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But at least in one instance, she hasn't been in lockstep with Trump's thoughts on health policy, telling The Associated Press in September that his cautions about pregnant women taking Tylenol were oversimplistic and “patronizing.”

Means' withdrawal came after her with lawmakers of both parties threw into question whether she could secure enough votes to advance out of the Senate health committee.

In an interview Thursday, Means said her nomination fell apart after a “yearlong smear campaign against me,” which she said was a larger effort to impugn the MAHA movement and its focus on reforming food and healthcare.

She said she will continue to “help with progress on this movement how I can.”

Means pitched ideas popular with MAHA

In nominating Means last May, Trump sought to hire a close Kennedy ally as the nation’s doctor. The 38-year-old Means, a Stanford-educated physician who became disillusioned with the health care system and pivoted to a career as an author and entrepreneur, popular with the MAHA movement, including that Americans are overmedicalized and that diet and lifestyle changes should be at the center of efforts to end widespread chronic disease.

But Means, who did not finish her surgical residency program and doesn’t currently have an active medical license, also had faced scrutiny for her lack of experience and . On top of those concerns, senators grilled her in February about Kennedy’s effort to pull back vaccine recommendations — leading to some contentious moments as Means toed the line between support for vaccines and calling them a decision best made by patients and their doctors.

In her confirmation hearing, Means was repeatedly asked about the birth dose of the hepatitis B vaccine, which the U.S. Centers for Disease Control and Prevention stopped recommending for all children late last year in a move and during a lawsuit. Means has raised doubts about the birth dose, posting on social media in 2024 that giving the vaccine to a newborn whose parents don’t have hepatitis B was “absolute insanity.”

Means' nomination had languished since the late February confirmation hearing, even as activists from the MAHA movement orchestrated a push to support her bid by surging phone calls to Republican senators Lisa Murkowski of Alaska and Susan Collins of Maine. They had both indicated reservations with the pick.

Means told The Associated Press her understanding was that Murkowski wasn't going to vote for her, and Collins had serious reservations.

“I think there was some talking past each other,” Means said of her conversations with the senators, noting they seemed focused on vaccines when she “wasn't coming in with any agenda to impact the vaccine conversation.”

In post Thursday, Trump called Means “a strong MAHA Warrior” and also criticized the “intransigence and political games” from GOP Sen. Bill Cassidy of Louisiana, the chair of the Senate health committee, who is facing a tough reelection this year and who interrogated Means about vaccines during the hearing.

Means' brother, Calley Means, a health adviser to the Trump administration, blamed Cassidy in a social media post, claiming his “constant delay tactics” sank the nomination because he didn't bring Means' nomination to a committee vote. Kennedy later piled on with his own post claiming Cassidy “did the dirty work for entrenched interests seeking to stall the MAHA movement.” Cassidy didn't respond to a request for comment.

Now Trump will try to fill the post a third time

Means is the second U.S. surgeon general pick whose nomination has been withdrawn in Trump’s second term. Trump withdrew his first nominee, Fox News medical contributor Janette Nesheiwat, after questions were raised about her academic credentials.

Saphier is director of breast imaging at Memorial Sloan Kettering Monmouth, according to her profile on the New York-based institution’s website. She has a doctor of medicine degree from Ross University School of Medicine in Barbados along with fellowships at the Mayo Clinic, the profile said.

Like Means, Saphier has questioned whether every child needs to get the hepatitis B vaccine at birth.

“I don't necessarily think it's necessary,” she in September. “My opinion is if a woman recently tested negative for hepatitis B and they’re living a low-risk lifestyle, no IV drug use, not a sex worker, they don’t have a hepatitis B positive person living in the home, then the newborn probably doesn’t need this vaccine and we can have a conversation about whether or not they should get the vaccine later in life.”

She also has criticized COVID vaccine booster requirements, arguing on a in September that they were not always rooted in evidence.

Saphier used the phrase “Make America Healthy Again” years before Kennedy popularized it. It was the title of a book she wrote in 2020 that criticized government handling of health care and the Affordable Care Act.

In at least one case, Saphier has diverted from Trump’s medical messaging. Last year, as Trump advised pregnant women, “Don’t take Tylenol” — promoting between the medication, vaccines and autism — Saphier said that while pregnant women generally are advised to take acetaminophen only under medical supervision, when necessary and at the lowest effective dose, equally important was that untreated fever or severe pain can also pose serious risks to mothers and babies. She noted that part was missing from Trump's message, delivered at a press conference with top U.S. health officials.

“For decades, women have endured a paternalistic tone in medicine. We’ve moved past dismissing symptoms as ‘hysteria,’” Saphier wrote in an email to the AP at the time. “The President’s recent comments on Tylenol in pregnancy are a prime example. Advising moderation was sound; delivering it in a patronizing, simplistic way was not.”

On a podcast at the time, Saphier said the press conference was “full of hyperbole” and “really painful to watch."

Saphier did not respond to a request for comment.

___ Kinnard reported from Columbia, S.C.