NEW YORK — Casey Means' nomination to be U.S. Surgeon General has stalled in the Senate Health, Education, Labor and Pensions Committee. Her confirmation hearing was held a month before the nomination stalled, during which senators questioned her on vaccines and other health topics.

To advance to a full Senate vote, Means likely needs the support of every Republican on the committee. Sens. Lisa Murkowski of Alaska and Susan Collins of Maine said they still had questions for Means after the confirmation hearing, with Murkowski saying she remained hesitant about the nomination.

Republican Sen. Thom Tillis of North Carolina said he is leaning against voting for Means. Tillis said he was leaning against voting for her because her resume put him on alert and she did not do herself any favors in the hearing.

The White House and Make America Healthy Again activists have made ongoing efforts to advance Means' nomination. White House spokesman Kush Desai said the Trump administration has held conversations with the Senate to advance her nomination. MAHA activists orchestrated a push to support Means by surging phone calls to Sens. Lisa Murkowski and Susan Collins.

Means' nomination was submitted almost a year ago. Her confirmation process has taken nearly 300 days since her nomination in May. A reason for the drawn-out nomination is the birth of her son last October on the day of her originally scheduled confirmation hearing, leading to her confirmation hearing being postponed in 2025.

During the confirmation hearing, Sen. Bill Cassidy, a physician from Louisiana, questioned Means about vaccines. Sen. Lisa Murkowski and Sen. Bill Cassidy pressed her about her past doubts regarding the birth dose of the hepatitis B vaccine.

Means said the hepatitis B vaccine is important and lifesaving and that parents should make their own decisions with their doctors. Sen. Bill Cassidy asked her whether she would advise Americans to vaccinate against the flu and measles during outbreaks. She did not commit to advising Americans to vaccinate against the flu and measles and instead emphasized the importance of informed consent.

Sen. Susan Collins asked Means about her past advocacy for the therapeutic use of psychedelic mushrooms. She said she would not recommend psychedelics for the American public.

Means said during her confirmation hearing that she had voluntarily made her Oregon medical license inactive. Adm. Brian Christine testified that she was eligible to serve in the Public Health Service Commissioned Corps. The Surgeon General is required to be part of the U.S. Public Health Service Commissioned Corps.