Health and Human Services Secretary Robert F. Kennedy Jr., joined by President Donald Trump, delivers an announcement on “significant medical and scientific findings for America’s children” in the Roosevelt Room of the White House on Sept. 22, 2025 in Washington, D.C. Federal health officials suggested a link between the use of acetaminophen during pregnancy as a risk for autism, although many health agencies have noted inconclusive results in the research. (Photo by Andrew Harnik/Getty Images)

WASHINGTON — A majority of Americans disapprove of Health and Human Services Secretary Robert F. Kennedy Jr.’s job performance and the federal government’s evolving vaccine policy, according to a poll released Thursday by the nonpartisan health organization KFF.

In addition, the vast majority of those surveyed have heard the unproven claims made by President Donald Trump, Kennedy and others in late September that taking acetaminophen, also known as Tylenol, during pregnancy could be one possible environmental factor in a child later being diagnosed with autism.

A total of 77% of the people KFF polled said they knew of the statements, though whether people believe the claims, which have yet to be established by the medical community, varied.

Only 4% of those surveyed said it is “definitely true” that taking Tylenol during pregnancy increases the risk of the child developing autism, and 35% said the claim is “definitely false.” Thirty percent said it is “probably true” and 30% said it is “probably false.”

Combined, 65% said it’s either probably or definitely false to say that taking acetaminophen during pregnancy increases the chance of a child developing autism, a complex disorder that experts believe is the result of both genetic and environmental factors.

When broken down by political party, 86% of Democrats, 67% of independents and 43% of Republicans said the claims were either probably or definitely false.

The survey shows 59% somewhat or strongly disapprove of how Kennedy is handling his new role at the top of the country’s public health infrastructure.

The level of support changes considerably depending on political party affiliation, with 86% of Democrats, 64% of independents and 26% of Republicans disapproving.

A slightly higher number, 62%, either somewhat or strongly disapprove of the United States’ vaccine policy.A similar trend emerged when those polled were broken up by political parties. Eighty-eight percent of Democrats, 67% of independents and 31% of Republicans somewhat or strongly disapproved of vaccine policy.

The survey shows a declining share of Americans have faith in the Centers for Disease Control and Prevention to provide trusted information about vaccines, compared with previous KFF polls in September 2023 and earlier this year.

A total of 63% of respondents two years ago trusted the CDC on vaccines, but that has declined to 50%.

Democrats’ faith in the CDC’s vaccine recommendations has dropped from 88% two years ago to 64%, independents have gone from 61% to 47% and Republicans have remained relatively steady, only going from 40% to 39%.

Across political parties, a person’s own doctor as well as the American Academy of Pediatrics and the American Medical Association remain broadly trusted for vaccine information.Eighty-three percent said they trust their doctor or health care provider, 69% believed information from the American Academy of Pediatrics and 64% had faith in the AMA.

The poll of 1,334 adults took place from Sept. 23 to Sept. 29 and had a margin of error of plus or minus 3 percentage points for the full survey. Questions broken down by a person’s political ideology had a margin of error of plus or minus 6 percentage points.

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The CDC says people age 65 and older should talk to their doctor about COVID 19 vaccines. (Photo by George Frey/Getty Images)

The Centers for Disease Control and Prevention on Monday updated its adult and child immunization schedules to to recommend COVID-19 shots for people 65 and older after they consult with their health care providers.

The CDC also is recommending in its updated immunization schedules that toddlers receive the chickenpox vaccines as a standalone immunization rather than in combination with measles, mumps, and rubella (MMR) shot.

The CDC announced what it called the return to “individual-based decision-making to COVID-19 vaccinations” in a press release on its website Monday morning.

The immunization schedules adopt recent recommendations by the Advisory Committee on Immunization Practices (ACIP), which has been overhauled by Health Secretary Robert F. Kennedy Jr., who fired  all 17 former members of the vaccine panel earlier this year and replaced them with his own appointees.

RFK Jr. fired everyone on a key vaccine panel. Here’s who he replaced them with.

“Informed consent is back,” said Acting Director of the CDC and Deputy Secretary of Health and Human Services Jim O’Neill. “CDC’s 2022 blanket recommendation for perpetual COVID-19 boosters deterred health care providers from talking about the risks and benefits of vaccination for the individual patient or parent. That changes today,” he continued.

“I commend the doctors and public health experts of ACIP for educating Americans about important vaccine safety signals. I also thank President Trump for his leadership in making sure we protect children from unintended side effects during routine immunization.”

According to the CDC press release, individual-based decision-making “means that the clinical decision to vaccinate should be based on patient characteristics that, unlike age, are difficult to incorporate in recommendations, including risk factors for the underlying disease as well as characteristics of the vaccine itself and the best available evidence of who might benefit from vaccination.

“Individual-based-decision-making,” the release continues,” allows for immunization coverage through all payment mechanisms including entitlement programs such as the Medicare, Medicaid, Children’s Health Insurance Program, and the Vaccines for Children Program, as well as insurance plans regulated by the Affordable Care Act.”

Vaccines greatly reduce rates of death and disease around the world. The American Academy of Pediatrics, American Academy of Family Practitioners, American College of Obstetricians and Gynecologists, American Medical Association, American Nurses Association, American Pharmacists Association, National Academy of Medicine, and World Health Organization endorse the use of vaccines.

The health insurance trade group AHIP issued a statement last month saying health plans would continue to cover all ACIP-recommended vaccinations, including updated formulations of the COVID-19 and influenza vaccines, with no cost-sharing for patients through the end of 2026.

Health insurance group says vaccines in Florida still a covered benefit

The Florida Board of Pharmacy met briefly last month to affirm that Florida patients don’t need a prescription from their physician before receiving a vaccine. That’s because Florida law authorizes certain pharmacists who work in collaboration with physicians to administer vaccines.

