Week of Feb. 26, 2026

From the editor’s desk

Casey Means—the Trump administration’s pick to become U.S. surgeon general and a leading voice in the MAHA movement—appeared yesterday in a Senate confirmation hearing.

In one of the most-reported-on moments from the hearing, Sen. Bill Cassidy, a Republican and a doctor, asked whether she would advise mothers to vaccinate their children. Her answer rang duplicitous—a “sort-of no” for the no crowd, and a “sort-of yes” for the yes crowd:

I’m not an individual’s doctor. And every individual needs to talk to their doctor before putting a medication in their body. I absolutely am supportive of the measles vaccine, and I do believe vaccines save lives.

In the other most-reported-on moment of the hearing, Cassidy pressed Means on whether she accepts evidence that vaccines don’t cause autism. Again, she gave our divided echo chamber of a nation its choice of answers: “sort-of no” and “sort-of yes.” When Sen. Bernie Sanders posed the same question directly (it’s in the second half of this clip), Means emitted a chaotic word-barf of a dodge, including:

Just to be very clear, vaccines, vaccine advocacy, or any anti-vaccine rhetoric has never been a part of my message. I don’t mention the word “vaccine” in my book. This is not a part of my core message.

Huh? If Means is confirmed as the nation’s top doc, she will very much need to mention the word “vaccine,” and it will be her job to promote clear, decisive, well-informed public policies on vaccinations that will affect the health of millions.

In a convoluted arrangement that is oh-so-2026, it will also be her job to answer to Secretary of Health and Human Services Robert Kennedy Jr., the very vaccine-denier who just ushered in a new era of measles outbreaks. Yes, the same measles that was eradicated in the U.S. in 2000, until we went hog wild with “personal liberty” and brought it back.

I acknowledge that Means has an impossible balance to strike here. She’s tasked with being qualified, honest and decisive. And she’s also tasked with remaining in Kennedy’s good graces. The dissonance is real. It’s a political trapeze act of a test that any nominee would be doomed to fail.

A final Senate vote has not yet been scheduled. While we wait, here are some telling examples of who has and has not expressed confidence in Means’ abilities and qualifications:

• Means graduated from Stanford Medical School, but she never finished her surgical residency. On her YouTube channel, there’s an edit of her 2024 interview on the Tucker Carlson Show, oddly devoid of context, in which both Means and Carlson come off sounding like dropping out of a surgical residency is cause for nothing but celebration. In this frenetically edited version of the interview, Means is positioned as a brave trailblazer, and Carlson gushes like a proud, drunk parent.

• Stanford Medical School’s statement on Means’ nomination, issued back in May 2025, is a non-endorsement that beats around the bush as avidly as Means did yesterday in the hearing. It must have been a tough job to be the PR person writing this: “As an institution, the Stanford School of Medicine recognizes the vital role of public service in advancing our nation’s health and well-being, and we are proud that Casey Means, MD, has been nominated to serve as the United States Surgeon General.” Translation, “Well damn, we can not be seen asserting we think the U.S. would be in good hands with her as the surgeon general, but we have to say something.”

• NPR’s Will Stone was diplomatic: “She’s primarily a wellness influencer and entrepreneur.”

• Stone interviewed Georges Benjamin, CEO of the American Public Health Association, who was more direct: “She is less qualified professionally than any other surgeon general in history. There’s no question about that.”

Take care,

—Kris Vagner, managing editor