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Jerome Adams, President Trump’s first-term surgeon general, is becoming one of the most prominent voices speaking out against the public health policies and decisions carried out in the president’s second term. 

Adams, known as a relatively low-profile member of the Trump administration during his tenure, has in recent weeks gone on something of a media campaign against the White House’s health care choices. 

During the pandemic, Adams at times broke from Trump, such as when the president downplayed the death toll of SARS-CoV-2 or suggested injecting bleach to combat infections.  

But now that he’s on the outside looking in, the criticism is becoming more frequent.

Adams has made veiled criticisms against Trump’s latest surgeon general nominee, and he’s spoken out directly against Health Secretary Robert F. Kennedy Jr.’s decision to fire every member of a key vaccine advisory panel. 

The ex-surgeon general has focused his criticism on the lack of credentials of those being placed in top administration positions and what that might mean for public health. 

“While I typically try to focus on policies over personalities, it has become necessary to directly address the role of Robert F. Kennedy Jr. as the head of HHS,” Adams said when reached by The Hill. 

“His position means he is directly involved in shaping the policies that affect national and global public health, which is why my most recent Times op-ed and social media posts specifically mention him,” he added. “However, I remain focused on the broader implications of these policies rather than solely on RFKs motivations and actions as an individual.” 

The Adams criticism has been on a few different topics.

Casey Means 

Soon after Trump replaced Janette Nesheiwat with Casey Means as his surgeon general nominee, Adams took to social media to highlight how Means lacks the credentials of past surgeon generals.

Means co-founded Levels, a health technology company that focuses on tracking health information through devices, after leaving a five-year residency program in Oregon. Means then garnered a large following online by expounding on health information aligning with the Make America Healthy Again movement. 

She is also the sister of Calley Means, who works as an adviser to Kennedy in the Department of Health and Human Services. 

Opponents of Means’s nomination have highlighted her decision to not complete her residency program as well as her medical license having lapsed. Both Trump and Kennedy have backed Means, though Trump has acknowledged he does not know her well.

Adams has repeatedly argued for maintaining certain standards for the position. 

“The Surgeon General’s position as a trusted public health authority and physician makes full training and licensure a critical expectation in addition to an implicit legal requirement,” he wrote on the X after Means was nominated.

While initially careful not to mention Means by name, Adams has since made it clear that he does not support her nomination.

“I do not know and have nothing against Dr. Means – but I feel strongly that the person who is leading America’s Public Health Service should be held to the same standard as the people he or she is leading,” Adams said online.

In an op-ed published by Stat, Adams, a licensed anesthesiologist, noted the past four confirmed U.S. surgeon generals had extensive experience and training relevant to public health policy. Adams before his own confirmation obtained a master’s degree in public health and was the health commissioner for Indiana. 

“Given the critical nature of this role, it is imperative that the surgeon general possess the requisite qualifications and experience,” he wrote. “While the president has the prerogative to nominate individuals for public office, the Senate holds the responsibility to confirm these appointments.” 

Adams isn’t the only former surgeon general to oppose Means. One of his predecessors, Richard Carmona who served under former President George W. Bush, said in an op-ed for The Hill that confirming Means to the position would “undermine the office.” 

“We owe it to the American people — and to those who built the Public Health Service on a tradition of merit and mission — to demand the very best,” wrote Carmona. “Our health, our security and our future depend on it.” 

In the face of backlash, Kennedy has highlighted Means’s atypical background as an asset rather than a disadvantage.

“She walked away from traditional medicine because she was not curing patients,” Kennedy told Fox News anchor Brett Baier. “She couldn’t get anybody within her profession to look at the nutrition contributions to illness, and she said, ‘If we’re really going to heal people, if we’re healers, we can’t just be making our life about billing new procedures.’”

Derailed vaccine policy 

When Kennedy announced he was getting rid of the entire sitting Advisory Committee on Immunization Practices (ACIP) for the Centers for Disease Control and Prevention (CDC), Adams was quick to denounce the decision. 

In an op-ed for Time published the day after the firings, Adams specifically cited Kennedy’s pledge that, “We won’t take away anyone’s vaccines.”  

He cited the ACIP firings along with the Food and Drug Administration’s (FDA) new framework limiting access to COVID-19 vaccines and the Centers for Disease Control and Prevention (CDC) no longer recommending the shot for children and pregnant women.

“ACIP has been a trusted, science-driven body that ensures vaccines are safe and effective, saving countless lives through its transparent recommendations. Its members, rigorously vetted for expertise and conflicts of interest, provide independent guidance critical to public health. Removing them without clear evidence of misconduct risks replacing qualified scientists with less experienced voices,” he wrote. 

On social media, he shared concerns he’s received that “HHS officials may have committed perjury during confirmation hearings.” Though he didn’t name anyone specific, he did repost epidemiologist and health economist Eric Feigl-Ding who accused Kennedy of telling “lies, damn lies.” 

“We are witnessing what appears to be a coordinated effort to dismantle the United States’ vaccine infrastructure,” Adams told The Hill. “This trend, which began with changes at the FDA, is now extending to the CDC and encompasses issues beyond just COVID-19 vaccines.” 

“I have heard concerns from health and medical colleagues, Republican donors, and individuals on Capitol Hill regarding the direction we are headed, and am trying to help give voice to those concerns,” he added. 

Kennedy on Wednesday announced eight new picks to replace the 17 ACIP members he fired. Among them were some noted spreaders of COVID-19 misinformation. 

Adams has also expressed ethical concerns about Kennedy’s new rule requiring placebo-controlled trials for new vaccines. 

“If a vaccine for a serious disease (e.g., measles, polio) already exists and is proven effective, giving participants a placebo instead of the vaccine could expose them to preventable harm or death. This violates ethical principles like ‘do no harm’ outlined in documents such as the Declaration of Helsinki,” he wrote on X.