Chickenpox

Meanwhile, the “new recommendation of standalone chickenpox vaccination for toddlers through age three follows evidence presented to ACIP by the CDC Immunization Safety Office’s that healthy 12–23 months old toddlers have increased risk of febrile seizure” from the combined chickenpox-MMR vaccine compared to those given immunization for chickenpox separately.

“The combination vaccine doubles the risk of febrile seizures without conferring additional protection from varicella compared to standalone vaccination,” the CDC statement says. Febrile seizures are brought on by high fevers.

Jess Deis, a nurse practitioner and nurse midwife in Kentucky and Indiana, learned she had cervical cancer after she qualified for Medicaid insurance in 2014. (Sarah Ladd/Kentucky Lantern)

Third in a five-part series.

It had been a decade since Jess Deis’ last women’s wellness exam when Kentucky expanded Medicaid and she finally qualified for the state insurance program.

Physicians recommend a cervical cancer screening — also referred to as a Pap smear, which is a swab of the cervix — as part of a wellness exam once every three to five years for women between the ages of 21 and 65. Deis, 43, was in her last semester of nursing school in 2014 when the test came back with abnormal results. Her doctor ordered additional testing.

“Then I got a call on a Sunday evening from a physician letting me know I had cervical cancer and I needed to see a specialist,” Deis said.

Cervical cancer is one of few cancers that has a known path of prevention after the approval of the first HPV vaccine in 2006. But that also means it falls at the intersection of three cultural issues that are facing strong political opposition — broad access to low-cost or free reproductive health care, access to vaccines for children, and sex education.

Kentucky had the highest cervical cancer incidence rate in the country between 2015 and 2019, according to medical research, and a mortality rate twice as high as the rest of the country. The state tied with West Virginia for the second-highest rate of 9.7 cases per 100,000 residents between 2017 and 2021. Oklahoma topped the list for that five-year period with 10.2 cases per 100,000, according to the National Cancer Institute.

Deis delayed the surgery to remove her uterus until after graduation, and later became a certified nurse practitioner. Now she provides Pap smears to patients multiple times a day at Planned Parenthood clinics in Kentucky and Indiana and other care via telehealth. She recently helped a patient who hadn’t been seen for a screening in 15 years discover she had advanced cervical cancer.

She is troubled by what could happen in the wake of the new Medicaid rule passed by Congress and signed by President Donald Trump in July that barred nearly all Planned Parenthood affiliates from receiving Medicaid reimbursements because some clinics in the nonprofit network provide abortions. Kentucky and Indiana both have abortion bans, but still have Planned Parenthood clinics to provide other reproductive health care.

“I don’t just worry; I know that there’s going to be more folks with stories like mine, but without the happy ending,” Deis said.

‘What we’re really talking about is our daughters getting cervical cancer’

The American Cancer Society recently reported the number of early cervical cancer cases has declined sharply among young people since the vaccine’s introduction nearly 20 years ago. But vaccine adoption rates for children are low in the states where rates are highest — about one-third of boys and girls between the ages of 13 and 17 were vaccinated in Mississippi as of 2020.

The vaccine is most effective when given before engaging in any kind of sexual activity for the first time, because it can prevent the sexually transmitted strains of HPV that present the highest risk of cervical cancer. More than 98% of cervical cancer cases are caused by HPV, and a 2024 study from the Journal of the National Cancer Institute found zero cases of cervical cancer in Scottish women born between 1988 and 1996 who were fully vaccinated against HPV between the ages of 12 and 13.

“We could make (cervical cancer) an eradicated disease,” said Dr. Emily Boevers, an Iowa OB-GYN. “But everything is falling apart at the same time.”

Boevers said limitations on Medicaid coverage and the loss of Title X family planning funding will make screenings and vaccines less accessible for the populations that need them the most, even if clinics don’t close as a result. But it will take years to see the consequences of these changes, she said, because it takes about 15 years on average for HPV to become cancer. 

“So what we’re really talking about is our daughters getting cervical cancer,” she said. 

Kentucky’s legislature acknowledged the importance of HPV vaccines as recently as 2019, when representatives passed bipartisan House Resolution 80, which encouraged females and males between the ages of 9 and 26 to get the HPV vaccine and everyone to “become more knowledgeable of the benefits of the vaccine.” Only four legislators voted against it.

But today, the U.S. Department of Health and Human Services is led by Secretary Robert F. Kennedy Jr., who has made false statements about the HPV vaccine’s safety and effectiveness and played a leading role in organizing a mass lawsuit against one of the vaccine’s manufacturers, Merck. The Associated Press reported the judge dismissed more than 120 claims of injuries from Gardasil, the name of one HPV vaccine, because of a lack of evidence. 

“Secretary Kennedy supports renewing the focus on the doctor-patient relationship and encourages individuals to discuss any personal medical decisions, including vaccines, with their healthcare provider,” a Health and Human Services spokesperson wrote to States Newsroom in September. “The American people voted for transparency, accountability, and the restoration of their decision-making power, and that is exactly what HHS is delivering.”

The response did not clarify whether Kennedy still thinks the vaccine is unsafe and what basis there is for that claim. 

Dr. Linda Eckert, a University of Washington School of Medicine professor and practicing OB-GYN, has an extensive background in immunizations and cervical cancer prevention. She served as a liaison for the American College of Obstetricians and Gynecologists to the CDC’s Advisory Committee on Immunization Practices until 2024. Members of the committee were recently dismissed by Kennedy’s agency and replaced by new members, several of whom have reportedly expressed anti-vaccine views. Eckert said the group had plans in motion to present to the ACIP in June a case for administering the HPV vaccine at the earliest age of 9 before it was disbanded. 

