Fortune | FORTUNE 09月23日
特朗普关于婴儿药物和疫苗的言论引发争议
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在一次白宫新闻发布会上,特朗普总统就孕妇和婴儿使用泰诺(对乙酰氨基酚)以及疫苗与自闭症之间的联系发表了引起争议的言论。尽管缺乏科学证据,他声称泰诺可能与自闭症风险增加有关,并重申了关于疫苗可能导致自闭症的已被证伪的说法。医学专家对此表示担忧,认为这些建议是错误且危险的。美国食品药品监督管理局(FDA)表示将通知医生泰诺的使用可能与自闭症风险增加有关,但并未提供充分的理由。许多医学组织和专家重申,目前没有确凿证据支持泰诺与自闭症之间存在因果关系,并强调了在怀孕期间安全退烧的重要性。同时,文章还提到了特朗普政府对叶酸代谢物作为潜在自闭症治疗方法的探索,以及科学界对疫苗与自闭症之间不存在联系的广泛共识。

👶特朗普总统在白宫新闻发布会上建议孕妇和婴儿避免使用泰诺(对乙酰氨基酚),并声称其可能与自闭症风险增加有关,尽管缺乏科学证据支持。这一说法引发了医学界的广泛质疑和担忧,因为泰诺在退烧和缓解疼痛方面被认为是孕期安全的选择之一。

💉特朗普总统再次提及了疫苗可能导致自闭症的已被证伪的说法,认为疫苗接种时间安排紧密可能与自闭症发病率上升有关。然而,数十年的科学研究和广泛的科学共识均已明确否定了疫苗与自闭症之间存在任何联系。

🔬尽管缺乏直接证据,美国食品药品监督管理局(FDA)表示将通知医生泰诺的使用可能与自闭症风险增加相关联。然而,包括母胎医学学会和美国妇产科学院在内的多个医学组织均重申,他们仍然推荐泰诺作为孕期治疗发烧和疼痛的合适选择,并批评了可能误导孕妇的言论。

💡文章还提到,特朗普政府正在探索叶酸代谢物 leucovorin 作为治疗可能存在大脑叶酸水平低的人群(包括部分自闭症患者)的选项。虽然一些小型研究显示高剂量叶酸可能对自闭症儿童有益,但科学界认为还需要更大规模、更严格的临床试验来证实其疗效。

📈科学界普遍认为,自闭症发病率的上升主要是由于诊断标准的扩大和对“谱系”障碍的更好识别,而非疫苗或特定药物的直接影响。专家强调,理解自闭症需要考虑遗传和环境等多种复杂因素,而非基于未经证实的说法。

“Don’t take Tylenol,” Trump instructed pregnant women around a dozen times during the unwieldy White House news conference, also urging mothers not to give their infants the drug, known by the generic name acetaminophen in the U.S. or paracetamol in most other countries. He also fueled long-debunked claims that ingredients in vaccines or timing shots close together could contribute to rising rates of autism in the U.S., without providing any medical evidence.

The rambling announcement, which appeared to rely on existing studies rather than significant new research, comes as the Make America Healthy Again movement has been pushing for answers on the causes of autism. The diverse coalition of supporters of Health Secretary Robert Kennedy Jr. includes several anti-vaccine activists who have long spread debunked claims that immunizations are responsible.

The announcement also sheds light on Trump’s own long-held fascination with autism and his trepidation about the childhood vaccine schedule, even as the president has taken pride in his work to disseminate COVID-19 vaccines during his first term.

Medical experts said Trump’s remarks were irresponsible. New York University bioethicist Art Caplan said it was “the saddest display of a lack of evidence, rumors, recycling old myths, lousy advice, outright lies, and dangerous advice I have ever witnessed by anyone in authority.”

Trump announced during the event that the Food and Drug Administration would begin notifying doctors that the use of acetaminophen “can be associated” with an increased risk of autism, but did not immediately provide justification for the new recommendation.

Evidence for potential link between Tylenol and autism is not conclusive

Some studies have raised the possibility that taking acetaminophen during pregnancy might increase the risk of autism — but many others haven’t found that concern, said autism expert David Mandell of the University of Pennsylvania.

