The Senate health committee on Wednesday questioned Dr. Nicole Saphier, President Donald Trump's third nominee for U.S. Surgeon General, as the country heads into respiratory virus season without a confirmed "nation's doctor." The post has been vacant since President Joe Biden left office in January 2025.
Committee Chairman Bill Cassidy, a Louisiana Republican and physician, opened the hearing by pointing to this year's measles deaths. "That is going to be a terrible legacy for this administration," Cassidy said, according to the Associated Press. He told Saphier and the other nominees that he hoped they would help restore public confidence in public health.
The vacancy matters to households because the Surgeon General's main job is speaking directly to Americans about health risks. That voice has been absent through a record measles year, and it remains absent as children return to school, COVID-19 activity climbs, and parents look for clear advice on fall vaccines.
An Empty Post During Overlapping Threats
The CDC's respiratory illness data show that COVID-19 activity was elevated and increasing nationally as of Sept. 11, although hospitalizations remain low. Rhinovirus, enterovirus, and group A strep infections are also rising, while flu and RSV activity remain low for now. Overall, the level of respiratory illness sending people to health care was still very low.
The CDC's measles tracker lists 3,294 confirmed cases this year as of Sept. 10, already more than the 2,289 recorded in all of 2025. Cases have appeared in 47 jurisdictions, from New York City to California.
Pennsylvania's outbreak has become the clearest example of the stakes. The state has reported four measles-associated deaths since late August, yet federal officials have not confirmed them in the national count. That kind of dispute over basic numbers is exactly what a surgeon general is expected to help explain to the public.
The surgeon general's office is not the only leadership gap. The CDC went without a confirmed director for about a year before Dr. Erica Schwartz was confirmed in August, and the White House formally nominated Heidi Overton to lead the FDA on Monday, according to STAT. Her nomination was not on this week's hearing schedule.
For families, those vacancies can mean slower, less consistent public messaging at the moment people most need it, as vaccine questions pile up ahead of flu season.
Saphier's Record and Senators' Concerns
Saphier is a radiologist, director of breast imaging at Memorial Sloan Kettering Monmouth in New Jersey, and a former Fox News contributor. According to the AP, she earned her medical degree at Ross University School of Medicine in Barbados and completed fellowships at the Mayo Clinic.
According to NPR, her vaccine views were expected to be a central issue. She has criticized COVID-19 booster requirements and questioned whether every child needs the hepatitis B vaccine at birth. She has also broken with administration figures at times. She told the AP last fall that Trump's warnings to pregnant women about Tylenol were oversimplistic and "patronizing," and she wrote that autism research must rest on rigorous science rather than controversy and conspiracy theories.
Her federal ethics filing lists holdings in health care, insurance, and processed food companies, including cigarette maker Philip Morris. She also owns DropRx, which sells unregulated herbal tinctures, including products containing kava, an ingredient that federal health agencies have linked to possible severe liver injury. The filing says she will resign from DropRx and its parent company and divest conflicting holdings if confirmed.
Saphier follows two unsuccessful picks. Trump withdrew Dr. Janette Nesheiwat after questions arose about her academic credentials, and Dr. Casey Means' nomination stalled after a contentious February hearing and never received a committee vote. The panel also heard from Chris Klomp, nominated for deputy HHS secretary, and Dr. Timothy Westlake, nominated to be assistant secretary for mental health and substance use. As of Wednesday, detailed accounts of Saphier's answers on specific vaccines were still emerging, and no committee vote had been scheduled.
Limits of the Job and Steps Families Can Take
The Surgeon General leads the U.S. Public Health Service Commissioned Corps and issues public health advisories, but the office has limited policymaking power. It cannot mandate vaccines, rewrite the CDC schedule, or approve medicines. Its influence comes from communication: steady messages during outbreaks, national reports, and warnings that doctors and schools often cite.
Without that voice, households rely more heavily on state and local health departments. Agencies such as the Pennsylvania Department of Health post outbreak updates and exposure alerts, and county and city health departments publish their own local guidance.
The people most affected by gaps in public guidance are those at highest risk from fall viruses and measles, including infants, older adults, pregnant people, people with chronic heart or lung disease, and unvaccinated children. Readers can check their state's respiratory activity on the CDC's data pages, confirm that children's MMR doses are current, and ask a clinician which fall COVID-19 and flu shots fit their age and health conditions.
Mild cold symptoms can usually be managed at home, but a child with a sore throat and fever may need a strep test. Trouble breathing, chest pain, confusion, dehydration, or a high fever with a spreading rash requires urgent care. People with a possible measles exposure should call ahead before visiting a clinic.
Cost can be a barrier. Many insurance plans cover recommended vaccines, but coverage can vary, so families should check with their plan before booking. The Vaccines for Children program supplies free shots to eligible children, and community health centers offer sliding-scale fees.
The HELP Committee must vote before the full Senate can act. The CDC updates its respiratory data on Fridays, and its measles counts weekly. MedicalDaily will report on the committee's decision and any new federal guidance as the season develops.
Key Questions Answered
Who is Dr. Nicole Saphier?
Saphier is a radiologist and director of breast imaging at Memorial Sloan Kettering Monmouth in New Jersey. She is a former Fox News contributor and President Trump's third nominee for surgeon general.
How long has the surgeon general post been vacant?
The U.S. has not had a surgeon general since President Biden left office in January 2025.
What can a surgeon general actually do?
The Surgeon General issues public health advisories and serves as the federal government's leading health communicator. The office cannot mandate vaccines, change the CDC schedule, or approve drugs.
What respiratory illnesses are rising right now?
As of Sept. 11, CDC data show COVID-19 activity elevated and increasing nationally, with rhinovirus, enterovirus, and group A strep also rising. Flu and RSV activity remain low.
Who is most at risk this fall?
Infants, older adults, pregnant people, people with chronic heart or lung disease, and unvaccinated children face the greatest risk of serious illness from respiratory viruses and measles.
When will senators vote on Saphier?
The HELP Committee had not scheduled a vote as of Wednesday. The full Senate can act only after the committee votes.