Although Black and Hispanic women are affected by cervical cancer at disproportionate rates because of systemic inequities, Eckert said the fastest rising group experiencing late-stage cancer is white women in the Southeast. But she added that Alabama was the first state in the country that launched a targeted campaign to eliminate cervical cancer. 

Treatment for the cancer once it develops can also be difficult to obtain, Eckert said. It can be expensive and require many follow-up visits, and usually leads to infertility either through hysterectomy or invasive radiation treatments. 

“It is a really devastating disease to treat,” Eckert said. “Even if you live, you are permanently changed.”

Recent study showed zero cases of cervical cancer after HPV vaccine 

Dr. Aisha Mays, founder and CEO of a Dream Youth Clinic in Oakland, California, said the services her clinic offers to young people for free includes most of the same services that Planned Parenthood clinics provide, including the HPV vaccine.

“That’s the work of Planned Parenthood and clinics like mine that are encouraging and doing regular Pap smear screenings and vaccines, and having really clear conversations with young people around the importance of these procedures,” Mays said.

The recent turn against vaccines by some segments of the public and members of President Donald Trump’s cabinet who doubt their effectiveness and baselessly claim that they cause injury and developmental issues like autism has made the promotion of HPV vaccines more difficult for Mays. Overwhelming evidence, including from the Centers for Disease Control and Prevention, shows that they are safe and effective.  

The vaccine can also protect against genital warts, anal cancer and oropharyngeal cancer, Mays said. There are about 40 strains of HPV in total that are known to infect the genitals, and more that can attach to certain patches of skin. Most people who have sex will come in contact with one or more of the strains by the time they reach their mid-20s or early 30s.

Mays’ clinic is largely funded by state and local grants, but it received more than $100,000 in federal funding for a sexual health education program through the U.S. Department of Health and Human Services’ Office of Population Affairs. It was a nationally distributed podcast hosted by adolescents, Mays said, and they chose topics to talk about related to sexual health, including HPV.

The program’s grant was one of many that have been cancelled under the Trump administration. An objective laid out in Project 2025, the blueprint document for the next Republican presidency written by conservative advocacy group the Heritage Foundation, was to ensure no subgrantees of sex education programs were promoting abortion or “high-risk sexual behavior” among adolescents. It also stated that any programming should not be used to “promote sex.”

HHS also terminated funding for one of California’s sexual health programs in August over the state’s refusal to remove references in the programming related to gender, including the idea that biological sex and gender identity are distinct concepts. Another directive of Project 2025 was to make sure biological sex is never conflated with gender identity or sexual orientation.

States with high rates of cervical cancer have low density of physicians

States with the lowest incidences of cervical cancer, including Massachusetts, New Hampshire, Connecticut and Minnesota, also have the highest density of physicians per capita. According to the Association of American Medical Colleges’ state physician workforce data, Massachusetts has the highest number of physicians per 100,000 people, and Oklahoma ranks in the bottom three.

Kentucky is in the bottom 15, and so is Indiana, where Marissa Brown works as a Planned Parenthood health center manager in Bloomington. Brown described her clinic as “an oasis in a desert” because there are few options for gynecological care in the area, and even fewer for obstetrics. Brown said they routinely see patients from rural areas two or more hours away, and many of them are coming for wellness exams that include cancer screenings.

Indiana used to have 38 Planned Parenthood clinics, but through 15 years of funding cuts and targeted anti-abortion legislation, the organization closed 21 of them between 2002 and 2017. In the years since then, another seven shut down to consolidate services. Many of them did not provide abortions.

“We hear a lot about patients coming in who can’t get into their gynecologist for four to 12 weeks,” Brown said. “We can do that in a few days to two weeks, and we have walk-in appointments too.”

Health Imperatives, a nonprofit network of seven community health clinics in southern Massachusetts, can no longer bill for Medicaid because they provide medication abortions and received about $800,000 in reimbursements for other services in 2023, like Planned Parenthood. One of Health Imperatives’ clinics is in Martha’s Vineyard, whose working-class residents have to work three to four jobs just to afford to live on the affluent island, said Julia Kehoe, the organization’s president and CEO.

More than a decade ago, she said she noticed a pattern: Their patients would come in for an annual gynecological exam, receive an abnormal cervical cancer screening, but not follow up, because the closest available specialist would require expensive travel off the island. Kehoe said that once their Martha’s Vineyard clinic purchased a colposcopy machine, from privately raised funds, in 2012, they started diagnosing some of their regular patients with now-advanced cancer.

“In the first year that we did colposcopies, we found four individuals who had stage three or four cancer, who we luckily were then able to connect up to Boston for critical care,” she said. “But if we had had that capacity earlier … we would have caught it earlier.”

States Newsroom reproductive rights reporter Sofia Resnick contributed to this report.

Coming Thursday: Telemedicine could help narrow the care gap in rural communities.

Ashley Mathy and Cindy Bentley, who both identify as having autism, record a video for the Self Determination channel on YouTube, a project of the Wisconsin Board for People with Developmental Disabilities (BPDD). States Newsroom spoke with three medical experts about the state of research as well as the complexity involved in understanding autism spectrum disorder. (Photo courtesy of the Wisconsin BPDD)

WASHINGTON — Health and Human Services Secretary Robert F. Kennedy Jr. stirred up major concerns and considerable speculation earlier this year when he announced the administration would release a report revealing the causes of autism by the end of September. 

Kennedy, an environmental lawyer with no medical degree, stood next to President Donald Trump on Sept. 22 as they presented the over-the-counter drug Tylenol as one potential driving factor behind autism diagnoses and pointed to folate, a B vitamin, as a possible treatment — both conclusions the medical community hasn’t yet reached. 

