Only one part this Friday.
The president announced Casey Means, MD, would be his nominee for Surgeon General of the United States hearings in the middle of 2025. The US Senate began considering her nomination this week. The back and forth has been interesting. Where to begin? First we can start with the previous nine permanent Surgeons General, beginning with the Carter Administration. Each of these men and women were accomplished board-certified physicians with relevant and wide-ranging medical and/or administrative experience. [1]
- Julius B. Richmond was the pediatrician instrumental in integrating psychiatry into pediatrics.
- Everett Koop was Surgeon-in-Chief at Children’s Hospital of Philadelphia. From 1946 to 1981, Dr. Koop was the leading pediatric surgeon at one of the best children’s hospitals in the world.
- Antonia Novello was a pediatric nephrologist and a Project Officer at the National Institutes of Health.
- Jocelyn Elders was a pediatrician and Director of the Arkansas Department of Health
- David Satcher was an academic physician who served as president of Meharry Medical College and as an administrator at the Centers for Disease Control and Prevention.
- Richarda Carmona was a surgeon at the University of California-San Francisco and an experienced medical administrator.
- Regina Benjamin was a family physician and accomplished administrator.
- Jerome Adams was a noted anesthesiologist and Indiana State Health Commissioner.
- Vivek Murthey was an internist at Brigham and Women’s Hospital, which is affiliated with Harvard Medical School.
Casey Means attended Stanford University School of Medicine. After graduation she began a residency in Otolaryngology (ENT) at Oregon Health & Science University in Portland. As recounted in her book Good Energy: The Surprising Connection Between Metabolism and Limitless Health (2024), she left her residency before finishing because she felt she was only treating disease rather than preventing it. She also reports that at Stanford she and her fellow students were not taught the causes of disease, only how to treat them. This is simply not believable. We have discussed this before, most extensively in Make America Healthy Again: Is MAHA a Trope or a Movement?
Casey Means has inevitably become a “thought leader” in the MAHA movement. After leaving her residency she opened a Functional Medicine practice for a while. She currently lacks a valid, active medical license. Means is also a principal behind the company Levels, which among other interventions recommends all people wear a continuous glucose monitor (CGM) despite little to no evidence that this is useful for a person without diabetes or other serious metabolic condition. It is expensive, though, and unlikely to be covered by health insurance. Thus, this intervention cannot be viewed as a serious solution to the chronic disease burden in the United States, despite the exhortations of the current Secretary of Health and Human Services.
So, does it matter that Casey Means never finished her graduate medical education that would have permitted her to become a practicing physician? This is a non-trivial question. From this account of her hearing from The Hill this past Wednesday (February 25th):
Means would be an unprecedented pick, not having completed her medical residency or having an active medical license. She is the sister of White House senior adviser Calley Means, one of Health Secretary Robert F. Kennedy Jr.’s top advisers, and a prominent “Make America Healthy Again” influencer in her own right.
Former surgeons general have spoken out against her nomination. Trump’s former Surgeon General Jerome Adams said of Means, “I feel strongly that the person who is leading America’s Public Health Service should be held to the same standard as the people he or she is leading.”
It is difficult to argue with Dr. Adams. One does not have to die to write an obituary, but it seems quite reasonable to expect the leader of American medicine have the same qualifications of those she is leading. In this case it apparently would be unprecedented, whatever her academic accomplishments.
Then there are a few other classic MAHA moments that come out of the Senate hearing, including vaccinations:
As with many of Trump’s health nominees, senators on both sides of the aisle zeroed in on Means’s views on vaccinations. Means sought to characterize her previous rhetoric about vaccines to be more about informed consent rather than questioning vaccine efficacy.
Sen. Bill Cassidy (R-La.), chair of the HELP Committee (and the Senator who clinched the approval of Robert F. Kennedy Jr. as Secretary of Health and Human Services), asked whether Means would encourage mothers to get their children vaccinated against measles, given the ongoing measles outbreaks across the country and the U.S. poised to lose its measles elimination status.
(From the nominee) “Like you, I’m a physician (probably not in California, where the law seems to say that only a licensed medical doctor can represent herself as a physician). I believe vaccines save lives. I believe that vaccines are a key part of… any infectious disease public health strategy,” Means said. “I’m supportive of vaccination. I do believe that each patient, mother or parent needs to have a conversation with their pediatrician about any medication they’re putting in their body and their children’s body.”
