDC continues to recommend annual flu vaccination for everyone aged 6 months and older without contraindications.
“I believe vaccines save lives. I believe that vaccines are a key part of every public — of any infectious disease public health strategy.”
— Dr. Casey Means, Senate HELP hearing, February 25, 2026
“I think it is an important vaccine, a lifesaving vaccine. I also think that parents’ autonomy needs to be respected.”
— Dr. Means referring to the hepatitis B vaccine at the hearing

Glyphosate and Pesticides: Health Concerns and a National‑Security Framing

Senators asked Means about pesticides after Trump signed an executive order to protect access to glyphosate, the active ingredient in Roundup. She said she has “significant concerns” about chemicals used in agriculture, naming glyphosate as one of them, and said farmers are in a difficult position because pesticide use cannot be removed from the food system overnight.

In a 2024 case in Pennsylvania, a jury ordered Bayer, the maker of Roundup, to pay $2.25 billion to a man who alleged long‑term glyphosate exposure caused his non‑Hodgkin lymphoma, according to court filings referenced in public reporting. The U.S. Environmental Protection Agency maintains an ingredients page for glyphosate as a registered herbicide (EPA glyphosate overview). At the hearing, Means described the executive order as focused on domestic supply and national security, not on changing the health risk assessment.

For broader pesticide context, KarmActive has covered regulatory debates such as legal challenges to pesticide‑coated seed exemptions (Environmentalists Sue EPA Over Pesticide‑Coated Seeds).

“I am not in any way backing away from this issue. It is a core passion of my life. We must study these chemicals to understand their effect.”
— Dr. Means, responding to questions on glyphosate and pesticides
Who regulates pesticides?
  • The U.S. EPA registers and evaluates pesticides such as glyphosate under federal law.
  • The Surgeon General can commission reports on health effects but does not approve or ban pesticides.

Birth Control and Mifepristone: Access Supported, Risks Emphasised

Senators raised Means’ past comments describing hormonal birth control as having “horrifying” risks and being used “like candy.” At the hearing, she said oral contraceptive pills and the abortion medication mifepristone should be “widely accessible,” and said her concern is that some women do not receive detailed counselling on side‑effect risks such as blood clots and stroke, particularly when other risk factors like smoking are present.

She told senators that whether mifepristone prescriptions should require an in‑person visit is outside the Surgeon General’s authority, noting that the U.S. Food and Drug Administration sets prescribing conditions. She repeated that every patient should have a thorough conversation with a clinician before taking any medication, including contraceptives and abortion medications.

“I absolutely think that oral contraception should be widely accessible… All medications have risks and benefits, and in our current medical climate with the burden on doctors, doctors do not have enough time for a thorough and informed consent conversation.”
— Dr. Means, Senate HELP hearing

Medical License: Inactive Status and Leadership of the Corps

Means completed most of her surgical residency but left the program in 2018 and allowed her Oregon medical license to move to “inactive” status in 2024. She confirmed in the hearing that she cannot currently write prescriptions and said she does not plan to reactivate the license because she would not be seeing patients as Surgeon General.

U.S. law does not require the Surgeon General to hold an active medical license, but the U.S. Public Health Service Commissioned Corps, which the Surgeon General leads, requires its officers who are clinicians to keep active, unrestricted licenses. Senators questioned how she would supervise officers held to active‑license standards when she is not bound by the same requirement. She responded that senior officers and the HHS ethics office have confirmed she is eligible to serve.

“My professional history is a feature. It’s not a bug.”
— Dr. Means on her non‑traditional career path and inactive license
License and role basics
  • An active license is required to treat patients or prescribe medications.
  • The Surgeon General role is primarily advisory and leadership‑focused, not a direct patient‑care post.

Conflicts of Interest: Ethics Agreement vs. Past Promotions

Sen. Chris Murphy cited records of sponsored posts and paid partnerships and accused Means of failing to disclose some commercial relationships when promoting products such as supplements and food subscriptions. Means said the documentation was “incorrect” and called it a false representation, stating that she has worked with government ethics lawyers and signed an ethics agreement to divest and recuse where required.