Kennedy throughout his tenure has also made overly broad and disparaging statements about people who have an autism diagnosis, often referring to traits exhibited in people with the most severe cases. For example, he claimed in April that children with autism would never function as independent adults, drawing intense criticism for making a generalization that would not apply to every person with a diagnosis.

The Trump-Kennedy announcement and Kennedy’s characterizations have raised questions about why someone would be diagnosed, what types of research have been done and what reputable science has found about causes. 

States Newsroom spoke with three experts before the announcement to gain a better understanding of autism spectrum disorder. Below are brief excerpts from those interviews. 

What is autism spectrum disorder? 

The two core characteristics of autism are challenges with social communication and the presence of restrictive and repetitive behavior, according to Autism Science Foundation Chief Science Officer Dr. Alycia Halladay. 

As understanding of the diagnosis has evolved, she explained, researchers and families have increasingly referred to it as autisms, plural, instead of autism, singular, in part, because there are so many different subtypes.

“It makes it more accurate when describing it — that autism is not just one entity of core autism features, that there is so much diversity across the spectrum, that it’s actually a group of developmental disorders,” Halladay said. 

The spectrum, she said, ranges from people who may speak rarely to those who are fluent in language, people with cognitive disabilities to those with IQs of more than 120 and people who can live independently to those who need round-the-clock care.

Dr. Michael Murray, a professor in the Department of Psychiatry and Behavioral Health at the Penn State College of Medicine, described it as “a neurodevelopmental disorder, meaning that people are born with it and it’s lifelong and it can cause a variety of challenges for people.”

“The most common and significant and probably pervasive symptom across the spectrum is challenges in understanding and interpreting what we call neurotypical — meaning everyone who is non-autistic — social behavior,” Murray said. “So just understanding all the non-verbal parts of social communication, understanding nuance and non-literal use of language. All those things can be really difficult for autistic people.”

Approximately 1 in 31 children in the United States and 1 in 45 adults fall somewhere along the autism spectrum,  according to data from the Centers for Disease Control and Prevention and a paper published in the Journal of Autism and Developmental Disorders. 

How is autism diagnosed?

Only an expert can diagnose an autism spectrum disorder using criteria in a guide used by health care professionals called the Diagnostic and Statistical Manual of Mental Disorders, or DSM. 

“You need someone who knows autism, who knows what to look for, who knows how to elicit behaviors or not elicit behaviors that are indicative of an autism diagnosis,” Halladay said. “So it’s really diagnosed by a psychiatrist, a psychologist, or somebody else who’s trained to understand what autism is and what it’s not.”

Murray said there are three social communication behaviors that doctors or other qualified medical professionals look for when considering whether to diagnose someone with autism. 

“It is difficulty in interpreting social information. It is difficulty giving social information through things like facial expression and tone of voice. And thirdly, is a difficulty maintaining appropriate peer relationships,” Murray said. “Now, once again, this is from a neurotypical description of peer relationships. There’s a lot of talk among neurodivergent individuals about whether that’s fair, that we rate social relationships based on how we think they should be. But nonetheless, that’s the criteria.”

Murray explained experts also observe the presence of restrictive and repetitive behaviors in assessing whether someone has autism. 

“And that captures things that are in the realm of interacting with the physical world around you,” Murray said. “So that need for sameness and inflexibility maintaining routines.”

Carissa Cascio, a senior scientist at the University of Kansas Life Span Institute and Kansas Center for Autism Research and Training, reinforced that autism is “strictly diagnosed based on behavior.”

“There are genes that have an association with autism that you can test for. There’s some genes that have a very strong association, and you can do a test for the presence of one of those genes,” Cascio said. “But for the diagnosis of autism itself, it’s strictly based on behavior.”

What do we know about the causes of autism?

While more scientific research is needed, a combination of genetics and environmental factors is responsible for the formation of autism spectrum disorders. 

“We know that one of the largest causes of autism is genetics. We know this because it runs in families,” Halladay said, adding there “are over 150 known genes associated with autism.”

“If there’s a variation in the gene, there’s a high likelihood of having an autism diagnosis,” she said. “And those genes are genes that tell cells in the brain where to go and how to connect, which seems to be a core biological feature of autism.”

Halladay emphasized that research has established the “most important part is the interaction between genetics and the environment.”

“Neither the gene nor the environmental factor is strong enough, but together, they increase the probability of having a child with autism,” Halladay explained. 

During the last 25 years, as Murray has advanced in his career, the medical community’s thinking about and understanding of autism spectrum disorders has “significantly increased.”

“We know right now that 80 to 90% of autism is accounted for by genetic differences …. It’s not just you got exposed to this thing in the environment, now you have autism. You have to have the genetic susceptibility first and then the environment might make it more likely, or maybe influence the expression of it,” Murray said.

Cascio said that when it comes to environmental factors, studies have shown pregnancy or the very early post-natal time frame are key. 

“We’re still parsing this out, but some of the environmental factors that seem to have more evidence behind them than others are older parental age, perinatal trauma, premature birth and low birth weight,” Cascio said. “And then there’s some maternal health factors that are gathering some evidence as well. So maternal infection and immune response, maternal exposure to medications or pollutants are sort of gathering some evidence.” 

While much more research is needed on the many potential environmental factors, Cascio said scientists know vaccines are not a component. 

“The things that we definitely can rule out are things that have been studied in great depth and not really produced much association. So you know, the idea that vaccines cause autism is a common belief. There have been dozens and dozens of studies that have all failed to find any association between vaccines and autism,” Cascio said.

There’s also not yet a clear link with Tylenol, also called acetaminophen, as a possible environmental factor. 

