Trump, Tylenol and Autism

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Speaker 9 From the New York Times, I'm Michael Bolvarro. This is the daily.

Speaker 9 During an extraordinary televised news conference on Monday night, President Trump repeatedly gave out unproven medical advice that linked autism to Tylenol and childhood vaccines.

Speaker 9 Today, my colleague Azine Ghuraji on what exactly Trump claimed, what decades of scientific research actually tells us, and the confusion that the president has now created.

Speaker 9 It's Tuesday, September 23rd.

Speaker 2 Azine, thank you for making time for us. After a very long day, we're reaching you at 9 p.m.

Speaker 10 I'm happy to be here. Thanks for having me.

Speaker 2 I think it's hard to overstate just how unusual

Speaker 2 and at times literally jaw-dropping this news conference that we're going to be talking about today was to watch. And I watched it alongside you.

Speaker 10 Yeah, I mean, I want to say that I've never seen anything like it. The president was acting like he was a doctor, but much of what he was saying was totally untethered from what we know from medicine.

Speaker 10 And it was potentially dangerous, according to a lot of the doctors who watched it. So it was truly remarkable.

Speaker 2 Well, I wonder if you can start by just describing the context for

Speaker 2 this news conference.

Speaker 10 So I think for me, this goes back to April when the CDC announced its latest data on the prevalence of autism among kids in the United States.

Speaker 10 And they found basically that the numbers had continued a really long-running trend of increasing. That now one in 31 kids in the United States have an autism diagnosis.

Speaker 10 And that number is five times higher than what the CDC found when it first started collecting this data in just 2000.

Speaker 10 So this is obviously news that is concerning, especially to our new health secretary, RFK Jr., who has spent much of his career focused on autism and even connecting autism repeatedly over his career to vaccines.

Speaker 10 And months into his tenure, he holds this big press conference where he says that autism is an epidemic and it is entirely preventable.

Speaker 10 And it is his job now as the health secretary of the United States to find out what is causing it to increase.

Speaker 10 And he promises that he will come to the American public with answers to that question by September.

Speaker 2 Somewhat arbitrarily, by September.

Speaker 10 Yeah, which everyone who has been studying autism for decades was incredibly skeptical of this and pretty worried because this has been a question that people have been studying their entire careers.

Speaker 10 And the idea that he could whip something together in five months was a little concerning.

Speaker 2 Right.

Speaker 2 But here we were on Monday, as promised, by the end of September, and we get a news conference and Kennedy is there, but right away it's pretty clear that President Trump is going to be dominating this news conference.

Speaker 10 Yes.

Speaker 11 Thank you very much.

Speaker 11 So I've been waiting for this meeting for 20 years, actually.

Speaker 10 President Trump is the first speaker at the conference. He kind of kicks things off and he immediately starts riffing pretty wildly.

Speaker 11 I always had very strong feelings about autism and how it happened.

Speaker 2 Right. And I just want to flag, at several key moments in Trump's speech here, he says things that are not grounded in science.
In fact, that science contradicts.

Speaker 2 And so we're going to fact-check what he said in a lot of detail

Speaker 2 after we talk about what it is he said.

Speaker 10 Yeah.

Speaker 10 So

Speaker 10 he starts off the press conference.

Speaker 11 Meteoric rise in autism is among the most alarming

Speaker 10 He says that, you know, this is a horrible, horrible crisis. And pretty quickly, he gets to what he thinks is behind this rise.

Speaker 11 Effective immediately, the FDA will be notifying physicians that the use of

Speaker 11 acid,

Speaker 11 well, let's see how we say that.

Speaker 11 Acetiminophen, acetaminophen.

Speaker 11 Is that okay?

Speaker 10 Which is acetaminophen,

Speaker 10 the active ingredient in the very common household painkiller, Tylenol.

Speaker 11 So taking Tylenol

Speaker 11 is

Speaker 11 not good.

Speaker 11 All right, I'll say it. It's not good.

Speaker 10 And he starts to establish what he says is a clear link between Tylenol and its use in pregnancy and autism in children. And he says repeatedly that.

Speaker 11 But with Tylenol, don't take it. Don't take it.

Speaker 10 Pregnant women should not take this drug.

Speaker 11 Don't take Tylenol.

Speaker 10 He says, you know, don't take it.

Speaker 11 Fight like hell not to take it. Tough it out.
There may be a point where you have to, and that you'll

Speaker 11 have to work out with yourself. So don't take Tylenol.

Speaker 10 Other things. He's really giving explicit,

Speaker 10 very black and white warnings to pregnant women to stay away from the only painkiller

Speaker 10 really recommended for use in pregnancy.

