President Donald Trump’s message that pregnant women should adopt extreme caution when it comes to taking Tylenol and following the current vaccine schedule reflects his deep frustration with the public health establishment, three people close to the White House told POLITICO.
Autism rates have grown from 1 in 150 in 2000 to 1 in 31 three years ago, according to government data, and Trump is sick of waiting for a solution, the people, granted anonymity to share their assessment of Trump’s attitude, said.
“President Trump certainly doesn’t sound like your average public health bureaucrat looking to retire into a pharmaceutical company or a doctor who is paid by those companies to vaccinate and medicate children,” one of the people said. “Of course, they never said a word of warning to parents who now suffer with love for their injured children.”
Still, Trump’s address from the White House Monday, full as it was with errors and overstatements, is causing headaches for his advisers. They are uneasy with Trump’s willingness to raise women’s alarm when the evidence is mixed about the risk of taking Tylenol, and virtually non-existent with regard to vaccines, two of the people told POLITICO. Inside the administration, the people said health officials have had to make peace with the president’s view that it’s better for women to be needlessly cautious than to risk harming their babies.
The reaction to Trump’s speech among public health advocates was overwhelmingly negative. In statement after statement, doctors’ groups, experts and scientists said Trump’s warnings weren’t backed by the science and would prompt many women not to treat pain and fevers or vaccinate their children, putting them at risk of disease. The rising rates of autism, many public health experts believe, are partly the result of changing diagnostic criteria and more awareness of the condition. They also suspect a variety of environmental and genetic factors could be involved.
The critics have no credibility with Trump, the people close to the White House said. Trump, like his health secretary, Robert F. Kennedy Jr., blames them for standing by while the autism problem worsened.
“That’s the establishment. They’re funded by lots of different groups,” Trump said Monday in response to a reporter’s question on the president’s reaction to a doctor’s group stating Tylenol was a safe treatment for pain during pregnancy.
Trump’s message on vaccines, that kids get too many shots too quickly, comes as Kennedy is set to decide on recommendations issued last week by his vaccine advisers to stop recommending that all Americans older than six months get an annual Covid shot and to stop offering a combined measles, mumps, rubella and chickenpox shot to children.
The advisers, many of them skeptical of vaccine safety, didn’t go as far as many public health advocates feared, or as Kennedy’s anti-vaccine allies wanted. They tabled a plan to delay infants’ inoculations for hepatitis B and voted against advising states to require people to get a prescription for Covid shots.
In July, Kennedy’s Department of Health and Human Services adopted a recommendation from the advisers who sit on his Advisory Committee on Immunization Practices to ban flu vaccines containing a mercury-based preservative that Kennedy believes may cause autism. The Centers for Disease Control and Prevention has said there’s no evidence to support that.
The president Monday backed delaying the hepatitis B vaccine until children are 12, stating that it’s a sexually transmitted disease and that it doesn’t make sense for newborns to be vaccinated. Doctors, such as Senate Health Committee Chair Bill Cassidy (R-La.), point out that babies can get the disease from their mothers, who may not be aware they’re infected and that infections have plummeted among children since the shot became available in the early 1990s.
Cassidy also criticized Trump’s Tylenol advice on Monday, saying it would leave pregnant women with no option for treating their pain.
Though Trump has offered shifting opinions about the benefits of vaccination, his message to Kennedy — who stood behind Trump during his speech — was that he should move further and faster in revising the childhood schedule.
Kennedy ultimately gets to decide what to do with the advisory panel’s recommendations and the vaccine schedule.
“They pump so much stuff into those beautiful little babies, it’s a disgrace,” Trump said. “It looks like they’re pumping into a horse. You have a little child, a little fragile child and you get a vat of 80 different vaccines.” Trump suggested spacing out vaccines over a longer period of time and separating shots currently given in tandem.
The government currently recommends that children get about 30 shots before they turn 18, more than 60 if you count annual flu and Covid shots.
The president’s remarks appeared at odds with the White House’s approach to vaccines heading into the midterm elections, which has been to focus more on the median voter than those who are either strongly pro- or anti-vaccine. White House aides have said vaccines remain a relatively niche issue and the most important thing is whether voters believe public health is going in the right direction.
Aides have also pointed to Florida Surgeon General Joseph Ladapo’s plans to roll back his state’s childhood vaccine requirements — a position Trump has publicly criticized — as an example of going too far. Short of that, they believe, the White House’s vaccine policy is unlikely to cause any issues in the midterms.
