1. United States
2. Mass.
3. Letter

America does face a serious chronic disease crisis. Rising metabolic dysfunction, childhood obesity, autoimmune illness, and mental health struggles deserve urgent, prevention-focused leadership. I support meaningful reform that shifts incentives toward nutrition, environmental health research, physical activity, and early intervention. But prevention reform cannot come at the expense of scientific clarity or statutory compliance. That is why I urge careful reconsideration of the nomination of Casey Means for U.S. Surgeon General. During her confirmation hearing before the Senate HELP Committee, Dr. Means declined to unequivocally state that vaccines do not cause autism. Decades of rigorous, large-scale research have found no causal link. That conclusion is supported by the Centers for Disease Control and Prevention, the World Health Organization, and the American Academy of Pediatrics. The Office of Surgeon General exists to communicate clear, evidence-based public health guidance, especially during outbreaks and moments of national uncertainty. When vaccination rates are declining and measles outbreaks are resurging, ambiguity on settled science undermines public trust. Chronic disease prevention and vaccine confidence are not opposing goals. They are complementary pillars of public health. Addressing ultra-processed food consumption, environmental exposures, and metabolic health does not require reopening questions that have already been thoroughly examined and answered by decades of epidemiological evidence. There are also governance considerations. The Surgeon General oversees the U.S. Public Health Service Commissioned Corps, a uniformed service of more than 6,000 public health officers. The role requires maintaining an active, unrestricted medical license. Dr. Means has placed her license on inactive status and has indicated she does not plan to reactivate it. That raises a legitimate statutory and institutional question separate from ideological debate. Additionally, prior financial ties within the wellness industry create avoidable credibility concerns in a role that demands unimpeachable public trust. This nomination should not be evaluated through a cultural or partisan lens. The question is whether the nominee can serve as a clear, steady, and scientifically grounded national health communicator while fully meeting the legal and operational requirements of the office. The Office of Surgeon General demands clarity, statutory compliance, and unwavering commitment to evidence. I urge you to weigh these standards carefully before advancing this nomination.