Speaker 11 That's the way I feel. I've been very strong on the subject for a long time.
You know, life is common sense to.

Speaker 10 And he's also saying

Speaker 10 I'm not a doctor.

Speaker 11 And there's a lot of common sense in this.

Speaker 10 This is how I feel.

Speaker 10 The people behind me, RFK, Marty McCarry, might disagree with this because they're waiting for the studies.

Speaker 11 But I'd like to be a little bit more, a little speedier. in the process of a recommendation because there's no harm in the But he's saying, listen to me, I'm the president.

Speaker 11 here's my medical advice to you and it's so important to me to take see the doctor four times or five times for a vaccine

Speaker 11 and then he starts talking about vaccines too just break it up break it up because it's too much liquid too many different

Speaker 10 he says that you know the the childhood immunization schedule is loading up kids with too many vaccines it's like 80 different vaccines and beyond vaccines and 80.

Speaker 10 Too many different things going into babies at too big a number.

Speaker 11 So let those be taken separately. And then hepatitis B is sexually transmitted.

Speaker 10 He talks about the hepatitis B vaccine.

Speaker 11 There's no reason to give a baby that's almost just born hepatitis B.

Speaker 10 You know, and says that it shouldn't be given to children until they are 12. He goes on and on.

Speaker 11 And by the way, I think I can say that there are certain groups of people that don't take vaccines and don't take any pills that have no autism.

Speaker 10 And he even says that people who don't get vaccinated don't get autism.

Speaker 2 Right. And he suggests that, for example, the Amish

Speaker 2 don't get vaccines and therefore don't get autism, which I went and fact-checked myself. I know we're going to fact-check after we get to these remarks.
And neither of those statements

Speaker 11 is true. But I'm not so careful.
Yeah.

Speaker 10 They are not true.

Speaker 11 And do all those other things, little things, just spread out your visits, et cetera, et cetera, on the vaccine. And I want to thank everybody.
This is a very important day. Thank you very much.

Speaker 2 AIDS who run the National Institutes of Health and the FDA,

Speaker 2 they give speeches of their own, much shorter, far more restrained than Trump.

Speaker 2 But ultimately, they all cast some level of doubt on the practice of taking Tylenol during pregnancy and reaffirm the idea that it's risky, maybe linked to autism.

Speaker 2 So let's zoom out and talk about what we really know to be true and based on science.

Speaker 2 And we're going to cover all of what Trump said, but let's start with the question of Tylenol, pregnant women, and autism.

Speaker 10 Yeah. So first off, No study has shown that Tylenol use in pregnancy causes autism in children.
I want to be very clear about that.

Speaker 10 What we have seen are some studies that have shown a positive association between Tylenol and childhood autism.

Speaker 2 And just explain the distinction between a positive association and a cause.

Speaker 10 Yeah, so it's a correlation. We can't conduct randomized controlled trials on pregnant women.
It is widely held. to be unethical to do something like that.

Speaker 10 So what researchers have to do is look at data on pregnant women, the choices that they make during their pregnancies, the experiences that they have, and look at the outcomes in their children.

Speaker 10 These are called observational studies.

Speaker 10 And the problem with the observational studies is that there can be lots of other things going on that might be underlying the relationships that we end up seeing in the results.

Speaker 10 In fact, I had a really interesting conversation with an epidemiologist who was the lead author on a study that RFK actually cited multiple times in this press conference because he did find a positive correlation between Tylenol use in pregnancy and autism.

Speaker 10 And he actually warned very explicitly against drawing any sort of causal conclusions here.

Speaker 10 He brought up the example of rising ice cream sales and rising violent crime in the summertime.

Speaker 10 And he said that, you know, it would be a mistake to assume that ice cream sales are causing violent crime, that actually the thing that's causing both of those things is the heat.

Speaker 10 So it would be a mistake to assume that Tylenol use during pregnancy is actually causing autism when there might be other underlying things at play, like what underlying health issues does the mother have?

Speaker 10 What are her genetics? Why is she actually taking Tylenol repeatedly over the course of her pregnancy? Is it to treat multiple fevers?

Speaker 10 These are the sort of questions that researchers need to be asking to actually tease apart cause and effect in these studies.

Speaker 2 In other words, in that metaphor of ice cream sales and violence going up in the summer, Tylenol's relationship to rising autism could be akin to either the ice cream sales or the violence going up.

Speaker 2 It may not be the real underlying cause. It may not be the heat.

Speaker 10 Right, exactly. And we know that autism, ADHD, other neurodevelopmental disorders have a big genetic component.

