Trump makes unmoored claims on Tylenol and autism

What happened

President Donald Trump yesterday used a press conference on autism to offer pregnant women unfounded and in some cases discredited medical advice on Tylenol and vaccinations. Health officials at the briefing said the Food and Drug Administration would approve leucovorin, a form of vitamin B currently approved to treat chemotherapy side effects, as a treatment for some children with “autistic symptoms,” and announced a new push to research environmental factors behind the complex brain disorder.

Who said what

“Don’t take Tylenol,” Trump advised pregnant women. “Fight like hell not to take it” unless they “can’t tough it out” or have an extremely high fever. The FDA was “far more measured” in a note to physicians yesterday, noting “accurately” that no “causal relationship” has been established between autism and acetaminophen use during pregnancy, The New York Times said, and that the matter is “an ongoing area of scientific debate.”

Trump, who “struggled to pronounce ‘acetaminophen’” in his warnings, “defied the careful guidance offered by some in the row of scientific advisers who stood behind him,” The Wall Street Journal said. The “tableau was reminiscent of the last time Trump played the role of physician-in-chief,” during the Covid-19 pandemic, except this time his “advisers nodded or kept their faces straight” instead of “openly” rolling their eyes.    

Some studies have “raised the possibility” of a link between prenatal Tylenol and autism, said The Associated Press, “but many others haven’t found that concern.” Acetaminophen is the “only over-the-counter drug approved to treat pain relief and fevers during pregnancy,” Politico said, and maternal medical organizations agree that the serious risk to mother and fetus from untreated fevers is worse than any theoretical risk from Tylenol. Trump’s remarks were the “saddest display of a lack of evidence, rumors, recycling old myths, lousy advice, outright lies and dangerous advice I have ever witnessed by anyone in authority,” New York University bioethicist Art Caplan said to the AP.

What next?

The FDA said it would approve leucovorin for the subset of autistic children with “cerebral folate deficiency,” based on the findings of small-scale studies, and order acetaminophen makers to change their label to “reflect evidence suggesting” use during pregnancy “may be associated with an increased risk of neurological conditions such as autism and ADHD in children.”

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