Trump

When the bar is set at suggesting that people inject bleach into their veins, it’s hard to reach a new low. But in a deranged press event on autism Monday evening, President Trump seemed to go for it—sharing “rumors” and his “strong feelings” not just on Tylenol but also his bonkers views on childhood vaccines.

Trump was there with his health secretary, anti-vaccine activist Robert F. Kennedy Jr., to link autism to the use of Tylenol (acetaminophen) during pregnancy. While medical experts condemn the claim as unproven and dangerous (which it is), Kennedy’s anti-vaccine followers decried it as a distraction from their favored false and dangerous explanation—that vaccines cause autism (they don’t).

Pinning the blame on Tylenol instead of vaccines enraged Kennedy’s own anti-vaccine organization, Children’s Health Defense. In the run-up to the event Monday evening, CHD retweeted an all-caps defense of Tylenol, and CHD President Mary Holland called the announcement a “sideshow” in an interview with Steve Bannon.

But fear not. The rift was short-lived, as their big feelings were soothed mere minutes into Monday’s event. After smearing Tylenol, the president’s unscripted remarks quickly veered into an incoherent rant linking vaccines to autism as well.

At one point in his comments, he rattled off a list of anti-vaccine activists’ most vilified vaccine components (mercury and aluminum). But his attack largely ignored the content of vaccines and instead surprisingly focused on volume. Overall, his comments were incoherent, but again and again, he seemed to swirl back to this bizarre concern.

Wut?

If you piece together Trump’s sentence- and thought-fragments, his comments created a horrifying picture of what he thinks childhood vaccinations look like:

They pump so much stuff into those beautiful little babies. It’s a disgrace. I don’t see it. I think it is very bad. They’re pumping. It looks like they’re pumping into a horse. You have a little child, little fragile child, and you get a vat of 80 different vaccines, I guess, 80 different blends and they pump it in.

It seemed that Trump’s personal solution to this imagined problem is to space out and delay vaccines so they are not given at one time:

Break it up because it’s too much liquid. Too many different things are going into that baby at too big a number. The size of this thing, when you look at it, it’s like 80 different vaccines and beyond vaccines and 80. Then you give that to a little kid.

From Trump’s loony descriptions, you might be imagining an evil cartoon doctor wielding a bazooka-sized syringe and cackling maniacally while injecting a baby with a vat’s worth of 80 different vaccines until it inflates like a water balloon ready to burst.

But this cuckoo take is not how childhood vaccinations go in routine well-baby doctor’s visits. First, most vaccines have a volume of 0.5 milliliters, which is about a tenth of a teaspoon. And babies and children do not get 80 different vaccines ever, let alone at one time. In fact, no recommendations would see anyone get 80 different types of vaccines cumulatively.

By age 18, it’s recommended that people get vaccinated against 17 diseases, including seasonal flu and COVID-19. And some vaccines are combination shots, knocking out three or four diseases with one injection, such as the measles, mumps, rubella (MMR) vaccine or the Diphtheria, tetanus, & acellular pertussis (DTaP) vaccine. And again, even those combination shots are 0.5 mL total.

Modern vaccines

Trump’s claim of 80 vaccines doesn’t even stand up when you count vaccine doses rather than different vaccines. Some childhood vaccines require multiple doses—MMR is given in two doses, and DTaP is a five-dose series, for example. According to current recommendations, by age 18, kids should have 36 vaccine doses against childhood diseases. If you add in a flu shot every year, that’s 54 doses. If you add in a COVID-19 vaccine every year, that’s 72.

While 72 might seem like a big number, again, that’s spread out over 18 years and includes seasonal shots. And medical experts point to another key fact—the vaccines that children get today are much more streamlined and efficient than vaccines of yore. A helpful myth-busting info sheet from experts with Yale’s School of Public Health points out that in the mid-1980s, children under age 2 were vaccinated against seven diseases, but those old-school vaccines included more than 3,000 germ components that can spur immune responses (aka antigens). Today, children under age 2 get vaccinated against 15 diseases, but today’s more sophisticated vaccine designs include just 180 antigens, making the protection more targeted and reducing the risk of errant immune responses.

In all, the facts should dash any worries of nefarious doctors inflating children with vast volumes of noxious concoctions. But for those who may hew closely to the cautionary principle, Trump’s “space the shots out” plan may still seem reasonable. It’s not.

At most, children might get five or six vaccines at one time. But again, the number of antigens in those shots is far lower than those in vaccines children received decades ago. And the number of antigens in those vaccines is just a fraction of the number kids are exposed to every day just from their environments. If you’ve ever watched a kindergartener touch every surface and object in a classroom and then shove their fingers in their nose and mouth, you understand the point.

Vaccinations don’t overwhelm children’s immune systems. And there’s no evidence that spacing them out avoids any of the very small risks they pose.

Data against dogma

After Trump shared his personal feelings about vaccines, the American Academy of Pediatrics rushed to release a statement, first refuting any link between vaccines and autism and then warning against spacing out vaccine doses.

“Pediatricians know firsthand that children’s immune systems perform better after vaccination against serious, contagious diseases like polio, measles, whooping cough, and hepatitis B,” the AAP said. “Spacing out or delaying vaccines means children will not have immunity against these diseases at times when they are most at risk.”

Such messages make no impact on the impervious dogma of anti-vaccine activists, of course. While medical experts and organizations like AAP scrambled to combat the misinformation and assure pregnant people and parents that Tylenol was still safe and vaccines don’t cause autism, anti-vaccine activists cheered Trump’s comments.

“We knew today was going to be about acetaminophen,” CHD President Mary Holland said, speaking on Bannon’s podcast again after the event. “We didn’t know if he’d touch on vaccines—and he was all over it. It was an amazing, amazing speech.

“I’m happy to say he basically gave parents permission not to vaccinate their kids—and definitely not to take Tylenol.”

In a new pop-up message on Tylenol’s website, the maker of the common pain reliever and fever reducer pushed back on Trump’s feelings.

Tylenol is one of the most studied medications in history–and is safe when used as directed by expecting mothers, infants, and children.

The facts remain unchanged: over a decade of rigorous research, endorsed by leading medical professionals, confirm there is no credible evidence linking acetaminophen to autism.

The same is true for vaccines.