When pressed by Cassidy, however, Means declined to say if she’d encourage other mothers to get their children vaccinated against measles.
This is all complete MAHA nonsense. The nominee is referring her to the concept of informed consent as a cover for her waffling on vaccines. This has been an effective trope of the MAHA movement for a long time, something like “talk to your doctor to see if the measles vaccine is right for your children.” While there are good and sufficient reasons that a very few people should not be vaccinated, the logic and consistency of Means’s position is belied by the story of young Ethan of Spartanburg, South Carolina, from The Independent:
Six weeks ago, Ethan was like most 7-year-olds — spending the weekend riding his new bike or playing Minecraft on his iPad on a rainy day.
“He just learned how to ride, he got the hang of it right away,” Ethan’s dad, Luis, said proudly. “He wanted to go outside because he wanted to jump on his bike…it was an amazing thing for him.”
Instead, since late January, the schoolboy has been confined to a hospital bed with measles encephalitis, a complication that causes swelling and inflammation in the brain. “He’s pretty much as if he was paralyzed,” his devastated father, 41, told The Independent in a phone interview from his son’s hospital bedside.
Ethan’s parents decided not to immunize him against measles as they did with his three brothers. Three out of four of them contracted measles. Still, despite Ethan’s ordeal, his mom stands by their decision. “We’re not blaming God for this,” said 35-year-old Kristina. “Yes, it hurts, of course, it hurts. But God has chosen Ethan for a reason. God is doing something, and we’re gonna glorify his name regardless.
This is where the anti-vax nonsense of Robert F. Kennedy Jr. and MAHA leads. And it is simply impossible to believe that Casey Means doesn’t fully understand this. Measles injures permanently and sometimes kills. But another trope of MAHA is that “only children who are already sick” will have Ethan’s outcome. So, I suppose this is Ethan’s fault, or his parents’. And no, God is not responsible for Ethan’s illness. That lies in other places, beginning with Andrew Wakefield (who begat RFKJr, the anti-vaxxer), and the measles virus took advantage of an opening, to anthropomorphize a very dangerous pathogen. By the way, Casey Means also hemmed and hawed about the Hepatitis B vaccine, knowing full well that there is no evidence this vaccine is harmful when given to infants. But she also knows that Hep B is easily transmissible in a daycare setting and that (1) there is no treatment for Hep B and (2) that those infected are likely to suffer severe liver disease by middle age, including liver cancer.
Jumping to another issue, Casey Means was asked about previous comments in which she has said that contraception is “disrespectful of life.” From Mediaite:
In the past, Means has criticized the dispensing of contraceptives “like candy” and hyped the risks of the pill, as well as repeated several variations on the “disrespect of life” theme.
Means faced a confirmation hearing on Wednesday before the Senate Committee on Health, Education, Labor, and Pensions. The controversial nominee faced several contentious exchanges, including with Sen. Murray.
The nominee replied that these comments are taken out of context. But she does have a valid point about doctor-patient conversation and understanding about this. Yes, oral contraceptives do have side effects as all women and their doctors know. But no, they are not “dispensed like candy. There is nothing new here from Casey Means except dissembling:
SENATOR PATTY MURRAY (D-WA): I’m curious if you are with the FDA that went through all of these and rigorously looked at them, or as Surgeon General, if you’re going to tell the truth to the American people.
CASEY MEANS: I absolutely believe these medications should be accessible to all women.
And also, all medications have risks and benefits, and in our current medical climate with the burden on doctors, we do not have, doctors do not enough time for thorough informed consent conversations.
Some of the horrifying side effects of birth control that I have mentioned include blood clots and stroke risks in women who have clotting disorders, who are smokers, who have obesity–.
This is perhaps a new MAHA trope to me. And it doesn’t take much political awareness to know where this is coming from. But the risks and benefits of oral contraceptives are not hidden.
From The New York Times:
Dr. Means also showed her unorthodox side. When Senator Susan Collins, Republican of Maine, pressed her on her past use of the hallucinogen psilocybin, also known as magic mushrooms, she said she was grieving her mother’s death, and looking for healing, when she took it.