“It is unlikely that this is the smoking gun that they’re hoping for,” Cascio said. “I think we all want to understand this better, but this is certainly not something that we feel has a strong weight of evidence behind it yet.”

A spokesperson for Kenvue, the company that manufactures Tylenol, wrote in a statement released in connection with the Trump-Kennedy press conference that “acetaminophen is the safest pain reliever option for pregnant women as needed throughout their entire pregnancy.  

“Without it, women face dangerous choices: suffer through conditions like fever that are potentially harmful to both mom and baby or use riskier alternatives. High fevers and pain are widely recognized as potential risks to a pregnancy if left untreated.”

Why have autism diagnoses increased over several decades? 

Health and Human Services Secretary Kennedy has repeatedly raised concerns with an increase in autism diagnoses over several decades, but experts say there are logical reasons for this. 

“In the early 1990s the CDC set up a system to collect and count the number of people with autism,” Halladay said. “So it definitely has increased since then, but one of the main reasons that’s been shown over and over again is access to services.”

Halladay believes most of the increase is due to greater knowledge and access, though she said, “there is room for some of the increase in autism to be a true increase in the number of people with autism due to something else.”

Murray explained that about 60% to 70% of people diagnosed as being on the autism spectrum are characterized as having “low-support needs, meaning that they clearly have the features of autism, but they are able to, with the appropriate level of supports, be in traditional schools or typical schools; they can, with job support, work and lead their lives the way they choose to.”

When Murray began his career, he said, those people never would have been diagnosed as having autism.  

“Secondly, we as a professional community are getting better and better at picking up these symptoms, particularly in kids who are quite young,” Murray said.

During the late 1980s and 1990s, Cascio said, a new version of the DSM and better tools helped medical professionals more accurately diagnose people along the entire autism spectrum. 

Additionally, Cascio said, there’s a similar concept called diagnostic substitution, where people who in the past may have been diagnosed with something else are now being correctly diagnosed with autism. 

How much research has been done on autism and over how many years?

Scientists have been researching autism for decades, building on past work to better understand how to diagnose and assist people across the spectrum, though experts said more is needed.

“The many, many scientific discoveries and funding into understanding autism has promoted scientists moving into the field,” Halladay said. “So there’s clearly an increased number over the past two decades of the number of people who are focused on studying autism.”

Murray said the first papers published in scientific journals regarding autism were in 1944. 

“So it is 80 years, at a minimum, of work,” Murray said.

Murray reiterated that autism spectrum disorders are not simple to study and said a “really important paper came out earlier this year talking about how there’s four genetically recognizable subtypes of autism. So it’s not a single autism. It is, at the very least, four autisms, and probably more.”

Cascio said addressing any aspect of autism is complicated.

“The behavior is complex. The genetics are complex. The brain is complex,” Cascio said. “And so this makes it a huge challenge for research. And there’s certainly no possibility that we would go from not fully understanding the causes of autism to having a definitive cause in five months.”

What are some of the biggest misconceptions about autism? 

The internet has led to misinformation, and in many cases disinformation, and health diagnoses are no exception.  

Halladay said people often try to simplify autism or believe an actor’s portrayal in a television show or movie is representative of everyone on the spectrum. 

“I think that because of the narrative of autism being oversimplified, that people are not understanding that it’s a more complex disorder,” she said. 

Murray said the autism spectrum may be pictured as a straight line and an expectation arises when someone is diagnosed that they are in just one spot. 

“That’s not really the way it is. There are needs or strengths that show up variably depending on the demands of the situation,” Murray said. “So for instance, someone who has a really exquisite sensitivity to sound, if they are attending a symphony, that may make that experience so much more rich for him or her versus the average person. 

“But if they are at a rock concert, it may be overwhelming. The same trait can be a source of vulnerability or a strength depending on the situation.”

Murray said there’s often a misconception that all people with autism are antisocial or don’t want to make and maintain friendships.  

“And that’s true for some people, right? They aren’t really interested in social interactions. It’s not their thing,” Murray said. “It’s also true for some neurotypical people that they’re really not interested in social interactions. But the vast, vast majority of autistic individuals just want a friend, and they want someone who they can count on and rely on. They want to be loved, just like everyone else in the world … They just need more supports or different situations to have that happen.”

Cascio said that people can form misconceptions after seeing actors portray people along the spectrum.

“I first became interested in autism after watching the movie ‘Rain Man,’” Cascio said. “And I think there’s a lot of people who see a depiction like that and think, ‘Okay, this is what autism looks like.’ And there’s just so much more complexity and variability from person to person and I would say that’s probably the biggest misconception.”

Cascio said it’s also human nature to want one clear answer to why someone develops autism or any other health diagnosis, but that oftentimes the best science shows a more complicated picture. 

“It’s uncomfortable for us to say, ‘This is really complex and we don’t understand it yet,’” she said. “And so when there is something that people hold up and say, ‘Here’s an explanation.’ I think it can be really tempting for people to just want to have it solved. And that’s a very natural reaction.”

U.S. Health and Human Services Secretary Robert F. Kennedy Jr., joined by President Donald Trump, delivers an announcement on “significant medical and scientific findings for America’s children” in the Roosevelt Room of the White House on Sept. 22, 2025 in Washington, D.C.  (Photo by Andrew Harnik/Getty Images)

WASHINGTON — President Donald Trump announced Monday that his administration believes it’s found one contributing factor of autism and a possible treatment, though experts have said such claims are inconclusive and not backed by scientific evidence.

Trump and officials from his administration said during a press conference the Food and Drug Administration will move to update the label on Tylenol, also called acetaminophen, to reflect their concerns that it could potentially be one of the environmental causes of autism. Numerous medical organizations and the manufacturer say there is no proven link.