Sen. Tammy Baldwin asked about Means’ acceptance of $10,000 from Genova Diagnostics for a video that appeared online in October 2025, months after her nomination was announced. Genova agreed in 2020 to pay up to $43 million to resolve government allegations of medically unnecessary laboratory tests billed to federal programs, according to the U.S. Department of Justice (DOJ press release). Means told senators she was not familiar with that settlement and focused her comments on one nutrient‑testing product she considered useful.

Her formal ethics commitments are described in a September 10, 2025 ethics agreement filed with the U.S. Office of Government Ethics .

“I have always been transparent about when I was paid to endorse a product.”
— Dr. Means when asked about sponsorship disclosures
First‑hand documents on conflicts
At a Glance

How Hearing Statements Compare with Medical and Regulatory Positions

Topic
Dr. Means at Hearing
Official Positions and Data
Flu vaccination
Evasive She said she believes vaccines can reduce risk “at a population level” but did not directly confirm that flu vaccination reduces children’s risk of hospitalization and death when pressed.
CDC reports that among pediatric decedents in 2024–25 with known eligibility and vaccination status, 89% were not fully vaccinated against influenza (CDC MMWR on pediatric flu deaths).
Vaccines and autism
Open‑ended She said she accepts current evidence showing no link but added that “science is never settled” and said she wants all plausible factors studied as autism rates rise.
The AMA and AAP cite large epidemiologic studies that have not found a causal link between recommended vaccines and autism.
Hepatitis B at birth
Nuanced She called the hepatitis B vaccine “lifesaving” and “very important” but questioned the need for a universal birth dose for infants of hepatitis‑B‑negative parents.
A December 16, 2025 CDC update describes hepatitis B vaccination for some low‑risk newborns as a “shared clinical decision‑making” issue, while the AAP guidance continues to recommend a birth dose for all infants.
Hormonal contraception
Access affirmed She said contraceptive pills should remain widely accessible and emphasised the need for clear counselling on clot and stroke risks in higher‑risk groups.
FDA labelling and professional guidance from bodies such as ACOG describe combined hormonal contraception as appropriate for most patients when risk factors are assessed and explained.
Mifepristone prescribing
Open‑ended She said whether mifepristone requires in‑person prescribing is outside the Surgeon General’s purview and did not take a firm position on telehealth rules.
The FDA regulates mifepristone and has allowed certified prescribers to use telehealth and mail dispensing under certain conditions.
Chronology

Key Moments from the February 25, 2026 Hearing

~10:00 AM ET
Opening statement: chronic disease and “broken” health system
Means told senators she views the United States as facing high chronic illness and mental health burdens and said she wants to move care toward prevention and “root cause” approaches. She referenced nutrition, metabolic health and environmental exposures as areas she would emphasise if confirmed.
Late morning
Vaccine questions from both parties
Senators including Tim Kaine, Bill Cassidy and others asked about childhood vaccine schedules, hepatitis B at birth and claims about flu shots. Means said she supports CDC guidance but wanted more “shared decision‑making” between parents and clinicians for specific vaccines.
Mid‑hearing
Inactive medical license and leadership of the Corps
Sen. Andy Kim questioned why she has not reactivated her license given that Public Health Service officers must maintain active credentials. Means answered that she would not be providing direct patient care as Surgeon General and that agency leadership has confirmed she is eligible to serve.
Later in the session
Pesticides, glyphosate and national‑security framing
Senators asked how she reconciles her stated concerns about pesticides with a recent executive order to secure domestic glyphosate supplies. Means said farmers face structural constraints and described the order as focused on supply and national security while repeating that she is concerned about potential health effects of chemical exposures.
Final round
Conflicts of interest and ethics compliance
Questions about product endorsements, the Genova Diagnostics payment and her company Levels led Means to refer senators to her ethics agreement with the Office of Government Ethics. She said she has coordinated with ethics officials to resolve or divest from conflicting interests and would continue to do so in office.
Hearing end
Committee adjourns without vote
The hearing concluded after roughly two and a half hours. At the time of writing, the Senate HELP Committee has not yet held a vote on her nomination. The hearing listing and materials are posted on the Senate HELP Committee site .
Role clarity