Speaker 10 So there have been some researchers who have attempted to account for that in these observational studies and actually do what's called a sibling matched control.

Speaker 10 So, they compare siblings born from the same mother. And when they do that, they see that the relationship, that the correlation between Tylenol use and autism actually goes away.

Speaker 10 So, that suggests that, you know, the genetics might be the heat in this scenario.

Speaker 2 But, just to be very clear, when President Trump says to America and to America's pregnant women, do not take Tylenol.

Speaker 2 That does not, based on your reporting, based on all the research that you have just described, seem at all grounded in the current science.

Speaker 10 No, that's not.

Speaker 2 I think something else the president raised was this question of, well, what's the downside of not taking Tylenol?

Speaker 2 He asked that a few times during this press conference, and he seemed to say there's no downside of pregnant women avoiding Tylenol. What does the research say about that?

Speaker 10 Yeah, I mean, he actually says, you know, to tough it out, but the research on this is very clear. You know, fevers in pregnancy come at great risk to both the mother and the fetus.

Speaker 10 In fact, during the news conference, the American College of Obstetricians and Gynecologists issued a statement stressing that the organization considers acetaminophen safe.

Speaker 10 And they said that the conditions people use acetaminophen to treat during pregnancy are far more dangerous than any theoretical risks and can create severe morbidity and mortality for the pregnant person and the fetus.

Speaker 10 You know, every doctor I spoke with, every medical group that was responding to this issue today has made clear fevers are not things that should be left untreated during a pregnancy.

Speaker 10 So in this case, do not listen to the president.

Speaker 2 I also, Azine, want to fact-check the president's claims about vaccines.

Speaker 2 It's been firmly established, and we've talked about it a lot on the show show and throughout Times Journalism, that there's no documented link between childhood vaccines and autism.

Speaker 2 But Trump insisted on suggesting that there was. He specifically targeted, as you mentioned earlier, the hepatitis B vaccines and the MMR vaccines.

Speaker 2 Both are extremely common vaccines given to newborns.

Speaker 10 Yeah. So there has been no data connecting the MMR vaccine, the vaccine against measles, mumps, and rubella, or connecting the hepatitis B vaccine to autism in children.

Speaker 10 And, you know, we have three decades of studies that have shown this. And yet today we heard the president of the United States casting doubt on vaccines yet again.

Speaker 2 Right.

Speaker 2 I mean, I think given everything you just walked through, the number of times that the president issued forceful and specific medical advice that contradicts what medical groups have said, what existing scientific research says, in some cases, the outright misinformation he put forward.

Speaker 2 What should our understanding be of why

Speaker 2 he would do this?

Speaker 10 I think this question feeds into a lot of pet narratives that Trump is focused on all the time.

Speaker 10 You know, his anti-establishment thinking, you know, the experts knew this and they were hiding this from you, that, you know, the pharmaceutical companies have actually been profiting off of your family's pain.

Speaker 10 And I'm going to be the one to be the truth teller in this situation.

Speaker 10 I think what's really important is to look at what Trump and his health advisors on that stage today actually didn't say, which is what we do know about the causes behind the rise in autism.

Speaker 10 And those answers don't feed the sort of anti-establishment narrative that Trump is seizing on here.

Speaker 10 Those answers have a lot more to do with how autism has been defined and diagnosed over the last several decades.

Speaker 2 We'll be right back.

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Speaker 1 You can't count on much these days.

Speaker 2 No way, Jim. This is incredible.

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Speaker 2 So Azine, right before the break, you mentioned that a big, well-understood cause of autism's rise is how it's been diagnosed.

Speaker 2 So just explain that and why that was not something mentioned in Monday's news conference.

Speaker 10 Yeah, so over the last several decades, what we actually consider to be autism

Speaker 10 has broadened a lot.

Speaker 10 Autism used to only refer to young children who had really severe impairments, people with severe language delays or, you know, who couldn't speak or who often had intellectual disabilities and couldn't live or function really independently.

Speaker 10 But over time, we have broadened the diagnosis of autism to include people with much less severe impairments.

Speaker 10 And we folded other diagnoses, including something called Asperger's, under one umbrella that we now refer to as autism spectrum disorder.

Speaker 10 So it's a spectrum from on the one end, people who really have these profound disabilities to on the other end, people who maybe have some social and communication challenges, but might be even highly intelligent.

Speaker 10 You know, Elon Musk is always brought up as an example of someone who has spoken about having an Asperger's diagnosis.