“I do believe that Americans are ready to hear about spirituality when it pertains to medicine,” Dr. Means said. She said that as surgeon general, she would not advise Americans to take the drug, though she cited “exciting work” into its potential benefits. “The science is still emerging,” she said.
It is true that psychedelics may have their uses, and if this country were not so self-righteous this research would be part of the mainstream. If psilocybin helped Casey Means deal with the death of her mother, good for her.
But the nonserious side of MAHA is also illustrated here:
Wednesday’s hearing unfolded during a precarious time for the MAHA movement. The White House has made clear that it wants Mr. Kennedy to pivot away from discussing vaccines to focus on his healthy eating agenda going into the midterm elections.
At the same time, Mr. Trump’s recent executive order promoting production of the weedkiller glyphosate — a possible carcinogen that has been the target of thousands of lawsuits — has infuriated the so-called MAHA moms who power Mr. Kennedy’s movement. (evidence that glyphosate is a carcinogen is strong)
Senator Ed Markey, Democrat of Massachusetts, pushed Dr. Means to disavow the president’s executive order. She spoke of her respect for American farmers and said that changing the agricultural landscape overnight would be devastating for both farmers and consumers. The Trump administration, she said, is making “good faith movement toward moving our system toward regenerative agriculture.”
She has previously called moving away from industrial agriculture practices that use toxic pesticides “the SINGLE most important strategy” for solving health and environmental issues, and called the use of pesticides a “slow-motion extinction event.”
No argument from me about industrial agriculture. And we certainly cannot wake up tomorrow and begin eating local again. Casey Means is right about that. However, it is impossible to see any “good faith movement toward moving our system toward regenerative agriculture” in the current administration. Talk is cheap. But this has been a problem with the Uniparty for the past sixty years, which we discussed earlier this week. Both sides do it, and the Trumpian reprieve for glyphosate is just another item in a long list. Good faith has nothing to do with it.
For those with the time and energy, Casey Means’s appearance on the Joe Rogan Experience with her brother Calley just about covers it all, especially her “going with the Rogan flow” on vaccines and the vaccine schedule (another major MAHA irritant that nevertheless has banished many infectious diseases from childhood). Their performances are very good.
Still, there is something more at work here, and this was covered here yesterday in From Fed Failures to Inflation and Stablecoins: America’s Trust is Cracking. It is not difficult to see how this applies to Casey Means as Surgeon General. Yes, she graduated from medical school, a very prestigious medical school at that. And yes, for a while she had a valid medical license to practice as an intern and ENT-in-training. The latter indicates she did well in medical school, because the competition for ENT residency positions is sharp. But she did not finish and she lacks a medical license now. There is scant evidence she has ever managed an organization of any appreciable size or had any extensive administrative experience. How is it that we should have trust in someone who has not demonstrated she has ever been a trustee of any organization, much less something as large and important as American medicine? Her waffling about vaccines certainly does not engender trust in her knowledge or judgment, except in the anti-vax MAHA universe.
The same is true of Jay Bhattacharya, who is the current Director of the National Institutes of Health. He, like Casey Means is a graduate of Stanford, including an MD and a PhD in economics. Dr. Bhattacharya (by way of his PhD) never completed his medical education, either. He apparently went straight from his MD to the PhD and has never treated patients except as a third- and fourth-year medical student under the direct supervision of a licensed physician. He has received NIH support for his work in the economics of healthcare and he has published papers in the field. But he has never been a physician or a scientist. Yet he is responsible for the largest and most productive biomedical research organization in the world. Nevertheless, he has apparently never done an experiment or managed a laboratory. [2]
A successful Assistant Professor of Biochemistry who has gotten grant support for his research and managed a laboratory consisting of several graduate students who have received their PhD, two technicians, and a gaggle of undergraduates has more relevant scientific and management experience than the economist Dr. Bhattacharya. Without going into the utterly spurious nature of the Great Barrington Declaration, why should we trust him to do his current job? But CDC staffers, where he is the current acting director may be enthusiastic because he may endorse the measles vaccine. But is this reason for trust? Or is it more a case of “hand, grasp straw”? And how does this square with the Surgeon General designee’s current view of the measles vaccine as a matter of an ill-considered version of informed consent?
Anyway, ‘tis a mess and the way forward seems to be a path of full of brambles with sharp thorns. But as the Rabbi said, while we as citizens are not required to finish the work, neither are we free to desist from it.
