Donald Trump on Thursday pulled his nominee for US surgeon general, Casey Means, and announced a potential replacement.

The US president said that Means will continue to fight for the so-called Make America Healthy Again (Maha) movement spearheaded by health secretary Robert F Kennedy Jr. He stated this was despite opposition from Bill Cassidy, the Republican US senator of Louisiana, to Means’s nomination.

“Despite Senator Cassidy’s intransigence and political games, Casey will continue to fight for MAHA on the many important Health issues facing our Country,” Trump said in a post on his Truth Social platform.

Trump then said he was instead nominating radiologist and Fox News contributor Dr Nicole Saphier for the post of US surgeon general.

After being nominated last May, Means’s nomination had been stalled since a bruising February confirmation hearing, where senators from both parties questioned her stance on vaccines and her decision to abandon her surgical residency. Lisa Murkowski and Susan Collins, both Republican senators, left with unresolved concerns, which denied Means the unanimous Republican committee support she needed to advance.

Now, Saphier is the third person Trump has nominated to the post. She is a radiologist and director of breast imaging at Memorial Sloan Kettering, a CDC advisory committee member and a longtime Fox News contributor.

She is also the author of a bestselling 2020 book titled Make America Healthy Again: How Bad Behavior and Big Government Caused a Trillion-Dollar Crisis, in which she argues that socialized medicine isn’t necessary for lower medical costs when you instead have healthy eating habits.

Kennedy, whose anti-vaccine record triggered a measles outbreak that killed children and drew fierce bipartisan condemnation, has since retreated to softer public messaging on immunization – making Saphier’s mainstream medical credentials a more politically convenient standard-bearer for the Maha brand.

Trump praised her as “a STAR physician” and “an incredible communicator”, suggesting her decade as a Fox News contributor was as much a qualification as her clinical record.

The appointment comes as the wider public health apparatus remains in disarray: there was a months-long gaps in leadership at the National Institutes of Health, and the CDC alone has cycled through four directors or acting directors since Trump took office, and has been without a permanent, Senate-confirmed leader since August 2025 – which triggered resignations in protest. As it stands, 80% of the top positions at the agency remain vacant.

The Associated Press contributed reporting