Speaker 2 And just how much is this broader diagnosis, this bigger spectrum of autism seen as accounting for the growth in autism in the U.S., this meteoric rise, as Trump puts it?

Speaker 10 It is a lot of the rise, but it is not the whole thing.

Speaker 10 The CDC has actually published data showing that while the number of diagnoses of kids with profound autism, so those are the kids with the most severe impairments, that those diagnoses have increased a little bit over the last couple decades, the increase in diagnosis among kids who are quote-unquote higher functioning is actually increasing a lot more quickly.

Speaker 10 So that seems to be very clearly a big driver in the increased diagnoses that we're seeing in this country.

Speaker 10 However, every researcher I've spoken to has said that that is not the only thing that is going on here. We've identified now hundreds of genes that are associated with autism.

Speaker 10 We know that those genes interact with each other. We also know that they interact in some way with the environment.

Speaker 10 And in terms of what environmental factors could be doing that, we have some evidence of things that are definitely playing a role. Air pollution is one.

Speaker 10 We know certain toxic chemicals interact with genes and contribute to a rise in autism.

Speaker 10 A very clear other factor is people having children later in life, which we know is happening more and more as people delay having kids.

Speaker 10 So all of those things are linked, but there's still a lot we don't know.

Speaker 10 And scientists are always going to be the first to say that it's very, very possible that there are other risks out there in the environment that we don't know about yet.

Speaker 2 But if we do know that this expanded diagnosis of autism is a pretty big factor in the rise in autism, I know you mentioned other potential factors, but this one seems kind of indisputable.

Speaker 2 Why wouldn't the health secretary or the president focus on that in this news conference?

Speaker 10 Yeah, I mean, RFK has actually been pretty dismissive of the role of diagnosis in increasing incidence of autism in the U.S. before.

Speaker 10 I I mean, we talked about this earlier, but it is not an answer that has a shadowy pharmaceutical company behind it. It is not an answer that has, you know, experts concealing things from the public.

Speaker 10 It's a lot more boring and procedural, frankly.

Speaker 2 What I hear you basically saying is that people like President Trump, people like R.K.

Speaker 2 Jr., prefer the silver bullet theory, the somebody did you wrong theory, and a broader diagnosis by the medical community of autism over the past 25 years doesn't fit into that.

Speaker 2 I want to return now to Monday's news conference and what happens next.

Speaker 2 Now that the president is putting so much weight on Tylenol, despite any evidence of causality when it comes to autism,

Speaker 2 the president and those around him started to outline a series of actions that would seem to flow from that alleged link. And so I want you to walk us through what comes now.

Speaker 10 So coming out of today's press conference, they announced four actions that they were going to take to address autism in the United States.

Speaker 10 The first thing that they do is RFK says that the FDA is going to be initiating the process to put a new label on acetaminophen.

Speaker 10 So presumably this will be something like a warning label on Tylenol to warn patients that there is this possibility of a link. The FDA also sent a letter to doctors across the U.S.

Speaker 10 today about the possible link between acetaminophen use during pregnancy and autism. Really, interestingly, they were far more measured in this letter than the president's remarks.

Speaker 10 The letter says really explicitly that a causal relationship has not been established. And they say that the matter is an ongoing area of scientific debate.

Speaker 10 But nevertheless, they still urge doctors to warn patients that there is the possibility of this link and that they shouldn't take Tylenol except in the case of high fevers.

Speaker 2 Right. Very different than the president saying do not take Tylenol when you're pregnant.

Speaker 10 Yes, very different. And then the third thing that they did was that the FDA announced that it was going to be approving a new treatment for autism.
It is this drug called Leucovorin.

Speaker 10 It is a B vitamin-based drug. And it has shown in very small studies.

Speaker 10 So we're talking about, you know, just dozens of participants in each, that it could have some positive benefits for children with autism. So improving communication, things like that.

Speaker 10 But this is very unusual for them to be pushing through an approval like this, you know, with so little data to back it.

Speaker 2 And what do you make of that? That this drug has only been tested in dozens of people, and yet now the government wants to approve it for use as a treatment for autism and is talking about it.

Speaker 2 and endorsing it on such a giant platform.

Speaker 10 Yeah, I mean, I think it is absolutely projecting to people that this is possibly going to lead to a cure.

Speaker 10 And the scientists who are actually researching Lucovorin as a possible treatment, they are the first to say, like, our findings are really early days.

Speaker 10 You know, they are promising, but this is not something that should be at the level of the federal government. pushing through a drug approval at the FDA.

Speaker 10 And the last thing is that they announced that they had determined the recipients of, you know, $50 million

Speaker 10 of new federal grants that would be used to study the causes of autism. And again, it's this mixed bag.
There are absolutely legitimate researchers who have received this funding.