Notes
[1] To obtain a license to practice medicine independently in the United States, a medical school graduate with an MD (or DO) must complete a course of graduate medical education (internship plus residency in the specialty of choice). These include, among others, pediatrics, general surgery, family medicine, internal medicine, psychiatry, anesthesiology, obstetrics and gynecology. Specialists such as cardiologists, nephrologists, and medical oncologists complete a residency in internal medicine before completing their specialty graduate medical education. The ENT residency began but not finished by Casey Means-MD is a rigorous five years.
[2] Scientists of my acquaintance have complained that RFKJr is Secretary of Health and Human Services but has no scientific experience. They forget that most HHS Secretaries have been politicians. On the other hand, previous Directors of the National Institutes of Health have been physicians or physician-scientists and have presided over research that has led to at least 29 Nobel Prizes in Physiology or Medicine and several more in Chemistry, as we have discussed here before.
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Re the local shoutout it sounds like those SC parents were taking their cues from their church rather than RFK or his aides. My county’s very unusual outbreak apparently tracks to a large group of Ukrainian and Russian speaking immigrants a few miles outside of town. They have their own churches and their own vaccine fears that they brought with them from overseas. I see them in stores (not lately) and they are even wearing Middle European style clothing as a kind of badge of apartness.
Which is not to quarrel with almost any criticisms of the Trump admin at this point. It seems to be a complete disaster.
But we are not off in the sticks here. Our local hospital system is undoubtedly–save BMW–the largest business.
I live not too far from Marin County that was for a time a locus of anti-vaxxer sentiment. Their ideas were prevalently floating about the local noosphere when my son was an infant and due for vaccines. When, in my previous state of ignorance I raised some unwarranted concerns, my doctor had the scientific data at his mental fingertips, and within about two minutes, I was convinced to proceed with getting the apple of my eye fully vaccinated. You’d think that in a high income, well educated, liberal coastal elite community they’d know better, and you’d have been wrong back then. Current data indicate that attitudes have changed for the the better.
The actor Anthony Edwards–who played a doctor on TV’s ER–was big on the vaccines cause autism movement. I believe this was well before RFK jr had much prominence. Of course people are paranoid when it comes to their kids but unless they want to home school–and many do–society has its rules and reasons.
Don’t get me wrong about where I live since there are other pockets of church school or even still segregationist groups avoiding our county schools. But the articles I’ve seen suggest the immigrant angle is big in our large outbreak.
Bhattacharya is a eugenicist that should be at the The Hague.
Two vaccine notes.
MMR should be split up into three separate vaccines. There are harmful side effects in the current regimen.
HepB has been pushed on newborns when there is very little chance of transmission from the mom to the newborn since monitoring and testing the mom during pregnancy is standard, based on what moms have told me. (I’m not a doc).The Japanese modified the protocol to delay the newborn HepB shot for six months and that practically eliminated the SIDS incidence there. I suggest that the US adopt that, if discussions aren’t underway already.
One aspect of vaccine hesitancy is that patients hear a party line recitation about each shot, but didn’t get dialog when asking about the now widely-publicized mRNA side effects, especially Pfizer’s. Docs need to get better training so that they may communicate more effectively with patients. In this era, people are less likely to take something on faith when they have so many examples to the contrary.
Doctors, nurses and patients all should benefit from a restoration of trust. Perhaps IM Doc and others in the field can opine.
I disagree on both. You present NO evidence of harm for either vaccine. The onus is on you to do so. All you give are handwaves and your comment serves to promote unjustified vax hesitance. I can see opposing not all that helpful vaccines like the flu shot, but none of these are in that category.
Regarding Hep B, your position is demonstrably bogus. First, with our terrible healthcare system, many mothers are NOT well monitored before birth. Look at our high maternal mortality rate. FFS.
Second, maternal transmission is NOT the only way to get Hep B. Your position that it is is bollock. Have you not heard of sexual abuse of minors? I had an aide who was repeatedly raped by an uncle at age 8 and someone I knew who started having sex at boarding school at age 12.
The fact show you are WAY WAY WAY off base and trying do an affirmative disservice by anti-vax fearmongering.
