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The new nominee for US surgeon general is an “effective communicator” who appears to be “mainstream enough” to pass confirmation before the US Senate, experts say.

But she has questioned routine childhood vaccines and other public health measures, and she is a progenitor of the “Make America healthy again” movement.

Nicole Saphier, a radiologist and Fox News medical contributor, is Donald Trump’s third pick for US surgeon general, following withdrawn nominations for Janette Nesheiwat and Casey Means.

The surgeon general can’t make new laws or regulations, can’t enforce policy and has no budget. Still, it’s one of the most influential health positions in the nation.

Means, who is not an actively licensed physician, faced opposition because of her significant conflicts of interest in the wellness industry and a lack of support for vaccines.

Saphier has also cast doubt on the childhood vaccine schedule, public health interventions for Covid, and healthcare for transgender children. She owns her own supplement company as well.

Saphier is “almost a lock” to pass her confirmation hearing, said Art Caplan, a professor of medical ethics at NYU’s Grossman School of Medicine and a polio survivor who has spoken with Saphier in the past and is familiar with her work. Saphier is “a very effective communicator” who appears “mainstream enough” to secure the position, Caplan said. “I don’t agree with her at all,” he said, but her positions on vaccines, for instance, likely “won’t prove to be fatal” to her nomination, he said.

Saphier is “overall a solid pick”, Jerome Adams, the surgeon general under the first Trump administration, said in a statement. “She is an exceptionally clear communicator – especially effective at reaching conservative audiences who often tune out traditional public health messaging.”

Unlike Means, Saphier has an active medical license and currently practices medicine, which “we really shouldn’t have to highlight,” Adams said, “but here we are”. Adams said he has worked with Saphier before and “she’s no sycophant”, adding: “Hopefully she’ll be allowed to follow the science wherever it leads.”

Saphier is a licensed physician specializing in breast imaging at Memorial Sloan Kettering Cancer Center’s Monmouth location. She has a strong focus on prevention, especially of breast cancer – which she has attributed in part to lower birth rates, pregnancy at older ages, and less breastfeeding, and she argued that cancer prevention should involve support for younger parents and for breastfeeding.

She would be the 25th top official in the second Trump administration to currently or previously work for Fox, having appeared on the network more than 640 times. Neishewat, Trump’s first surgeon general pick, was also a Fox contributor.

Saphier wrote a book in 2020 called Make America Healthy Again, four years before Robert F Kennedy Jr, now the secretary of the US Department of Health and Human Services (HHS), used the slogan himself at a political rally. The Maha movement would bring together Kennedy’s sometimes unruly coalition of supporters, including anti-vaccine activists, nutrition advocates, environmentalists and supplement sellers. On her podcast, Saphier talks about a range of topics, including substance use, GLP-1 drugs, nutrition, infectious disease, “forever chemicals” and microplastics.

Saphier’s book emphasizes the role of individual action, not “big government”, in improving health. While she “leans heavily toward ‘personal responsibility’ and is skeptical of government intervention”, that position will hopefully “soften” once she gets a better view of the public health landscape in America, Adams said. “You can’t always make the healthy choice when the environment only offers bad ones.”

The surgeon general makes recommendations on health, including vaccines – and Saphier has frequently downplayed vaccines, especially mandates to attend school, which are set at the state, not federal, level.

In February 2025, as measles began rising in the United States, she said most “good research” shows that vaccines aren’t linked to autism. In March 2026, she once again expressed concern about the spiraling measles outbreak and decreasing vaccination rates.

“We have to get back on track,” she said on her podcast, before taking aim at vaccine mandates for school attendance. “We need to roll back a lot of the mandates, but we also need to make sure that there is clear messaging that vaccines – while they come with risks, they are overwhelmingly safe and they do prevent morbidity and mortality from what would be a preventable illness.”

Saphier criticized how the administration handled changes to the routine childhood vaccine schedule.

“I didn’t really like the way they communicated these new changes. I think it created a lot more confusion,” she said on the podcast in January. She highlighted the differences between the US and other countries, saying that comparisons were like “apples and oranges”.

She has also called the schedule into question, looking “more critically” into childhood vaccines after her son became ill with whooping cough, she said in September on her podcast.

“Questioning the vaccine schedule, that doesn’t mean you’re anti-vax,” she added.

When it comes to decreasing vaccination rates across the country, “we have to figure out what’s causing this and what can we do to move forward so that people can actually trust the public health process all over again,” she said. She attributed the decline to Covid vaccine mandates and rising misinformation online.

She also questioned why hepatitis B vaccines are required for school attendance. “It’s not highly contagious,” she said in the same podcast episode, though hepatitis B can linger on surfaces, such as nail clippers and sports equipment, for up to a week. Hepatitis B can cause severe illness in children, but decades of evidence demonstrate the safety and effectiveness of hepatitis B vaccines.

“Sometimes she talks about spacing out the vaccine schedule. That’s nonsense. There’s no reason to do that,” Caplan said. “What’s dangerous to a child is not getting all the vaccines properly.” Caplan also pointed to the rise of misinformation and the decline of vaccination: “To sow doubt about the safety of vaccines at a time when we need them more than ever is still a bad thing, and I don’t agree with her when she does that at all.”

Saphier claimed incorrectly in February 2021 that children did not transmit Covid as well as adults do, and she said teachers should return to school before vaccines were fully rolled out because “science shows it is safe to go back to school without a vaccine.” In December 2021, when the Omicron variant emerged, Saphier said: “It is time to move forward and allow this mild infection to circulate so we can continue to build that hybrid immunity.” About 244,000 Americans died of Covid the following year. In 2022, Saphier claimed that the US Centers for Disease Control and Prevention (CDC) were preparing to mandate Covid shots for all schoolchildren – a rumor that was widely circulated and remains an anti-vaccine talking point.

In more recent months, she pushed back on statements from Trump and health officials attempting to link autism to acetaminophen (Tylenol) use during pregnancy, pointing instead to the risk of high fevers.

“The message can’t be, absolutely do anything to avoid Tylenol. It should be, use it sparingly and only use it after talking to the doctor,” she said in September.

But she praised removing the full recommendation for Covid vaccination among children. “I was always against vaccinating healthy young kids. I’m very happy to see at this point that they are removing it from the recommended vaccine schedule,” she said. She criticized the American Academy of Pediatrics for recommending vaccines after Kennedy slashed recommendations. When Kennedy was nominated for HHS, Saphier said he was “by far one of the best visionaries when it comes to the healthcare industry”.

Saphier has also been a vocal opponent to gender-affirming care. In an interview on her podcast with someone who detransitioned Saphier said that being transgender is a mental health issue constituting a “national emergency” and questioned whether being transgender is a “fad”. She has also opposed research on hormone blockers.

Separately, Saphier owns Drop Rx, an herbal tincture company. She praises the power of supplements like hers on social media, including how “rosemary and sage decrease Alzheimer’s risk” – claims that have not been evaluated by the US Food and Drug Administration, since the multibillion-dollar wellness industry is largely unregulated.

When cancer research was halted last year, Saphier said her colleagues were concerned, but she defended the cuts made by the “department of government efficiency” (Doge), the short-lived and expensive attempt headed by Elon Musk to cut government programs.

“I think Doge is probably one of the greatest things to happen in US history,” she said.