Dr Casey Means, nominated to serve as US surgeon general, faced pointed questioning from senators over her past remarks on vaccines and environmental health during a confirmation hearing that underscored divisions over public health policy.

Means, a physician known for her work on metabolic health and preventive medicine, was pressed by members of the Senate committee on her views regarding routine childhood immunisations and the safety of widely used agricultural chemicals.

Lawmakers from both parties sought clarification on statements she had previously made in interviews and online posts that appeared critical of aspects of vaccine policy and pesticide regulation.

In her testimony, Means affirmed her support for evidence-based medicine and said she recognises the role vaccines have played in reducing infectious disease.

She emphasised that, if confirmed, she would rely on established scientific processes and collaborate closely with federal agencies, including the Centers for Disease Control and Prevention and the Food and Drug Administration, to guide public health recommendations.

Several senators raised concerns about vaccine hesitancy and declining immunisation rates in parts of the country, asking whether her previous comments might undermine public confidence.

Means responded that public trust depends on transparency and open scientific dialogue, adding that strengthening metabolic health and addressing environmental risk factors should complement, not replace, vaccination strategies.

The hearing also touched on pesticide exposure and chronic disease, with Means advocating for continued research into environmental contributors to long-term health conditions.

She said public health policy should integrate nutrition, environmental science and preventive care, while remaining grounded in peer-reviewed evidence.

The nomination comes at a time when federal health agencies are navigating persistent misinformation, shifting disease patterns and debates over regulatory oversight.

The surgeon general serves as the nation’s leading public health communicator, tasked with issuing advisories and shaping national health priorities.

The Senate committee is expected to vote on whether to advance the nomination in the coming weeks, as lawmakers weigh Means’ professional background and her assurances that she would uphold established scientific standards if confirmed.