At a press conference today, President Donald Trump dispensed one clear piece of medical advice to American parents in a rambling, repetitive monologue: Don’t. Take. Tylenol. He told pregnant women that they could help keep their children safe from autism by not taking the drug whenever they could avoid it (“fight like hell,” he instructed). He advised parents not to give Tylenol to their young children. He denounced giving the hepatitis B vaccine to infants and suggested that parents space out their children’s immunization schedule. (“They pump so much stuff into those beautiful little babies, it’s a disgrace,” he said.) He declared that children ideally should be given the measles, mumps, and rubella vaccines separately, though such individual shots are not available in the United States. “This is based on what I feel,” the president said.
Trump had been hinting at his big announcement for weeks, and it was evident that he wasn’t interested in making sure the contents had passed through the normal research process. “I don’t want to wait any longer. We don’t need anything more. And if it’s wrong—it’s not going to be wrong, but—if it is wrong, it’s fine. We have to do it,” Trump told the audience at a dinner for the American Cornerstone Institute on Saturday. Today, instead of opting for measured guidance, or urging additional research, Trump borrowed a strategy from his health secretary, Robert F. Kennedy Jr.: pushing ahead with a sensational conclusion based on a handful of disputed studies.
Researchers have been studying possible causes of autism for decades, and they generally dismiss singling out one culprit like a drug or a vaccine ingredient. (Instead, the consensus is that genetics play a large role, along with an array of environmental factors.) Some studies have found a possible association between acetaminophen and neurodevelopmental disorders. In 2015, the FDA issued a notice about a possible link between prenatal Tylenol use and ADHD, though it also mentioned that the cited studies had design flaws. Last month, Andrea Baccarelli, the dean of Harvard’s school of public health, published a review of other studies in which he and his co-authors concluded that acetaminophen use during pregnancy is associated with neurodevelopmental disorders, including autism, and that pregnant women should be advised to limit their use of the drug. (Baccarelli was invited to appear at today’s announcement but did not attend, a Harvard spokesperson told me. In a statement sent to reporters shortly before the White House announcement, he wrote that his August review suggests the “possibility of a causal relationship” between Tylenol and autism, but also noted that acetaminophen is “an important tool for pregnant patients and their physicians.”)
Two recent large studies, meanwhile, challenge any connection at all. A Swedish study, published last year, analyzed the health records of more than 2 million children and found that acetaminophen use was not associated with autism. A study of more than 200,000 Japanese children, published earlier this month, likewise didn’t find any meaningful association. That paper suggested that links in other studies could be explained, at least in part, by “misclassification and other biases.” A spokesperson for Kenvue, the company that makes Tylenol, told me in an email, “We believe independent, sound science clearly shows that taking acetaminophen does not cause autism. We strongly disagree with any suggestion otherwise and are deeply concerned about the health risks and confusion this poses for expecting mothers and parents.”
None of that nuance was aired during the announcement. Instead Trump professed to feel “very certain” about the Tylenol theory, and repeatedly warned Americans off the drug. This is not how science—or public health—normally works. The president of the United States doesn’t tease that he’s figured out the cause of a disorder before the research has been done to support that conclusion. Nor does he warn the American people against a common medication or the childhood-vaccine schedule without detailed evidence of his reasoning, or the full support of his staff. “It may be stronger from me than from the group,” he said in his speech, referring to Kennedy, FDA Commissioner Marty Makary, NIH Director Jay Bhattacharya, and Mehmet Oz, his head of Medicare and Medicaid. “They are waiting for certain studies. I don’t—I just want to say it like it is.” (Trump’s spokesperson, Kush Desai, wrote in an email that “the Trump Administration does not believe popping more pills is always the answer for better health” and that “there is mounting evidence finding a connection between acetaminophen use during pregnancy and autism.” The Department of Health and Human Services did not respond to a request for comment.)
Trump also went further than his deputies in calling out even fringier theories of autism. Of all the speakers at the White House today, Trump was the most explicit in blaming vaccines for poor health outcomes—a notion that has been repeatedly debunked—and he did so at length, at one point going on an extended tangent about a worker at Trump Tower whose son was supposedly “fried” by a fever following a childhood immunization. As I reported earlier this month, Kennedy has been in regular contact with a former Duke University researcher, William Parker, who believes that Tylenol given to young children is mostly responsible for autism. (Parker’s theory is such an outlier that none of the autism researchers I spoke with had heard of it, or him.) Today, Kennedy, Bhattacharya, Makary, and Oz didn’t bring up Parker’s theory, though Trump seemed to endorse it. “Don’t have your baby take Tylenol,” Trump said.
Ever since Trump announced that his administration would find the cause of autism within months, researchers have feared that the team would jump to unsupported conclusions. But Trump hardly seems to care if he’s wrong. Besides, he repeatedly insisted, eschewing Tylenol during pregnancy has “no downside.” (Tylenol is considered the safest fever reducer available for pregnant women.)
During today’s announcement, Kennedy at least acknowledged the trade-offs inherent in scaring pregnant Americans off Tylenol, and allowed that, sometimes, using it is unavoidable. “The FDA also recognizes that acetaminophen is often the only tool for fevers and pain in pregnancy, as other alternatives have well-documented adverse effects,” Kennedy noted in his remarks. “HHS wants therefore to encourage clinicians to exercise their best judgment in the use of acetaminophen for fevers and pain in pregnancy by prescribing the lowest effective dose and shortest necessary duration, and only when treatment is required.” (Today, the FDA posted an even more measured notice to physicians, signed by Makary, that underscored a possible association between acetaminophen and autism is “an ongoing area of scientific debate.”) Trump, meanwhile, repeatedly instructed pregnant women to “tough it out.” Sowing doubts regarding vaccines, going all in on fringe theories, and opting for extreme positions instead of embracing nuance: At MAHA’s big reveal, Trump seemed determined to steal Kennedy’s spotlight.
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