Marty Makary, the former Johns Hopkins surgeon now serving as commissioner of the Food & Drug Administration, is as media savvy as anyone with a medical degree, and he certainly comes across more credibly than either of his bosses, President Trump and health secretary Robert F. Kennedy Jr.
Makary was a regular guest on Tucker Carlson’s show on Fox during the pandemic. He raised questions about the nation’s response to the crisis and, with each appearance, alarms among infectious disease experts who were trying to get more Americans vaccinated.
Last December, Trump nominated Makary to be FDA commissioner, in keeping with his myopic practice of putting cable TV personalities into positions of power. Johns Hopkins Medicine officials applauded the appointment.
The other night, Makary appeared on CNN to defend the administration’s warning on Tylenol. (On Tuesday, Trump had told pregnant women not to take it, claiming without evidence a link to autism in children.)
The host of the show, Erica Hill, challenged some of Makary’s statements. But the real sting came the next day, when Makary received a hot rebuke from a rising star of social media, a fact-checking Ph.D named Jessica Knurick.
Knurick, a registered dietitian with a doctorate in nutrition science, lives in Colorado and frequently posts videos challenging some of the medical disinformation that infests social and mainstream media. She comes with receipts, too — that is, she does her homework. Several of her videos have gone viral, and the one she produced this week on Makary had some 2.2 million views on Facebook and Instagram by Friday morning.
Knurick caught Makary in an assertion he should not have made.
He gave full support to the claim that use of Tylenol by pregnant women is linked to neurodevelopmental disorders in children, including autism. He said a study by the dean of Harvard’s School of Public Health had concluded there was a “causal relationship” between prenatal use of Tylenol and autism.
The dean, Andrea Baccarelli, has backed off that position, saying there is only a “possibility of a causal relationship” and that further study is needed.
But, as Knurick pointed out in her video, even before Baccarelli backed off, a reading of the study would have found this statement in its conclusion: “Our analysis demonstrated evidence consistent with an association between exposure to acetaminophen during pregnancy and offspring with [neurodevelopmental disorders, including Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder], though observational limitations preclude definitive causation.”
Knurick further pointed out that Makary, in an official FDA letter to physicians just a day before his CNN appearance, reported no causal relationship.
“To be clear,” Makary wrote, “while an association between acetaminophen and autism has been described in many studies, a causal relationship has not been established and there are contrary studies in the scientific literature.”
Makary’s letter also said “acetaminophen is the safest over-the-counter alternative in pregnancy among all analgesics and antipyretics; aspirin and ibuprofen have well-documented adverse impacts on the fetus.”
That last sentence, deserving emphasis, received none during all of Trump’s blithering about Tylenol.
After Makary’s appearance, CNN’s Hill turned to Dr. James McPartland, a child psychologist and director of Yale’s Center for Brain and Mind Health. In the sober voice of a clinician, he offered words to the wise: Women should follow the existing guidance on Tylenol during pregnancy — use it, or any drug, sparingly.
McPartland also disputed Makary’s claim that autism, while more commonly diagnosed among children and young people, is not prevalent in people over age 60.
Not true, the Yale psychologist said.
Also false: Trump’s claim that autism does not exist among the Amish.
The assertion that we have an “autism epidemic” — something RFK Jr. has said and Makary repeated on CNN — is undercut by the fact that diagnostic trends have changed over time; the definition of the spectrum has expanded, therefore more people have been included.
Tylenol is used to reduce maternal fevers that may occur during pregnancy. Asked about the dangers posed by prenatal fevers, Makary said: “Any association between fevers and adverse outcomes in the fetus are attributed to the underlying infection — that is, the cause of the fever, not the fever itself.”
Other professionals with far more experience in the field would disagree: Helen Tager-Flusberg, for one. She is director of the Center for Autism Research Excellence at Boston University. She says prenatal fevers are more strongly associated with autism than with Tylenol.
“It is safer for pregnant women to take acetaminophen as needed than to suffer pain, high fever or infection,” Tager-Flusberg said this week. “[President Trump’s advice] is completely contradicted by what we know about the greater risks to the developing fetus that are posed by prolonged fever or infection or the stress associated with severe pain.”
On the risk of autism, the March of Dimes says: “More research is needed in this area.”
Jessica Knurick suggested that Makary went strong on a link between Tylenol and autism because Trump and Kennedy are determined to identify a cause for autism and pledged to have one by this month.
“Marty and the Trump administration had to meet a predetermined deadline to give the public an answer about autism by September, which is absurd and anti-scientific on its face,” Knurick said. “So they pulled a single review article published last month, treated it like some bombshell — as if they alone had uncovered the truth — all while relying on the fact that less than 30 percent of Americans are scientifically literate, and two-thirds don’t even understand the scientific method.
“This is the perfect storm,” she added, “a country with low scientific literacy; social media platforms that reward conspiratorial, emotional content; AI chatbots that give people a false sense of certainty and an administration, including the FDA commissioner, exploiting it all for their own gains.”
Dan Rodricks writes a weekly column for Baltimore Fishbowl. He can be reached at djrodricks@gmail.com or via danrodricks.com
Gee, where was Jessica during the Covid era? A non-vaccine being forced on the public would have been right up her alley.