Why Tylenol's in the headlines

Why Tylenol’s in the headlines

Last week, US President Donald Trump issued some health advice to pregnant women to avoid paracetamol, an ingredient in certain pain relief drugs, that had medical experts rushing to clarify the science…  The advice came from studies ordered by US Health Secretary Robert F Kennedy Jr - he’s the one behind the Make America Healthy Again movement, and he’s driving some big changes in the US health industry… So in this Squiz Shortcut, we’ll look at:

• why last week caused such a stir

• who RFK Jr is

• and what his agenda means for the rest of the world - and us here in Oz…

Prefer to listen or watch?

Listen to Andrew Williams and Larissa Moore cover this topic in this Squiz Shortcut podcast episode, or check it out on YouTube - and hit subscribe while you’re at it.

Listen time: 15 minutes

Squiz the Shortcut

Remind me of what President Trump said…
He told pregnant women: “Don’t take Tylenol” - that’s a widely used pain relief drug sold in America with the active ingredient of acetaminophen (which we know in Australia as paracetamol). He said it “can be associated with a very increased risk of autism”, and his advice for pregnant women was to “fight like hell” not to take it, except in cases of very high fever.

Is it true?
Medical experts were very quick to respond… In Australia, paracetamol is the active ingredient in Panadol which is a super common brand of painkiller often used to bring down fevers. And here, the medical advice for expectant mothers is that paracetamol is safe to take in recommended doses during pregnancy. 

What happens if a fever is left untreated?
A fever, or high temperature, can be dangerous if left untreated in pregnancy. It’s linked to miscarriage, premature births, and developmental issues… 

How did Trump’s announcement go down?
Even though medical experts responded fast, many women in the US, UK and Australia were sent into a panic. Multiply that by every country in the world that those medications are sold in, and you can see why the announcement created waves. 

Where did Trump’s information come from?
He pointed to studies commissioned by US Health Secretary Robert F Kennedy Jr (or RFK Jr as he’s known)... The research involved some top universities like Harvard, and 27 out of 46 studies found that there was a possible association between mothers who reported taking paracetamol during pregnancy and a slightly higher rate of neurodevelopmental issues in babies - but they haven’t found concrete evidence that the drug is the cause of autism.

Just explain that a bit more…
Sure thing… They couldn’t discern whether neurodevelopmental issues were caused by fever in the first place, or paracetamol used to treat the fever… The US Food and Drug Administration summed it up last week, saying there’s “an association in some studies, but no causal link has been established.”

What is autism?
It’s a neurodevelopmental condition that affects how a person's brain develops and functions. And it covers a broad spectrum… For some people, it means profound disabilities like being non-verbal or being unable to cope with certain sensory things like loud sounds and bright lights. But in milder cases, people might have differences in the ways they learn, they might have difficulties in expressing themselves or understanding social cues and norms, and that can sometimes be interpreted as behavioural issues.

What causes it?
Experts say it’s very hard to pinpoint a single cause… Genetics, the age of parents, and some pre-existing conditions are all thought to be factors. In the US, there’s been a big focus on the condition due to a rise in diagnoses over the past 25 years.

How much have they risen?
The latest Centres for Disease Control and Prevention (or CDC) report in 2022 found that 1 in 31 children are being diagnosed with autism by 8yo, compared to 1 in 150 in 2000. But experts say people are far more aware of the condition nowadays and screening has improved. So, parents and schools are more alert to the signs, and diagnoses are being made much earlier. It’s something we’re seeing here in Australia too - autism cases rose 42% between 2018 and 2022… 

Tell me about that…
Autism is one of the fastest-growing categories of NDIS plans, with children diagnosed with mild autism staying on the scheme long after their early intervention period, which has led to massive cost blowouts. And it’s a big factor in why the Albanese Government is planning to restructure the scheme.

What’s planned?
The Government is looking to move children with mild cases of autism into a new early support program called Thriving Kids which will be separate from the NDIS. It was a controversial move when it was announced in August by Health Minister Mark Butler - and it caused a fair bit of confusion among parents who are concerned that their kids still need help. It’s a sensitive issue, and one that’s attracting political heat... In America, the push to find a root cause and a treatment for autism is one of several issues taken up by the Make America Healthy Again movement - or MAHA (a riff on MAGA)…

Who’s MAHA made up of?
A disparate group of voters - a lot of health conscious parents, anti-vaxxers, and people who generally distrust big institutions like pharma companies and public health agencies…  And their plan is to “reform America's food, health, and scientific systems to identify the root causes of the chronic disease epidemic and Make America Healthy Again” - that’s the wording on the US Department of Health and Human Services website… 

So they’ve got some influence?
Yep… They’ve rallied around RFK Jr since he was appointed Health Secretary by Trump… And there’s been some commentary from political analysts with the view that Trump’s announcement about Tylenol looked a lot like appeasing the group. As we mentioned, medical experts were critical of the President for sowing what they called “confusion and panic” among expectant parents, but MAHA supporters are saying it’s validation that their concerns are being heard and acted on at the highest level. 

