Pressed by the physician who chairs the Senate health committee, President Donald Trump's third nominee for surgeon general said plainly that childhood immunizations do not cause autism. "I do not believe childhood vaccines cause autism," Dr. Nicole Saphier told the panel this week, according to CIDRAP's account of the hearing. Asked whether the measles, mumps, and rubella shot is lethal, as the president has claimed, she said she does not believe it is, and called MMR the greatest tool available for combating measles.
Those sentences reach ordinary households because parents are making routine immunization decisions against shifting federal signals. The clearest example came minutes later. Saphier called hepatitis B vaccines one of the most tangible ways to prevent cancer and said United States evidence shows universal birth-dose vaccination to be safe and effective, yet she declined to say the birth dose should be recommended, describing it as a nuanced conversation for parents and pediatricians.
The distance between praising a vaccine and recommending one is not academic. After Health Secretary Robert F. Kennedy Jr. replaced the members of the Advisory Committee on Immunization Practices, the reconstituted panel moved the universal hepatitis B birth dose from a recommendation to shared clinical decision-making. In a delivery room, that decides whether a shot is standard care or an option.
The Exchange That Defined the Hearing
Sen. Bill Cassidy, a Louisiana Republican and chair of the Senate Committee on Health, Education, Labor and Pensions, opened by pressing Saphier on vaccines. When she characterized the president's comments as an attempt to reach vaccine-hesitant parents, Cassidy pushed back, saying the way to dispel confusion is not to sow more confusion.
Saphier, a radiologist at Memorial Sloan Kettering Cancer Center and a former Fox News contributor, emphasized chronic disease prevention in her opening statement. Her nomination followed the withdrawal of Casey Means, whose own hearing was contentious, and the country has had no Surgeon General since 2025.
On the hepatitis B question, Cassidy pointed out that praising the evidence stops short of saying the dose should be recommended. Saphier said the universal birth dose has been the most effective policy in the United States for reducing infection and that she is open to future discussions.
Pennsylvania's Outbreak Raises the Stakes
The testimony landed against the worst measles outbreak Pennsylvania has recorded in more than three decades. The Pennsylvania Department of Health reported 731 confirmed cases across 38 counties, including 117 new cases in a single week, along with 141 hospitalizations and four measles-associated deaths this year. Two of the four were infants, and two were adults, and all four were unvaccinated.
Nationally, the CDC's measles tracker listed 3,294 confirmed cases as of September 10 across 47 jurisdictions, already more than the 2,289 recorded in all of 2025. The agency's page states that federal death records do not currently identify measles as an underlying cause for 2026 and that the CDC is developing a standardized definition with state epidemiologists. One state therefore reports four deaths while the national count stands at zero.
Confidence is slipping as well. A Reuters/Ipsos poll summarized by CIDRAP found 76 percent of respondents consider the MMR vaccine safe for children, down from 84 percent in 2020.
Parents Caught Between Two Federal Messages
MedicalDaily previously reported on the hearing and the long Surgeon General vacancy, noting that detailed accounts of her vaccine answers were still emerging. Those answers are now on the record, which shifts the question from who will fill the job to what the nation's top health communicator is willing to say.
The families most affected are deciding this month: parents of newborns weighing the hepatitis B birth dose, parents of toddlers due for MMR, and anyone in an outbreak county. Infants too young for a first MMR dose, pregnant people, and people with weakened immune systems face the highest risk of severe measles and depend on coverage around them.
Two MMR doses provide 97 percent lifetime protection. Parents unsure of their children's status should check records with a clinician or state registry, and anyone with fever and a spreading rash after a possible exposure should call ahead before visiting a clinic. Most recommended vaccines are covered by insurance, and the Vaccines for Children program supplies free doses for eligible children.
Next Steps for the Nomination and the Counting Fight
The committee must vote before the full Senate can act, and no vote had been scheduled when the hearing closed.
Chris Klomp, the nominee for deputy health secretary, fielded questions from the same panel and said a clear definition of measles-associated deaths is needed, along with a commitment to publish the data transparently. Cassidy told him that if people are dying from measles, the public should know.
Two questions remain unresolved: whether federal and state officials will agree on how measles deaths are counted, and whether the hepatitis B birth dose returns to a formal recommendation. For now, families near an outbreak should follow county alerts and confirm MMR doses with a clinician.
Key Questions Answered
What exactly did the nominee say about vaccines and autism? She told the Senate health committee that she does not believe childhood vaccines cause autism, and that she does not believe the MMR vaccine is lethal.
Did she recommend the hepatitis B vaccine at birth? Not in those terms. She praised hepatitis B vaccines as a cancer-prevention tool and said U.S. evidence supports the universal birth dose as safe and effective, but called the decision nuanced.
How large is the Pennsylvania outbreak? The state reported 731 confirmed cases in 38 counties, 141 hospitalizations and four measles-associated deaths in 2026. All four people who died were unvaccinated.
Why does the CDC show no measles deaths this year? The agency says federal death records do not currently list measles as an underlying cause for 2026, and that a standardized definition is being developed with state epidemiologists.
Who faces the greatest risk? Infants too young for a first MMR dose, unvaccinated children and adults, pregnant people, and people with weakened immune systems.