The FDA will also publish a notice in the Federal Register to change the label on leucovorin, a pharmaceutical intended to counteract the negative effects of certain cancer medications, so that doctors can prescribe it as a potential treatment for autism. 

“They are strongly recommending that women limit Tylenol use during pregnancy unless medically necessary,” Trump said. “That’s, for instance, in cases of extremely high fever that you feel you can’t tough it out. You can’t do it. I guess there’s that.”

Health and Human Services Secretary Robert F. Kennedy Jr. said the FDA “is responding to clinical and laboratory studies that suggest a potential association between acetaminophen use during pregnancy and adverse neurodevelopmental outcomes, including later diagnosis for ADHD and autism.”

Kennedy noted, however, that the FDA recognizes that Tylenol “is often the only tool for fevers and pain in pregnancy, as other alternatives have well documented adverse effects. 

“HHS wants, therefore, to encourage clinicians to exercise their best judgment in the use of acetaminophen for fevers and pain in pregnancy by prescribing the lowest effective dose for the shortest necessary duration and only when treatment is required.”

Kennedy, an environmental lawyer with no medical or research training, said in April the department will shift its research into autism toward potential environmental causes, and pledged to have “some of the answers by September.”

‘Not a single reputable study’

Trump and Kennedy’s announcement was met with deep skepticism. 

Alison Singer, president of the Autism Science Foundation, wrote in a statement released Monday that she’s “unsure why this announcement came today and how the conclusions were drawn.”

“No new data or scientific studies were presented or shared. No new studies have been published in the literature. No new presentations on this topic were made at scientific or medical conferences,” Singer wrote. “Instead, President Trump talked about what he thinks and feels without offering scientific evidence. He said ‘tough it out,’ meaning don’t take tylenol or give it to your child. It took me straight back to when moms were blamed for autism. If you can’t take the pain or deal with a fever, then it’s your fault if your child has autism. That was shocking. Simply shocking.”

American College of Obstetricians and Gynecologists President Dr. Steven J. Fleischman wrote in a statement the Trump administration’s claim about Tylenol is “not backed by the full body of scientific evidence and dangerously simplifies the many and complex causes of neurologic challenges in children.”

“In more than two decades of research on the use of acetaminophen in pregnancy, not a single reputable study has successfully concluded that the use of acetaminophen in any trimester of pregnancy causes neurodevelopmental disorders in children,” Fleischman wrote. “In fact, the two highest-quality studies on this subject—one of which was published in JAMA last year—found no significant associations between use of acetaminophen during pregnancy and children’s risk of autism, ADHD, or intellectual disability.”

ACOG writes on its website that women who experience headaches during pregnancy can use over-the-counter medications like Advil, also called ibuprofen, and Aleve, also known as naproxen, “for migraines that don’t get better with acetaminophen, but only in the second trimester and only for 48 hours or less at a time. It’s not clear if NSAIDs are safe for a fetus during the first trimester. Taking NSAIDs during the third trimester may lead to birth defects.”

Oz wants state Medicaid programs to cover prescriptions

At the press conference, FDA Commissioner Dr. Marty Makary said leucovorin could possibly help alleviate low folate levels, which may be one potential factor in autism. 

“Autism may also be due to an autoimmune reaction to a folate receptor on the brain not allowing that important vitamin to get into the brain cells,” Makary said. “We have a duty to let doctors and the public know we are going to change the label to make it available. Hundreds of thousands of kids, in my opinion, will benefit.”

Administrator of the Centers for Medicare and Medicaid Services Dr. Mehmet Oz said the agency will try to ensure anyone on a government health program can have a prescription for leucovorin covered. 

“Over half of American children are covered by Medicaid and CHIP,” Oz said. “Upon this label change, state Medicaid programs in partnership with CMS will cover prescription leucovorin around the country. It’s yours, but you have to go to a doctor to get a prescription, because they know your child, they know you and they know the medication.”

Oz said he believed that “private insurance companies will rapidly follow our lead if they have not already done so.”

CMS, he said, is also contacting state governments to aid the Trump administration in studying the use of leucovorin as a possible treatment for autism. 

“Collecting real-world data, which is what many of you have been asking us to do in the community, is fast, it is life-saving and we’ll get answers based on what happens over the next few months with this approach,” Oz said. 

NIH research projects picked

Director of the National Institutes of Health Jay Bhattacharya said his agency has selected 13 projects to receive a share of $50 million to look for autism’s root causes and therapies. 

“The studies feature a new kind of science called exposomics, where scientists consider environmental and medical factors, nutrition, events during pregnancy in combination with biology and genetics to answer vital questions about autism,” Bhattacharya said.

Bhattacharya also gave a brief description of autism spectrum disorder, noting it “encompasses a very wide range of symptoms, ranging from mild difficulties in social interactions to profoundly autistic children who experience severe disabilities in speech and behavior.

“Given this wide range of symptoms across the spectrum, it seems certain that there will be a wide range of biological contributors to explaining the cause.”

‘Findings are not entirely consistent’

The Autism Science Foundation wrote in a statement released earlier this month that “low maternal folate levels during early pregnancy have been linked in several studies to an increased risk of autism in children, though findings are not entirely consistent.”

“Data suggesting that leucovorin may be effective come from four small randomized controlled trials, all using different doses and different outcomes, and in one case, reliant on a specific genetic variant,” the Autism Science Foundation notes. “This science is still in very early stages, and more studies are necessary before a definitive conclusion can be reached.”

As for Tylenol, the Society for Maternal-Fetal Medicine released a statement earlier this month that it “continues to advise physicians and patients that acetaminophen is an appropriate medication to treat pain and fever during pregnancy.”

