On Tuesday, Casey Means—a wellness influencer with no active medical license—appeared before the Senate Health, Education, Labor and Pensions (HELP) Committee for her confirmation hearing as Donald Trump’s nominee for Surgeon General. Over more than two hours, Means systematically refused to recommend measles or flu vaccination to parents, declined to rule out a vaccine-autism link despite decades of refuting scientific evidence, and defended past statements attacking hormonal birth control—all while insisting, in a formula repeated like an incantation, that she “believes vaccines save lives.”
The hearing took place against the backdrop of a national measles emergency—982 confirmed cases in 2026 as of late February, with tracking data indicating the total had surpassed 1,000, on pace to far exceed 2025’s three-decade record of 2,281—and the most sustained assault on public health infrastructure in American history, waged over the past year by Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. If confirmed on a party-line Republican vote, Means would become the first surgeon general in US history without an active medical license—the nominal head of the nation’s public health at the very moment public health is being systematically destroyed.
The spectacle of Democratic senators posing “tough questions” to a nominee they are powerless to stop epitomizes the bankruptcy of bourgeois politics. The hearing was not an exercise in democratic accountability. It was theater, staged amid the ruins of a public health infrastructure that both parties, over decades, have starved of funding and subordinated to corporate interests.
When pressed by committee chairman Sen. Bill Cassidy—himself a physician—on whether she accepted the overwhelming scientific evidence that vaccines do not cause autism, Means replied: “I do accept that evidence. I also think that science is never settled.” She added: “We do not know as a medical community what causes autism. We should not leave any stones unturned.”
This is the classic formulation of the anti-vaccine movement, superficially accepting science while leaving the door wide open to conspiracy. Speaking on the right-wing Joe Rogan Experience podcast in October 2024, Means was far less circumspect, stating, “One vaccine probably isn’t causing autism... What about the 20 that they’re getting before 18 months?”
The pattern of evasion was relentless. Asked whether she would encourage parents to vaccinate their children against measles amid an active outbreak with children dying, Means would say only: “I do believe that each patient, mother, parent needs to have a conversation with their pediatrician.” The formulation transparently expresses general “support” for vaccines while refusing to recommend any specific vaccine to any specific person.
Means’ evasions extended to reproductive health. She has previously called birth control pills a “disrespect for life” with “horrifying health risks,” urging women to “stop overusing birth control pills en masse for illogical reasons.”
At Wednesday’s hearing, Means claimed her statements were “taken out of context.” Her book Good Energy contains a chapter titled “Trust Yourself, Not Your Doctor” and describes science as “a weird new mind-control term.” At the hearing, she falsely claimed: “Anti-vaccine rhetoric has never been a part of my message.” The contradiction between her published record and her hearing testimony is deliberate. She tells the Senate what it needs to hear while signaling to the anti-vaccine base that she remains one of them.
Born in 1987 to a politically connected Washington family, Means graduated from Stanford Medical School and began a surgical residency at Oregon Health and Science University before quitting. She has since built a career as a wellness influencer, with 845,000 Instagram followers, co-founding a health app called Levels and holding equity in Truemed, a company owned by her brother Calley Means, a senior adviser at HHS on food and nutrition policy.
According to a Public Citizen report filed with the Federal Trade Commission (FTC) on February 4, Casey Means failed to disclose financial relationships in 79 out of 140 instances (56 percent) of promoting affiliated products on social media, an obvious conflict of interest violation.
The Means nomination is only the latest episode in the most far-reaching assault on public health in modern American history. Since Kennedy’s confirmation as HHS Secretary on February 13, 2025, the Trump administration has waged a systematic war on American public health.
On June 9, 2025, Kennedy fired all 17 members of the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP), replacing them with anti-vaccine figures including Dr. Robert Malone and Great Barrington Declaration co-author Dr. Martin Kulldorff. On January 5, 2026, he unilaterally slashed the childhood vaccine schedule from 17 to 11 universally recommended vaccines, bypassing career CDC scientists entirely.
HHS has proposed a 26 percent budget cut, including a proposed 54 percent cut to the CDC and a proposed 40 percent cut to the National Institutes of Health (NIH). Over 20,000 scientists and public health workers have been fired. Ninety percent of the National Institute for Occupational Safety and Health (NIOSH) staff have been terminated. Jay Bhattacharya—co-author of the Great Barrington Declaration, which advocated mass infection at the height of the COVID-19 pandemic—now simultaneously heads both the NIH and the CDC.
The consequences are measured in children’s lives. The United States recorded 2,281 measles cases in 2025—the highest since 1991—with three deaths: two children in Texas and one adult in New Mexico. These figures are set to be dwarfed in 2026, with over 1,000 measles cases already tracked. National kindergarten MMR vaccination coverage has fallen to 92.5 percent, below the threshold for herd immunity, with 39 states failing to meet the standard. In November 2025, the Pan American Health Organization declared the Americas had lost measles elimination status.
The largest ongoing outbreak, in Spartanburg County, South Carolina, has devastated a working-class community with more than 900 confirmed cases. A second outbreak tore through the Dilley Immigration Processing Center in South Texas, where detained immigrant children were held in conditions that guaranteed the spread of a vaccine-preventable disease. The World Socialist Web Site warned in July 2025 that the Trump-Kennedy attacks “will kill millions globally,” with USAID cuts projected to cause 14 million additional deaths through 2030 and the Gavi withdrawal threatening 75 million unvaccinated children.
The Democratic senators’ opposition was pure political posturing. It will do nothing, as Means is on track for confirmation on a party-line vote. Similarly, the Democrats voted unanimously against Kennedy’s confirmation a year ago, and then did nothing to oppose his retrograde policies. They have mounted no campaign to mobilize opposition to the gutting of the CDC, the ACIP purge, the slashing of the vaccine schedule, or the mass firing of scientists. As ranking member Bernie Sanders stated: “Secretary Kennedy and the Trump administration continue to spread dangerous conspiracy theories about vaccines, making it harder for Americans to protect their children from deadly diseases.” It is an accurate description of the crisis and an inadvertent indictment of his own impotence.
The bipartisan character of this catastrophe did not begin with Trump. For decades, under both Democratic and Republican administrations, public health has been starved of funding and subordinated to the pharmaceutical and insurance industries. These processes have only accelerated since the start of the ongoing COVID-19 pandemic, which has killed over 1.5 million Americans and over 30 million people worldwide, while debilitating hundreds of millions more with Long COVID globally.
The defense of science and public health—the defense of the lives of the working class against a ruling class that treats mass infection and death as acceptable policy—is inseparable from the fight for socialism. This requires the independent mobilization of the working class, through rank-and-file safety committees, in opposition to both capitalist parties.