politics
The political implications of Monday's autism announcement
Mark Schiefelbein/AP
At a White House event about autism Monday, as President Trump dispensed medical guidance "based on what I feel," as he put it, he began to take on a new role of sorts: doctor in chief. "Don't take Tylenol," he counseled pregnant women, contrary to medical research. He also claimed he understood autism and its causes "a lot more than a lot of the people who studied it." At multiple points, he asserted that infants don't need the hepatitis B vaccine until they turn 12 — also contradicting existing evidence.
"Presidents have a long history of giving the public advice on public health issues," said sociologist John Evans. But "there has never been a president who has taken stances that are in opposition to the vast majority of scientists and doctors." STAT's Jonathan Wosen and Angus Chen wrote about Trump's turn into medical advice and what experts make of it.
Trump also embraced explicit anti-vaccine rhetoric at Monday's event, making his strongest and most specific suggestions on the childhood vaccine schedule to date. The remarks signal the growing influence of health secretary Robert F. Kennedy Jr., STAT's Chelsea Cirruzzo and Daniel Payne report, and come as Kennedy dismantles and reforms the process that reviews, approves, and recommends vaccines. Read more.
medicine
What doctors have to say about all this
The White House event has drawn a flood of pushback from medical societies and experts through official statements, interviews, and social media. STAT's Elizabeth Cooney, myself, and Annalisa Merelli spoke with doctors and leaders about what patients should know when it comes to the dangers of untreated fever in pregnancy, leucovorin as a treatment for autism, and more.
Much more research is needed on the claims about Tylenol and leucovorin in particular, experts emphasized. It would be easy to conduct a large-scale clinical trial on leucovorin, American Medical Association CEO John Whyte told me, noting that the group would be happy to work with the federal government to come up with a research agenda and help figure out the process. But "they haven't asked us, they haven't asked AAP or ACOG — really any of us" for input on the new autism research initiatives, he said. Read more.
In the meantime, parents may flock to a dietary supplement with the same key ingredient as leucovorin. But as STAT's Tara Bannow reports, there's a big difference between the medication and the supplement. For starters: In patients with autism, the dose is typically 50 milligrams per day, but most folinic acid supplements have just 800 micrograms per pill. That means you'd have to take 1,000 folinic acid tablets to get the 50 milligram dose of leucovorin. Read more.
fact check
FDA cited testimony that was tossed out in court
FDA Commissioner Marty Makary made a comment Monday that made many heads in the STAT newsroom turn: "To quote the dean of the Harvard School of Public Health, 'There is a causal relationship between prenatal acetaminophen use and neurodevelopmental disorders of ADHD and autism spectrum disorder.'" When did he say that, we wondered?
It turns out that Andrea Baccarelli, the dean in question and a preeminent epidemiologist, made the statement in written testimony to a federal judge two years ago. But the judge excoriated Baccarelli's testimony, and ruled that the testimony (along with that of four other expert witnesses) should be excluded from the case. To this day, it's unclear what Baccarelli believes about acetaminophen and autism. Read more from STAT's O. Rose Broderick, and keep your eye out for more historical context on the issue from another reporter later today.
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