See for instance:
https://www.cidrap.umn.edu/childhood-vaccines/vaccinating-newborns-against-hepatitis-b-saves-lives-why-might-cdc-panel-stop
With Robert F. Kennedy Jr. as the current u.s. Secretary of Health and Human Services — what could the u.s. Surgeon General, while RFK jr. remains in office, do to ameliorate the damage RFK jr. has done and continues to wreck upon Health in the u.s.? Trump could as well name a horse, like Incitatus, were he still alive, to act as u.s. Surgeon General.
Always love your work here, KLG, and I thank you for this important piece.
May I suggest that you consider adding the following, for clarity, in brackets:
“it seems quite reasonable to expect the leader of American medicine have the same qualifications of those she is leading. In this case it apparently would be unprecedented [if the Surgeon General did not], whatever her academic accomplishments.
Thank you, Carla! I was a bad copy editor.
Why would you say there is no sign the Hep B vaccine is harmful when there has been plenty of signs of harm, including some studies that included children?
A case-control study of serious autoimmune adverse events following hepatitis B immunization
Rheumatic disorders developed after hepatitis B vaccination
Autoimmunity following hepatitis B vaccine as part of the spectrum of ‘Autoimmune (Auto-inflammatory) Syndrome induced by Adjuvants’ (ASIA): analysis of 93 cases
Autoimmune hazards of hepatitis B vaccine
Neuromuscular disorders associated with Hepatitis B vaccination
A Shadow Falls on Hepatitis B Vaccination Effort (behind a paywall, but I accessed the article and it says among other things, “Physician Philippe Jacubowicz, who heads an organization in Paris called REVAHB, has collected data on more than 600 cases of illnesses, many with MS-like symptoms, in people who had received the hepatitis B vaccine. In addition, patient advocacy groups in Britain and Canada have studied more than 100 cases each, as has an outspoken U.S. accuser of the hepatitis B vaccine, Bonnie Dunbar, a molecular biologist at Baylor College of Medicine in Houston.)
I could list many more articles showing problems with the hep-b vaccine but I hope this will do. You did specifically mention harm to infants, but I hope these articles show that vaccine-hesitant people have plenty of reason to think twice about infant vaccination for hep-b. To suggest there has been no harm from the Hep-b vaccine and speak condescendingly to vaccine-hesitant people (with words like ‘trope’) utterly disregards the huge amount of scientific literature on the topic and shows why it is so hard to have an informed conversation around vaccines.
I don’t know anything about RFK or this new Surgeon General candidate, but the fact that she didn’t finish medical school increases my trust in her. For a simple reason: corrupt authorities cannot threaten to take her license away if she doesn’t toe their line. Since so few know the covid story I’m referring to, I’ll retell it here:
During the covid vaccination campaign, there were many signs of corruption regarding the covid vaccines, including during the trials, conflict of interest in the NIH approval committees, conflicts of interest w/Fauci himself, signs the medical journals published information inappropriately (including discussed in articles featured on this site), signs the gov’t withheld huge amounts of incriminating documentation (in one example, telling a judge they would need 55 years to release vaccine-related documentation), suppression of conversations around ivermectin on social media, and much more.
So where were the licensed physicians to protect us from the corruption? Oh right, medical boards in all 50 states threatened to remove the medical license of any physician who advocated caution around the vaccine. Nobody who went to a licensed physician got unbiased advice, because every single doctor in this country felt tremendous pressure to recommend the vaccines regardless what they really thought – just to protect their career.
The corruption was epic – epic! When did doctors band together to make sure they could never have their career threatened for telling the truth? When was there accountability so this wouldn’t happen again? These things never happened, there has been no accountability or change, so why would people trust that doctors would tell them the truth about any particular vaccine or drug after they were fooled during the covid vax campaign?
Part of debating in good faith is acknowledging the legitimate evidence of all sides. Please at least acknowledge the existence of all the evidence that vaccines like Hep-B have actually caused harm to large numbers of people, and why so many people might distrust licensed physicians.
And I won’t comment on the measles vaccine’s effectiveness. However, when authorities have proven utterly untrustworthy, you should expect some large fraction of people not to believe them even if they do tell the truth. So the blame for lack of measles-vaccination once again lies with the utterly untrustworthy and unaccountable authorities who’ve earned the distrust, not with the people who refuse to be fooled again and do their best to make decisions in a low-trust environment.