“At this time, the weight of scientific evidence that acetaminophen use during pregnancy causes an increased risk for autism or ADHD is simply inconclusive,” SMFM President Sindhu K. Srinivas wrote in the statement. “In maternal-fetal medicine, as in all of medicine, our recommendations are based on an evaluation of rigorous research and data, clinical expertise, and our patients’ values and preferences.” 

The statement goes on to say that “untreated fever and pain during pregnancy carry significant maternal and infant health risks. Untreated fever, particularly in the first trimester, increases the risk of miscarriage, birth defects, and premature birth, and untreated pain can lead to maternal depression, anxiety, and high blood pressure.” 

Former Chief Medical Officer at the Centers for Disease Control and Prevention Dr. Debra Houry, who resigned from the agency earlier this year, said on a call with reporters before the announcement that she was concerned the conclusions will be premature and not based on solid science. 

“As of three weeks ago, we hadn’t seen evidence that acetaminophen was linked with autism, so it’s curious to know how quickly that was developed,” Houry said. 

Tylenol has information on its website rebutting the assertion that its product has been conclusively linked as a contributor to autism diagnoses. 

“Credible, independent scientific data continues to show no proven link between taking acetaminophen and autism,” its website states. 

The company adds that the best advice is for people to talk “to your healthcare professional before taking or administering acetaminophen.”

Former Director of the Centers for Disease Control and Prevention Susan Monarez testifies before the Senate Committee on Health, Education, Labor, and Pensions in the Dirksen Senate Office Building on Sept.17, 2025 in Washington, DC. (Photo by Kevin Dietsch/Getty Images)

WASHINGTON — Former Centers for Disease Control and Prevention Director Susan Monarez testified before a U.S. Senate committee Wednesday that she was fired after just 29 days because she refused to pre-approve vaccine recommendations or fire career officials for no reason. 

Monarez, who was nominated by President Donald Trump earlier this year and confirmed by the Senate in July on a party-line vote, became a central figure in the country’s debate over public health last month after she refused to resign. 

Monarez testified that during a meeting in late August, Health and Human Services Secretary Robert F. Kennedy Jr. told her she needed to commit to approving upcoming recommendations from the Advisory Committee on Immunization Practices without reviewing any data or research. 

“He also directed me to dismiss career officials responsible for vaccine policy without cause. He said if I was unwilling to do both, I should resign,” Monarez said. “I responded that I could not pre-approve recommendations without reviewing the evidence and I had no basis to fire scientific experts.”

Monarez testified before the Health, Education, Labor and Pensions Committee during the nearly three-hour hearing that she told Kennedy if he didn’t trust her, then he could fire her.

During that same late August meeting, Monarez said Kennedy told her the childhood vaccine schedule would be changing in September and that she needed to be on board with that.

“We got into an exchange where I had suggested that I would be open to changing childhood vaccine schedules if the evidence or science was supportive,” Monarez testified. “And he responded that there was no science or evidence associated with the childhood vaccine schedule.”

ACIP is scheduled to meet Thursday and Friday at the CDC’s headquarters in Atlanta, Georgia. 

Kennedy testified before a separate Senate committee earlier this month that he did demand that Monarez fire career CDC scientists but said he didn’t tell her to accept the recommendations of the vaccine advisory panel without further review.

“What I asked her about is she had made a statement that she was going to not sign on and I wanted clarification about that,” Kennedy said at the time. “I told her I didn’t want her to have a role if she’s not going to sign onto it.”

Vaccine safety at issue

Monarez said that undermining vaccine safety will lead to an increase in preventable diseases, some of which have long-term or even lifelong consequences for children’s health. 

“I believe that we will have our children harmed for things that we know they do not need to be harmed by — polio, measles, diphtheria, chickenpox,” she said. 

Former CDC Chief Medical Officer Dr. Debra Houry told the committee there are significant ramifications if the new members of the Advisory Committee on Immunization Practices, who were appointed by Kennedy after he fired all of the former members, don’t use rigorous science and data to make their recommendations. 

“It’s going to be heartbreaking,” Houry said. “I think what concerns me is these aren’t harmless diseases. We just saw the case in California of a young child that died of encephalitis years after measles. These diseases have long-term consequences and in the U.S. we have gone so far in reversing this. We don’t want our children to die.”  

Houry was one of several CDC officials who resigned after learning about Monarez’s firing, which happened just weeks after a gunman opened fire at the CDC’s headquarters, killing a police officer. 

Both Monarez and Houry testified, in response to a question from Connecticut Democratic Sen. Chris Murphy, that confusion about vaccines and CDC recommendations had real consequences. 

“I myself was subject to threats,” Monarez said. “And I am very concerned that the further promulgation of misleading information will undermine not just the safety and health of our children, but it will also exacerbate some of these tensions — the willingness to commit harm if someone is affronted by a belief that the people like us that are trying to help them are actually not trying to help them.” 

Houry told the committee the gunman fired about 500 rounds, with approximately 180 of those hitting the building. 

“Each bullet was meant for a person, and each of my staff were very traumatized afterwards,” Houry said. “I had staff that were covering their kids in the day care parking lot. There were people that were out at the ride-share as bullets were passing over their head. I have many that won’t speak about vaccines now and removed their names off of the papers. They don’t wish to present publicly anymore because they feel they were personally targeted because of misinformation.”

‘Did we do something wrong?’

HELP Committee Chairman Bill Cassidy, R-La., said at the beginning of the hearing he intended to invite Kennedy and possibly other HHS officials to testify before his committee later in the year if they wanted to respond to what was said in the Wednesday hearing. 

He also raised concerns that Monarez was fired after less than a month in the role, despite her being nominated by Trump, confirmed by the Senate and Kennedy saying while swearing her in that she had “unimpeachable scientific credentials.”