What are they saying?
Del Bigtree, Kennedy’s former communications director and founder of the advocacy group Informed Consent Action Network said of Trump’s announcement: “I think that for the MAHA movement, this is like the dark clouds have finally parted and a single ray of sunshine is shining down.”

Tell me a bit about RFK Jr…
He’s a Kennedy from the line of famous American politicians. He’s the son of the former Democratic politician Robert F Kennedy (known as Bobby), a Senator who ran as a Presidential candidate in 1968, and the nephew of former President John F Kennedy. The family has a prominent place in American political history after both men were assassinated while serving in public office…

How old was RFK Jr when his father was killed?
He was 14yo when his father was killed in 1968… He’s had a mixed history with Trump, and was on the opposite side of politics for a time - but like Trump, he’s grown up in one of America’s most influential families, and he’s no stranger to controversy.

What sort of controversy?
He’s become known as one of the world’s most vocal anti-vaccine activists, having spent decades campaigning against childhood vaccines and more recently Covid-19 vaccines, even after his claims were disproved by medical evidence. And it’s not just his views on vaccines that have made headlines…

What else should I know?
One thing that frequently gets brought up - and we think it adds to the picture of the man so we’ll tell you about it here too - is his “freezer full of roadkill” which he keeps to feed his pet falcons… 

Waste not, want not…?
Something like that… It came to light after he admitted to illegally dumping the carcass of a bear cub in Central Park, New York, back in 2014. He said he’d been collecting road kill for years and he saw the cub hit by a car, picked it up, then decided he didn’t have time to preserve it, so he dumped it in the park and positioned it to look like it had been hit and killed by a cyclist… The spectacle of a dead bear cub in the middle of a New York landmark made the news, and he had to fess up.

What happened?
The story went viral, giving plenty of ammunition to his critics during his subsequent political campaigns - and his bid for his current post heading up US Health… And he says the state of health in America needs urgent attention.

What are the issues?
The US has extremely high rates of obesity and chronic disease, and he reckons Americans were healthier when he was a kid, so he’s trying to bring the country back to that standard. And in just a few months, he’s made big changes…

What sort of changes?
He’s banned artificial dyes in foods, arguing they’re linked to hyperactivity and violence in schools. The evidence on that is patchy, especially given a lot of foods that bright colourful dyes are found in contain large amounts of sugar - think lollies, ice cream and kids cereals. And sugar is also linked to behavioural issues, but the dyes are a key MAHA concern.

How do Americans feel about the changes he’s making?
Recent polling shows that they’re broadly in favour of his agenda on reducing chemicals in food and to improve food safety guidelines to make them easier to understand - but his stance on vaccines has significantly less support amongst the US public…

What is he changing in the vaccine space?
Kennedy has long argued that childhood vaccines like MMR - that’s for measles, mumps and rubella - aren’t safe. That’s refuted by medical advice which says that the health risks associated with measles are far worse than that of the vaccine. But the World Health Organisation (WHO) has pointed to an uptick in measles outbreaks because of vaccine hesitancy - and that’s got medical experts around the world worried… 

What are they concerned about?
Public health officials say Kennedy’s continual messaging that vaccines are dangerous is undermining trust, which could lead to parents avoiding vaccines or pain relief when it’s needed, resulting in more preventable illness, hospitalisations, and even deaths… But he’s pressing ahead.

What else is he doing?
He recently fired the head of the CDC Susan Monarez because she wouldn’t pre-approve the recommendations of his vaccine advisory panel which, after he fired the original panel in June, is now stacked with people who've expressed anti-vaccine views… And there are more changes in store…

Like what?
That panel is in the process of re-evaluating the vaccine schedule for hepatitis B and the MMR vaccine for children, as well as the Covid-19 vaccine. And there’s also moves afoot for the FDA to revoke approval for the polio vaccine…

What are his political opponents saying?
Democrats have been scathing in their criticism of the Trump Administration’s moves to overhaul the health system while ignoring the advice of experts. Former Democratic Presidential nominee Hilary Clinton put it bluntly last week. She said: “When your president says something, when a Kennedy, who's the secretary of HHS, says something, what are you supposed to believe? … Too many Americans are listening to this very destructive anti-science tirade that we’re hearing from this administration. And it’s going to cost lives. It already is costing lives.”

What does it mean for the rest of the world - and us in Australia?
When America shifts direction, the ripple effects are very often global - and that’s got medical experts around the world worried with respect to vaccine hesitancy and the spread of infectious diseases. But for the moment, Australia is keeping calm and sticking to the science - especially when it comes to paracetamol…

What are our guidelines again?
The message from the Therapeutic Goods Administration is clear: paracetamol remains safe in pregnancy when used as directed. The risks of leaving a fever untreated are much higher. And if you’ve got any doubts, see your doctor…

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Onto our Recommendations

Listening: This episode of The New Yorker’s podcast The Political Scene titled How MAHA is sowing vaccine confusion is a good one if you’d like to know a bit more about what’s been going on at the CDC and the politicisation of health in the US.

Reading: This article from CNN which fact checks the claims Trump made in his statement about Tylenol and vaccines last week… And we’ll also include this link to the full announcement.

Reading:  And here’s some extra information on autism if you’d like to know more about it.

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