One challenge is that it’s hard to disentangle the effects of Tylenol use from the effects of high fevers during pregnancy. Fevers, especially in the first trimester, can increase the risk for miscarriages, preterm birth and other problems, according to the Society for Maternal-Fetal Medicine.

Trump also urged not giving Tylenol to young children, but scientists say that research indicates autism develops in the fetal brain.

Responding to Trump’s warnings, the Society for Maternal-Fetal Medicine said they still recommend Tylenol as an appropriate option to treat fever and pain during pregnancy. The president of the American College of Obstetricians and Gynecologists said Monday that suggestions that Tylenol use in pregnancy causes autism are “irresponsible when considering the harmful and confusing message they send to pregnant patients.”

Trump press secretary Karoline Leavitt said in a statement Monday evening that the administration “does not believe popping more pills is always the answer for better health” and that it “will not be deterred in these efforts as we know millions across America are grateful.”

Tylenol maker Kenvue disputed any link between the drug and autism on Monday and said in a statement that if pregnant mothers don’t use Tylenol when in need, they could face a dangerous choice between suffering fevers or using riskier painkiller alternatives. Shares of Kenvue Inc. fell 7.5% in trading Monday, reducing the company’s market value by about $2.6 billion.

Kennedy announced during the news conference that at Trump’s urging, he was launching a new all-agency effort to uncover all the factors that could be contributing to autism, a question scientists have been researching for decades.

Trump administration explores the potential role of folate

FDA Commissioner Dr. Marty Makary also took the stage to announce it was taking the first steps to try to approve a folic acid metabolite called leucovorin as a treatment option for patients believed to have low levels of folate in the brain. That may include some people with autism.

Leucovorin is used to counteract the side effects of various prescription drugs, including chemotherapy and other high-dose medications that can negatively impact the immune system. It works by boosting folate levels, a form of vitamin B that’s critical to the body’s production of healthy red blood cells.

Women already are told to take folic acid before conception and during pregnancy because it reduces the chances of certain birth defects known as neural tube defects.

In recent years a handful of studies have suggested positive results when high-dose folic acid is used to treat children with autism, with researchers in China and other countries reporting improvements in social skills and other metrics. Those small studies have been quickly embraced by some parts of the autism community online.

The theory is that some, not all, children with autism may not properly metabolize folate, Mandell said. But the recent studies “are really tiny,” he said. To prove an effect, “we would need an independent, large, rigorously controlled randomized trial.”

Decades of studies show no link between vaccines and autism

During the press conference, Trump said he’s a believer in vaccines but claimed without evidence that giving vaccinations close together at the recommended ages has a link to autism. Spacing out shots as he suggests can lead to an increased risk that children become infected with a vaccine-preventable disease before returning for another visit.

Though anti-vaccine activists, including Kennedy, have long suggested a link between vaccines and autism, widespread scientific consensus and decades of studies have firmly concluded there isn’t one.

Autism is not a disease but a complex developmental condition that affects different people in different ways. It can include delays in language, learning or social and emotional skills. For some people, profound autism means being nonverbal and having intellectual disabilities, but the vast majority of people with autism experience far milder effects.

The disorder affects 1 in 31 U.S. children today, a sharp rise from just a few years ago, according to the CDC. Experts say the increase is mainly due to a new definition for the disorder that now includes mild cases on a “spectrum” and better diagnoses. They say there is no single cause to the disorder and say the rhetoric appears to ignore and undermine decades of science into the genetic and environmental factors that can play a role.

The announcement is the latest step the administration, driven by Kennedy and his supporters, has taken to reshape America’s public health landscape.

Beyond cutbacks at federal health agencies, the Centers for Disease Control and Prevention has been roiled by disagreements over Kennedy’s vaccine policies. An influential immunization panel stocked by Kennedy with figures who have been critical of vaccines last week changed shot guidance for COVID-19 and other diseases.

Swenson reported from New York. Associated Press writers Matthew Perrone and Laura Ungar contributed to this report.

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特朗普 泰诺 自闭症 疫苗 公共卫生 Trump Tylenol Autism Vaccines Public Health
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