What the Surgeon General Role Covers in Cases Like This

What the Surgeon General can do

  • Lead the U.S. Public Health Service Commissioned Corps of about 6,000 officers.
  • Issue Surgeon General’s reports and advisories on topics such as tobacco, alcohol, mental health and environmental exposures.
  • Communicate guidance on vaccines, chronic disease prevention and other public‑health priorities.
  • Recommend research or coordinated action on topics like glyphosate, nutrition and chronic disease trends.

What the Surgeon General cannot do

  • Ban or approve pesticides such as glyphosate (EPA regulates pesticides).
  • Authorize or withdraw drug approvals or set prescribing rules for mifepristone (FDA authority).
  • Unilaterally set or change the CDC childhood vaccine schedule.
  • Alter Medicaid or Medicare coverage rules (Centers for Medicare & Medicaid Services).
  • Provide patient care or write prescriptions without an active medical license.
Disclosure

Key Financial and Professional Relationships Discussed

Genova Diagnostics
$43 million DOJ settlement and a $10,000 payment to Means
In 2020, Genova Diagnostics agreed to pay up to $43 million to resolve allegations of medically unnecessary lab tests billed to federal programs, according to a U.S. Department of Justice press release. At the hearing, senators said Means received $10,000 from Genova for a video that appeared online in October 2025. Means replied that she had not been aware of the earlier settlement when she recorded the video.
Source: DOJ laboratory‑testing settlement and Senate HELP testimony.
Levels Health
Health‑tech company co‑founded by Means
Means co‑founded Levels, a company that helps users track glucose data through continuous glucose monitoring paired with an app. In her ethics agreement, she committed to divest and recuse from matters involving Levels to meet conflict‑of‑interest standards.
Ethics details: Office of Government Ethics agreement dated September 10, 2025.
Wellness products and sponsorships
Past endorsements questioned in Senate
Senators referenced sponsorship arrangements with supplement brands and food‑delivery companies. Means said she has disclosed paid endorsements in line with requirements and that she has worked with government ethics officials to address any conflicts before entering office.
Source: Senate HELP questions and Means’ responses during the hearing.
Good Energy (2024)
Book co‑authored with Calley Means
Means co‑authored the book Good Energy with her brother Calley, now a senior adviser at HHS. The book promotes nutrient‑dense food, sleep, movement, targeted light exposure and glucose monitoring as ways to reduce chronic disease risk. Senators referenced past book passages and interviews when asking about her current views at the hearing.
Source: Good Energy publication details and Senate HELP hearing discussion.

Coverage Recap

The Senate HELP Committee held a confirmation hearing on February 25, 2026 for Dr. Casey Means, a Stanford‑trained physician and health‑tech entrepreneur nominated to serve as U.S. Surgeon General. The hearing record describes questions about her support for the current vaccine schedule, her public comments on autism and flu shots, concerns about glyphosate and other pesticides, her inactive medical license, her positions on hormonal contraception and mifepristone, and her past financial relationships with companies such as Genova Diagnostics and Levels Health. The Committee has not yet recorded a final vote on her nomination, and official documents remain available through the Senate HELP website, the Office of Government Ethics, the Department of Justice, the CDC and other federal health agencies.

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Sunita Somvanshi

With over two decades of dedicated service in the state environmental ministry, this seasoned professional has cultivated a discerning perspective on the intricate interplay between environmental considerations and diverse industries. Sunita is armed with a keen eye for pivotal details, her extensive experience uniquely positions her to offer insightful commentary on topics ranging from business sustainability and global trade's environmental impact to fostering partnerships, optimizing freight and transport for ecological efficiency, and delving into the realms of thermal management, logistics, carbon credits, and energy transition. Through her writing, she not only imparts valuable knowledge but also provides a nuanced understanding of how businesses can harmonize with environmental imperatives, making her a crucial voice in the discourse on sustainable practices and the future of industry.

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