Thank you for your comment. Your six citations reveal much about the scientific literature, especially the 585,110papers retrieved going back to 1799 when “vaccine” is used as the query. Given the size of this body of published work, one can cherry pick papers that support any conclusion. But that requires a thoroughly uncritical approach. What follows is a brief discussion of your citations 2-6 followed by the first in your list, which is by far the best illustration of what happens when one uncritically believes everything one reads in the biomedical literature. (emphasis added)
A case-control study of serious autoimmune adverse events following hepatitis B immunization
Rheumatic disorders developed after hepatitis B vaccination. From the conclusions: Hepatitis B vaccine might be followed by various rheumatic conditions and might trigger the onset of underlying inflammatory or autoimmune rheumatic diseases. However, a causal relationship between hepatitis B vaccination and the observed rheumatic manifestations cannot be easily established. Further epidemiological studies are needed to establish whether hepatitis B vaccination is associated or not with an incidence of rheumatic disorders higher than normal.
Autoimmunity following hepatitis B vaccine as part of the spectrum of ‘Autoimmune (Auto-inflammatory) Syndrome induced by Adjuvants’ (ASIA): analysis of 93 cases. From the conclusions: Common clinical characteristics were observed among 93 patients diagnosed with immune-mediated conditions post-HBV, suggesting a common denominator in these diseases. In addition, risk factors such as history of autoimmune diseases and the appearance of adverse event(s) during immunization may serve to predict the risk of post-immunization diseases. The ASIA criteria were found to be very useful among adults with post-vaccination events. The application of the ASIA criteria to pediatric populations requires further study.
Autoimmune hazards of hepatitis B vaccine
This review is authored by one Marc Girard. It was published in 2005 and has been cited about 30 times. M. Girard apparently uses his home address and an AOL email address. This does not mean the paper is invalid, but these are bright red flags. The paper has been cited four times since it was published. It could be a neglected classic, but probably not. From the Abstract: Then, a review is made of data suggesting that HBV is remarkable by the frequency, the severity and the variety of its complications, some of them probably related to a mechanism of molecular mimicry leading to demyelinating diseases, and the others reproducing the spectrum of non-hepatic manifestations of natural hepatitis B. To be explained, this unusual spectrum of toxicity requires additional investigations based upon complete release of available data.
Neuromuscular disorders associated with Hepatitis B vaccination. The author of this paper seems to be a legitimate scientist with more than fifty entries in PubMed from 1991-2017. From the Abstract: The hepatitis B virus (HBV) is an important infectious cause of acute and chronic liver disease throughout the world. Recombinant hepatitis B vaccines have been developed to combat morbidity and mortality associated with HBV infection. These vaccines have been associated with autoimmune diseases mostly among adult vaccine recipients. Epidemiological surveys have not established unequivocal causality between the hepatitis B vaccine and the development of various autoimmune neuromuscular disorders. However, case histories and series hint at a temporal association between hepatitis B vaccines and the development of various neuropathy syndromes, polyarteritis nodosa complicated by vasculitic neuropathy, myasthenia gravis and dermatomyositis. Conceivably, the hepatitis B vaccines have a potential to occasionally trigger the onset of immune diseases in individuals with an underlying genetic or immunological susceptibility.
A Shadow Falls on Hepatitis B Vaccination Effort. This is a news article by the longtime science journalist Eliot Marshall, whose work I have followed for probably forty years. It was published in Science in 1998. If the shadow of the title had been anything other than a fleeting moment, more would have come of it.
The general thrust of these papers, such as they make their points, is that people with autoimmune disorders or likely to develop autoimmune disorders are at risk of serious outcomes when they are vaccinated. This has been well known since, well, forever. It is also the reason that herd immunity (short video, measles starts at 1:00) is so important for diseases such as measles that are highly transmissible – it protects the vulnerable. Are individuals sometimes harmed by vaccines? Yes, but this is rare. I have a young friend who was in the “one-in-a-million” who got polio from the attenuated vaccine. Despite substantial physical challenges she is now a board-certified physician. We do have a mechanism to help (compensate is the wrong term) those very few, but it is on the current RFKJr hitlist. When he goes away, vaccines are sure to follow.