Speaker 10 We're going to be looking into the genetics and the interplay with the environment. But RFK also made clear that they're also going to be looking again,

Speaker 10 despite the many, many studies that have failed to show a link, at the possibility that vaccines play a role in development of autism.

Speaker 2 I mean, how should we think about what happened on Monday? On the one hand, the White House is giving people with autism something.

Speaker 2 They're elevating autism in a way perhaps no administration has ever done before.

Speaker 2 But the way, especially Trump did that, seems to absolutely test and in a few cases, absolutely exceed the bounds of what we think of as responsible public health.

Speaker 2 And just to put a point on that, our colleague, Christina Jewett, got an email from the head of medical ethics at NYU's Medical School, pretty prestigious medical school here in New York.

Speaker 2 And after watching this news conference, this is what he wrote to her: quote, the announcement on autism was the saddest display of a lack of evidence, rumors, recycling old myths, outright lies, and dangerous advice I have ever witnessed by anyone in authority in the world claiming to know anything

Speaker 2 about science.

Speaker 2 So how should we think about that

Speaker 2 stacked up against what may be

Speaker 2 what the Trump administration thinks is providing an answer to families with autism?

Speaker 10 I mean, I have spoken to many autistic people, many families of autistic people in the process of doing this reporting. And the autistic community is not a monolith.

Speaker 10 There are people who are viewing what what RFK is doing and from beginning to end see it as harmful.

Speaker 10 But then I've spoken with the parents of kids with the most severe impairments and they have really made clear that they're so torn about RFK and this moment for autism in this country. They

Speaker 10 absolutely appreciate that he is spotlighting autism, that he's throwing research money to find out the causes, that he is talking about their experience.

Speaker 10 But they really, really struggle with and are really worried about the fact that that comes with recycling these theories about autism that have been just proven to be false.

Speaker 10 That it comes with a lot more fear-mongering directed towards pregnant women.

Speaker 10 So that, you know, if they do have a child with autism, that they somehow think that it was something they did during pregnancy, that it was their fault, that, you know, they didn't tough it out.

Speaker 10 They see RFK and Trump doing that, and they kind of don't know what to do with it.

Speaker 10 They appreciate the focus, and they really struggle with what the consequences of what that focus might be.

Speaker 2 Well, Zin, thank you very much. We appreciate it.

Speaker 10 Thanks, Michael.

Speaker 2 We'll be right back.

Speaker 12 Comcast is committed to bringing access to the internet to all Americans, including rural communities across the country, like Sussex County, Delaware.

Speaker 13 We were being left behind. Everybody around us seemed to have internet, but we did not.

Speaker 13 High-speed internet is one of those good things that we needed to help us move our farming, our small businesses, our recreation forward.

Speaker 12 Learn more about how we're bringing our next generation network to more people across the country at ComcastCorporation.com/slash investment in America.

Speaker 1 You can't count on much these days.

Speaker 2 No way, Jim. This is incredible.

Speaker 3 But you can always count on Sundays with the NFL on CBS and Paramount Plus.

Speaker 8 There we go.

Speaker 2 This time for real.

Speaker 5 Watch your local NFL game live every Sunday, all the way through the AFC Championship game.

Speaker 3 And he's in for a touchdown.

Speaker 4 Visit paramountplus.com/slash NFL to get started today and count on Sundays with the NFL on ZBS and Paramount Plus.

Speaker 14 Fall Adventures are here. Grab the keys to a new Toyota.
Get a low-cost lease on Privus, one of 17 fuel-efficient Toyota hybrids. Plus, every new Toyota comes with Toyota Care.

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Speaker 9 Here's what else you need to know today.

Speaker 9 On Monday, ABC said that the the late-night host Jimmy Kimmel would return to its airwaves beginning tonight, despite the fierce outcry from conservatives over his comments about the assassination of Charlie Kirk.

Speaker 9 The reversal came after Hollywood unions and hundreds of actors and directors condemned ABC's decision as a betrayal of free speech.

Speaker 9 But at least one major owner of ABC stations, the Sinclair Broadcast Group, said that it would not run Kimmel's show and would instead replace it with news.

Speaker 9 Today's episode was produced by Alex Stern, Nina Feldman, and Rob Zipko with help from Alexandra Lee Young. It was edited by Liz O.
Balin and Michael Benoit and was engineered by Alyssa Moxley.

Speaker 9 That's it for the day.

Speaker 9 I'm Michael Mobonco.

Speaker 9 See you tomorrow.

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