Conflicting Messaging on Tylenol-Autism Confuses the Public

Kids are smart.  We know this because many of us have kids and all of us were kids.  I’m not suggesting that every kid is an Einstein who regards the laws of physics to be... ‘child’s play’.  But in many circumstances, they punch above their juvenile weights to get stuff done.  At times, they are master negotiators.  Here’s a vignette illustrating one of their master techniques. 

Act I, Scene 1

“Mom, can I have ice cream now?”

“Johnny, of course not!  You haven’t even had breakfast yet!”

Act I, Scene II

“Dad, can I have ice cream now?  Mom said it was ok.”

“Sure, son.  Go ahead.”

Sound familiar?  We parents know that we do better when we speak in one voice to our youngsters.  When we don’t, our wily progeny can exploit this with great skill. 

Kid vs parents - not a fair fight!

 

The value of speaking with one voice applies to us adults as well.  Let’s look briefly at some rather conflicting messaging we have all been exposed to regarding the Tylenol-Autism Follies.

• President Trump issued his own view in a tweet a portion of which appears below:           "Pregnant Women, DON’T USE TYLENOL UNLESS ABSOLUTELY NECESSARY, DON’T GIVE TYLENOL TO YOUR YOUNG CHILD FOR VIRTUALLY ANY REASON"

         Earlier, the president advised at a White House briefing, “Fight like hell not to take it.”

• Vice President Vance stated in a recent interview with News Nation that pregnant women should heed the advice of their medical professionals, slightly different than his boss’s point of view.
• Many medical studies, including one published last year in the prestigious Journal of the American Medical Association, found no significant connection between Tylenol and autism.
• The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics publicly and vehemently rejected any causal relationship between Tylenol and autism.
• Senator Bill Cassidy, a Louisiana Republican who, like this writer, is a gastroenterologist, expressed deep skepticism of a Tylenol-autism causal connection.
• The Centers for Disease Control and Prevention (CDC) states on its website that “…a direct causal relationship between acetaminophen [Tylenol] and autism or ADHD has not been established”, Yet, it goes on to advise pregnant women to avoid the product as a precaution.
• The U.S Food and Drug Administration (FDA), like the CDC, notes that studies have shown a correlation between Tylenol and autism but not causality, but still urges caution.  It does state plainly in a release to physicians from FDA Commissioner Makary that “acetaminophen [Tylenol] is the safest over-the-counter alternative in pregnancy among all analgesics [pain relievers] and antipyretics [fever-reducers]…”
• Kenvue, the manufacturer of Tylenol, stated that “independent, sound science clearly shows that taking acetaminophen [Tylenol] does not cause autism.”

I am not commenting here on the substance of the Tylenol-Autism claims.  Readers who have followed my writings over the years will likely know my view.

The point of this post is to express concern over conflicting messages on this issue being thrown into the public square from sources that, at least by title, should be responsible and authoritative.  This public communication failure not only erodes trust in our public health institutions and government officials, but it also confuses the public who has less certainty if a medication is truly safe and effective.  Whom should the public turn to for medical advice among a cacophony of 'authoritative' opinions?  As politics has seeped into the medical arena, it has tainted our public health organizations and their advice to us.  And like m opening vignette of a child angling for morning ice cream, political groups and others can exploit the differences among experts to serve their own agendas. 

Is it really a controversial view that public health should be science-based and free of political influence?