But I could have stopped reading at your first citation, which is an article by the father-son team of Mark and David Geier. Mark (father) is now deceased. He had his medical license revoked. David, who apparently took a few biology classes in college, was charged with practicing medicine without a license. Both have been anti-vaccine “activists” (some would say cranks) with a very long history. You can read that damning tale here if you are so inclined. Is it a coincidence that the current Secretary of Health and Human Services has called upon David to “investigate” vaccines? No. Using the Geier duo as an authority on vaccines is the exact analog of using the spurious work of Charles Murray, William B. Shockley, Arthur Jensen, Richard Herrnstein, Cyril Burt, and Hans J. Eysenck to argue that certain human groups, distinguished by the color of their skin, are dumber than others.
Regarding Casey Means MD (which is how she identifies herself at her website), I wrote that she did graduate from medical school but then neglected to finish the graduate medical education (GME) required for her to become board-certified in her chosen specialty (ENT). Consequently, she now lacks an active, valid license to practice medicine. This means she is not a physician despite having graduated from medical school. Is this important? I think it is. So does the 20th Surgeon General of the United States, Jerome Adams who was nominated by Donald Trump and subsequently confirmed unanimously by the US Senate. He is not the only one who feels this way. Long block quote from STAT News, which is generally behind a paywall:
Eight years ago, I sat before the Senate for my confirmation hearing to be surgeon general. Republican Todd Young (Ind.) and Democrat Joe Donnelly (Ind.) introduced me, and I was confirmed unanimously.
That bipartisan support reflected more than politics. It reflected preparation: a medical degree, completion of an anesthesiology residency, board certification, an active license, a master’s in public health, and service as Indiana’s health commissioner. I was also actively practicing at a Level I trauma center.
That is what the job demands — not just a platform, but the training, experience, and authority to lead nearly 6,000 uniformed officers in the Commissioned Corps of the U.S. Public Health Service through hurricanes, outbreaks, and whatever crisis comes next. During my tenure, I practiced at Walter Reed and aboard the USNS Comfort in disaster zones. The officers I led were required to maintain active, unrestricted licenses. So was I.
Now the Senate is considering Casey Means for the role. She graduated from Stanford Medical School but left her surgical residency at Oregon Health & Science University shortly before completion. Her medical license went inactive in January 2024, and she acknowledged at her hearing that she currently cannot prescribe medications and has no desire to treat patients.
This is not a minor technical issue. The surgeon general is the nation’s “top doc” and a three-star admiral. By policy and long-standing tradition, physicians in the Commissioned Corps must complete residency training and maintain an active, unrestricted license. If confirmed, Means would be responsible for enforcing standards she does not meet herself. Disciplining an officer for a lapsed license while your own remains inactive would erode morale and credibility at the very top — not to mention opening the office up to legal liability.
Qualifications either matter — for everyone — or they do not. Confirming an unlicensed nominee signals that standards are flexible when convenient. That is unfair to every past surgeon general who completed rigorous training and practiced medicine before assuming the office.
I understand the desire for disruption. Our health care system is too expensive, too fragmented, and too focused on treatment over prevention. Means speaks passionately about metabolic health and reducing ultra-processed foods. Those conversations are important.
But the surgeon general is not a wellness influencer. The role carries statutory responsibilities and operational authority over uniformed officers who deploy in national emergencies. Credibility in that role rests on shared professional standards.
There are also questions about conflicts of interest. Means co-founded Levels, a company marketing continuous glucose monitors to non-diabetics through subscription plans that was valued at $300 million in 2022. She has pledged to divest certain holdings, which is appropriate. But perception matters in public health. If the surgeon general issues guidance on nutrition, devices, or supplements, the public will surely question whether prior business interests influence policy. We have seen how even the appearance of entanglement can weaken public trust.
The failings of the political and biomedical establishments during the pandemic and otherwise has been a continuing theme here. As is the ridiculous American healthcare “system.” You are not making a novel case. A good faith argument requires a thorough and objective understanding of the underlying evidence. Your citations do not do this. Finally, whether you will “comment” on the measles vaccine is completely irrelevant. After the vaccine was first used in the United States more than sixty years ago, measles basically disappeared. I had both rubeola (14-day measles) and rubella (German measles) as a child. Like most of my contemporaries, I had no serious sequelae. We were the lucky ones. Now the world faces the prospect of a return of this very serious disease. Here are the data showing the worldwide effectiveness of vaccines, if you care to look.