“We as senators need to ask ourselves, did we look past something? Did we do something wrong?” Cassidy said. “It may be that we did nothing wrong, in which case, Dr. Monarez and Dr. Houry, the onus is upon you to prove that the criticisms leveled by the secretary are not true.”

Cassidy later added that “it may be impossible to learn who’s telling the truth.”

Vermont independent Sen. Bernie Sanders, ranking member on the committee, said the Trump administration’s decision to fire Monarez after less than a month in the CDC director’s role was because “she refused to act as a rubber stamp to implement Secretary Kennedy’s dangerous agenda to substantially limit the use of safe and effective vaccines that would endanger the lives of the American people and people throughout the world.”

Sanders raised concerns that the loss of career officials at the CDC and other federal health agencies could hamper the country from addressing disease outbreaks in the months and years ahead. 

Confusion over whether Monarez was recorded

There were a few awkward moments in the hearing, in addition to the serious discussion about the Trump administration’s approach to public health. 

One came after Florida Republican Sen. Ashley Moody mentioned twice during her five minutes of questions that Monarez had spoken with Cassidy about her firing, implying that was somehow improper.  

Cassidy gave a lengthy statement afterward, clarifying the record. 

“As chairman of the committee with jurisdiction over the CDC that favorably reported Dr. Monarez as the CDC director, it is entirely appropriate for someone with oversight concerns to contact my office, or me, or frankly any of us,” Cassidy said. “Upon receiving outreach from Dr. Monarez, I contacted both the secretary and the White House to inquire about what was happening and to express concerns about what was alleged. As soon as the director was fired, the HELP Committee began reviewing the situation, as it is our responsibility, and any and all communication with the witnesses was conducted by HELP staff in coordination with attorneys.”

Another somewhat uncomfortable and slightly confusing moment came after Oklahoma Republican Sen. Markwayne Mullin told Monarez that someone had recorded her meeting or meetings with Kennedy.

Mullin then repeatedly questioned her recollection of her conversations with Kennedy, implying that he had a different view because he had listened to the recording. 

The exchange led Cassidy to give another statement to the committee. He appeared somewhat frustrated that someone gave just one senator on the panel the recording, that Mullin had not shared it with any other members of the committee and that HHS had chosen not to give it to the committee in response to a request for documents related to Monarez’s firing. 

“If a recording does not exist, I ask Sen. Mullin to retract his line of questions,” Cassidy said. “I’ll also note that if he has it, I’m also curious why only one senator was given this and why we’re just hearing about it now.”

A few minutes later, Cassidy announced to the hearing room that Mullin told reporters elsewhere that he was mistaken about there being a recording of the meeting or meetings. 

Monarez lawyer

Several GOP senators on the panel also questioned Monarez at length about when and why she chose to hire legal representation and why she ultimately went with Mark Zaid, who has made public statements against Trump and his policies. 

Monarez testified that she wasn’t aware of Zaid’s political beliefs when she hired him and hasn’t spoken with him about politics. 

“I was seeking some critical counsel to be able to help me make sure that I was understanding and aware of everything that had transpired and preparing for what might be next, including this committee hearing,” Monarez said. “Mark and I have never spoken about politics. I never asked him about his politics. He has never asked me about my politics.”

In this photo illustration, a pharmacist holds a COVID-19 vaccine. States and clinicians are working on getting correct information on vaccines to vulnerable groups amid shifting federal guidance. (Photo illustration by Joe Raedle/Getty Images)

The state health department is recommending COVID-19 vaccines for all Wisconsinites 6 months and older and authorizing pharmacies to give the vaccine without an individual prescription.

In addition, Wisconsin’s insurance regulator issued guidance to health insurance companies that the shots are to be provided without a patient co-payment.

Both department declarations were issued Tuesday following Monday’s executive order from Gov. Tony Evers to protect vaccine access.

At the Department of Health Services (DHS), Dr. Ryan Westergaard, chief medical officer and state epidemiologist for communicable diseases, issued a standing medical order recommending the vaccine for all eligible Wisconsin residents this fall. With the order, no prescription is needed, DHS said.

The health department said its recommendation for the vaccine follows guidance from the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians.

States, public health organizations and agencies have been stepping in to recommend the vaccines for COVID-19 and for other communicable diseases following a shift at the federal Department of Health and Human Services (HHS) away from vaccine recommendations under the administration of President Donald Trump and HHS Secretary Robert F. Kennedy Jr.

Kennedy, who has long embraced anti-vaccine views, has replaced the members of a CDC committee on vaccination with vaccine skeptics, and the body is expected to consider softening or eliminating some recommendations for the COVID-19 vaccine and some childhood immunizations. 

The Food and Drug Administration has narrowed its recommendations for the COVID-19 vaccine to people 65 or older, while public health advocates have called for maintaining the vaccine schedule for all ages.

The DHS order states it “is also intended to authorize vaccination for other groups for whom professional society guidance supports vaccination — such as children, adolescents, pregnant people, and healthy adults under 65 — even though these uses are considered ‘offlabel.’”

“Everyone in Wisconsin should be able to make the choice to protect themselves and their families against COVID-19, and that choice should be based on the best available science and medical recommendations,” DHS Secretary Kirsten Johnson said in a department statement. “As the federal government limits access to the vaccine, we want to reassure Wisconsinites that recommendations from our nation’s leading medical associations are clear, and we will work every day to support access to care and resources to help families make the best decisions on how to protect themselves from illness and disease.”

The Office of the Commissioner of Insurance (OCI) said in a bulletin that based on “the evidence-based guidance” from DHS and state laws against discrimination in insurance coverage, “the commissioner continues to expect that all governmental self-funded and fully insured group health plans and individual health plans will cover, without cost sharing, all costs associated with administration of COVID-19 vaccinations for all policyholders.”

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