Trump “feels very strong about the autism situation,” one of the people said. “These are incremental steps as part of a larger effort that President Trump is taking very seriously to turn over every stone.” The person said Trump believes the government should “treat people like adults and let people have information as it comes out that they think is serious,” rather than waiting for definitive proof.
The president insisted his administration’s work on vaccines is as important as stopping wars.
“So I’ve been waiting for this meeting for 20 years,” Trump said Monday, recalling talking with Kennedy about autism two decades ago. Trump later told the story of a former Trump Tower employee whose son the president says was diagnosed with autism after developing a high fever following vaccination. He also told that story a decade ago, during a GOP presidential debate.
On Monday, Trump insisted on offering the new Tylenol guidance despite the reticence of senior administration health officials and even Kennedy, one of the people said.
The officials had long hoped they could align on a clear timeline and had Kennedy’s endorsement. The initial plan was to release a literature review on the state of research into autism causes and treatment options on Sept. 29. Tylenol is one of 31 hypotheses. Next, they planned an announcement that working groups would begin new studies. Next year, they expected initial findings from those efforts, including on Tylenol.
What the officials hoped to avoid was premature communication that could sow confusion or subject the administration to criticism that it had gotten ahead of the science. To their frustration, Trump insisted on moving forward.
During the speech, Trump explained his thinking.
“I always had very strong feelings about autism and how it happened and where it came from,” he said, adding that as he learned more about the condition he determined that public health officials were holding back out of what he saw as excess caution.
“It’s turning out that we understood a lot more than a lot of people who studied it, we think. And I say we think because I don’t think they were really letting the public know what they knew,” he said.
Autism manifests itself across a spectrum, with some experiencing severe symptoms and others mild ones. It can affect social communications, cause repetitive behaviors and impact language development.
POLITICO Magazine published an opinion piece by three of the officials who joined Trump for his speech, National Institutes of Health Director Jay Bhattacharya, Food and Drug Administration Commissioner Marty Makary and Centers for Medicare and Medicaid Services Administrator Mehmet Oz as Trump began speaking. The three, all medical doctors, offered a far more nuanced take on Tylenol and autism than Trump did.
The opinion piece said that high-quality studies had linked acetaminophen, Tylenol’s active ingredient, with autism, but had not proved causation. They acknowledged that acetaminophen is the only over-the-counter medication approved to treat fevers during pregnancy and said that it, therefore, “should be used judiciously in pregnancy, and under medical supervision of an obstetrician.”
The advice tracked that of Dr. Andrea Baccarelli, the dean of the Harvard T.H. Chan School of Public Health on whose meta-review of studies on Tylenol and autism the officials relied.
Trump went further. “With Tylenol, don’t take it. Don’t take it,” he advised, adding later that women could make an exception if they had an “extremely high fever” and couldn’t “tough it out.”
The administration health officials standing behind Trump hoped that their statements and the concrete details of the autism initiative would be received independently of the spectacle they knew Trump planned, one of the people said.
Responding to criticism that the whole affair looked as if politics had hijacked science, one of the people said administration officials had come to see that there’s a difference between politics, science, and medicine.
Trump’s view, wrapped as it may be in gut feelings and his desire to cultivate Kennedy’s coalition of vaccine skeptics, they see as the political part, the person said.
Health officials in the administration are handling the science — with a review of the autism literature still coming later this month and a plethora of new research initiatives now under way — and they are writing the official medical guidance. In contrast to Trump’s advice, it says women should use Tylenol sparingly, and little new yet on vaccines.
But if Trump’s goal was to bolster Kennedy allies in his big tent, the political part is working. After the speech, anti-vaccine advocates said they were thrilled.
“Donald Trump should be called the MAHA president,” Tony Lyons, a longtime Kennedy ally who now runs an advocacy group supporting the health secretary’s Make America Healthy Again movement, said on former Trump adviser Steve Bannon’s podcast. “He’s the autism president.”
Bannon, in an interview with POLITICO Tuesday, said he saw it the same way. “He so out-Bobbied Bobby,” Bannon said, using Kennedy’s nickname. “I think the White House staff may be at a higher level of shock than even the MAHA movement. No one expected this. The watchword was ‘incrementalism,’ step-by-step. This was the opposite of that. This was a full-throated embrace of the autism crisis.”