Hi KLG: “Casey Means also hemmed and hawed about the Hepatitis B vaccine, knowing full well that there is no evidence this vaccine is harmful when given to infants. But she also knows that Hep B is easily transmissible in a daycare setting” For the record: I am German-American and I am vaccinated against Hep B. But that is because I ran an outdoors business in Central Asia. Hep B is NOT easily transmittable as you say. This is common knowledge. On the website of the Hep B foundation it says: “Hepatitis B is transmitted through direct contact with infected blood.”https://www.hepb.org/blog/hepatitis-b-transmission-newly-diagnosed/
In fact we have a single payer system here in Germany and private equity has also managed to get its fingers into the pie. We also have more and more unnecessary procedures that solely exist to generate money for share holders. Not for patients.
Still Big Pharma has not been able yet to do something as unnecessary as force a Hep B vaccination on newborns. In fact I had to pay my Hep B vaccination myself and thankfully my GP took the time to go with me through possible averse effects. NO medical intervention is entirely without risk and considering the Billions big pharma spends on buying researchers and influencing publishing I don´t exactly trust the “science” regarding adverse effects.
As far as I know the US is now at 72 recommended shots before the age of 18 and that is at least twice the number it is in most European countries. If you don´t evaluate existing vaccines but only trust the “science” as financed by Big Pharma you will in the end destroy any believe in vaccines. That is what seems to be happening in the US. From your article it seems that the new lady proposed for Surgeon General has indeed quite a few crackpot ideas. But her insistence on having a fresh look at things like Hep B for newborns seems to me the only way to regain the trust of the US public.
When a crackpot who is making millions from quackery has one “good idea”, it does not invalidate or override condemnation of the crackpot. Casey Means is a very clever self-promoter.
It is quite clear that American medicine is profit-driven. And here is a woman who has milked her pretense of professionalism for many, many pennies and now believes she also merits power and prestige. There’s no vaccine for this illness, unfortunately.
Thank you, Tom67. But it’s blood and bodily fluids. HepB can survive on a surface for up to seven days. Unlikely, but it has been shown to be transmitted in a daycare center in New Zealand. Comparison with countries that have universal healthcare is not valid, which is what the current administration is doing with Denmark. And one of those vaccines “before 18” is against HPV. Like you I have been vaccinated as an adult against HepB because I have worked in a building connected to a teaching hospital. But I was never vaccinated against HPV because it was unavailable. Eight weeks of chemotherapy and radiation and one year without a sense of taste and severe weight loss were the result of that, and checkups with my ENT (thankfully not Casey Means MD) are scheduled every six months for the duration, which at my age will not be that long.
In any case, very little of the anti-vax hysteria in this country is directed at holding the medical establishment to account. Big Pharma and Big Medicine are largely unaccountable, and this particular infection is spreading to Europe as you note. Here this is simple hysteria.
You don´t convince me. It’s just a fact that the US has an inordinate amount of recommended vaccines compared with the rest of the world. Given the power of Big Pharma and Big Medicine that you supposedly oppose how can anybody be sure that it is all legit? As a scientist you surely know that feedback mechanisms increase the more variants you introduce. One vaccine by itself might be safe but has anybody ever looked into their combinations and how they effect each other? Especially considering how the numbers increased after Congress gave them protection from any liability and also after the experience with the Covid vaccines. Tertium non datur: if there isn´t a neutral and rigorous examination into such questions the public will simply loose all trust and reject all vaccines. Even super safe and proven ones. I hope you understand my argument.
Your statement is false. I just looked at the childhood vaccination schedule for Thailand. It has as many in the first 8 months except for omitting Covid-19 and having a tuberculosis vaccine at birth (along with the first Hep-B) while we have HepB + RSV. I did not bother going later than that.
Ok, I was wrong. There are countries after all that have a schedule like the US. At least none of the European countries has. Here please a comparison between the US and Denmark. https://tracybethhoegmdphd.substack.com/p/the-child-immunization-schedule-in
That AGAIN is false. You need to stop Making Shit Up and relying on sources who lie to promote an anti-vax agenda.
I looked only at France because it is considered to have the best health care in the EU. France has 8 vaccines that they administer to children from birth to 8 months. That includes Hep B. It is 8 even though they do not administer the Covid vaccine to kids that young.