Casey Means, a former surgeon turned wellness influencer, is also under consideration to serve as surgeon general — or as HHS assistant secretary for health. Means’ brother Calley, meanwhile, has been widely discussed as Kennedy’s likely chief of staff.

Neither of the Meanses have any experience in government, though Calley Means is a former food industry lobbyist. The two are close advisers to Kennedy and his Make America Healthy Again movement aimed at radically remaking health and food policy.

Trump advisers are also considering two physicians who gained prominence for their vocal criticism of the government’s pandemic response for top jobs, the people briefed on the discussions said. Johns Hopkins surgeon Marty Makary is the team’s primary target for FDA commissioner, while Stanford University physician and economist Jay Bhattacharya has emerged as a leading candidate to head the National Institutes of Health. Makary has called for overhauling the FDA’s leadership and culture, and praised Kennedy’s focus on challenging long-held food and health care standards that he blames for contributing to chronic disease. Bhattacharya has similarly advocated for major shakeups of the health department and argued that top NIH officials hold too much influence within the agency.

Vinay Prasad, a health researcher who’s risen in conservative health circles due to his opposition to key parts of the pandemic response, has also been discussed as a potential surgeon general.

The Washington Post first reported Bhattacharya’s status as a top choice for NIH.

Not all of those under consideration are newcomers to the Trump orbit: Paul Mango, who was HHS deputy chief of staff during Trump’s first term, is being eyed for head of the department’s massive Medicare and Medicaid agency, the people briefed on the discussions said, though no final decisions have been made.

Some Trump allies argued he would bring needed policy heft and government experience to an otherwise untested senior team. Mango has also been floated during some of the transition’s conversations as a potential HHS deputy secretary.

The short list for each top role came out of a series of discussions at Mar-a-Lago over the weekend and early this week, following Trump’s decision to nominate Kennedy to run HHS. Those conversations have included a rotating mix of Trump advisers and close Kennedy allies — including, at times, Kennedy himself.

The people briefed on the discussions cautioned that the list is not final and could still change. Trump could also make a decision to fill any of the open positions at any moment, they acknowledged, including picking someone that his team hasn’t even considered.

After former Rep. Matt Gaetz (R-Fla.) was picked by Trump to lead the Department of Justice last week, the health team revisited their lists of health candidates “to make sure they are interesting to Trump,” said a person familiar with the transition effort granted anonymity to discuss the process candidly.

The Trump transition did not respond to a request for comment.

The group currently under consideration offers a window into how Trump may fill out one of his largest and most consequential federal agencies, with the search focusing largely on loyalists best known for airing contrarian views and antagonizing the mainstream public health establishment.

The possibility that figures like Ladapo and Bhattacharya may end up atop health agencies they’ve spent years maligning has deeply troubled public health experts. Even some Republicans in Trump’s orbit privately question whether they’ll be able to advance any of the administration’s priorities — much less get confirmed by the Senate.

It also highlights the growing influence over health care that Trump has granted to Kennedy, who Trump said on the campaign trail he would give broad leeway to shape his administration’s priorities on health and food issues.

Ladapo — a vaccine skeptic who has frequently alarmed public health organizations by pushing debunked claims and casting doubt on the safety of vaccines from his perch as Florida surgeon general — has consulted closely with Kennedy over the last several weeks as he’s mapped out his agenda. The Means siblings are also firmly entrenched in Kennedy’s MAHA orbit, advocating for major overhauls of the nation’s food and health systems while trafficking at times in vaccine skepticism and other disputed medical theories.

Aaron Siri, the managing partner of a law firm closely tied to the anti-vaccine movement, is also in the mix as a potential pick for HHS general counsel. Siri and his firm played a central role in challenging vaccine mandates at various schools and workplaces during the pandemic.

In addition to Kennedy allies, the Trump transition has discussed bringing back a pair of first-term Trump officials, though it remains unclear whether they would be willing to return for a second tour.

Joe Grogan, a former drug industry lobbyist who was Trump’s top domestic policy adviser, was on the transition’s short list for HHS deputy secretary.

Former CDC Director Robert Redfield is also well-liked by transition officials who believe he could either return to run the agency again or slot in as Kennedy’s assistant secretary for health.

Redfield, who along with Mango worked on the Operation Warp Speed project that successfully developed the Covid vaccines during Trump’s first term, has publicly defended Kennedy’s nomination to HHS amid criticism of his anti-vaccine views. Kennedy previously called the Covid vaccine the “deadliest vaccine ever made,” and has promoted false theories that vaccines are linked to autism.

“Kennedy is not anti-vaccine,” Redfield said on NewsNation on Sunday. “What Kennedy is about is transparency about vaccines, honest discussion about vaccines, asking for the data to show that these vaccines are safe and they’re efficacious.”