Bulwark Takes: Dr. Ashish Jha SHREDS Trump’s Pseudoscience

Podcast: Bulwark Takes
Host: Jonathan Cohn (for The Bulwark)
Guest: Dr. Ashish Jha, Dean, Brown University School of Public Health
Date: September 24, 2025

Episode Overview

In this episode, Jonathan Cohn is joined by Dr. Ashish Jha to dissect and rebut a recent White House press conference in which former President Donald Trump made unsubstantiated claims linking Tylenol (acetaminophen) and childhood vaccines to autism. Dr. Jha provides a science-based, commonsense perspective, debunking misinformation and discussing the real risks and tradeoffs in pregnancy and vaccine policy.

Key Discussion Points & Insights

1. Reactions to the Trump Press Conference

• Initial Impressions:
  Dr. Jha calls it “possibly the worst public health conference coming out of the White House I have ever seen,” claiming it was even worse than Trump’s infamous 2020 “bleach” press briefing.

  • “It was terrible. And I cannot imagine if you’re a pregnant woman who saw that and went to bed last night, what you must be thinking about how you’re going to manage the rest of your pregnancy.” (Ashish Jha, 03:22)

• Critical Tone:
  The episode is frank, at times incredulous, at the lack of scientific foundation and the potential harm of Trump's statements, especially to pregnant women.

2. The Science Behind Tylenol/Acetaminophen and Autism

• Trump’s Claim: That Tylenol in pregnancy is “linked to autism.”

  • “Don’t take Tylenol, don’t take it. Fight like hell not to take it.” (Donald Trump, 05:25)

• State of the Evidence:

  • There have been small, not super well-done studies suggesting a link, but the most robust data refutes this.
  • Key Study:
    • Swedish study (JAMA, 2024): Followed 2.5 million children over 25 years. Sibling comparison showed no difference in autism rates when the same mother took Tylenol during some pregnancies but not others, controlling for confounders (e.g., genetic, maternal health factors).
      • “What you see in the Swedish study is when you look at the sibling study, the effect completely goes away.” (Ashish Jha, 07:45)
      • Danish studies corroborate this conclusion.
  • Meta-Analysis Discussed by Trump:
    • August 2025, by Andre Baccarelli et al. (Harvard): Cited as supporting the Tylenol-autism link, but in reality, it includes only 7 autism studies out of 46, and even these reflect the same limitations—the best research finds no significant association.
      • “This is not a new study that came out in August. It’s much more focused on ADHD...the best studies don’t [find an association].” (Ashish Jha, 10:52)

Memorable Quote

• “There is a real cost of telling moms, don’t take Tylenol and tough it out, because there is real potential danger to the baby.” (Ashish Jha, 14:14)

3. Why Blanket Warnings Are Harmful

• Patient Fears: Pregnant women naturally worry about what they take, but ignoring medical advice or “toughing it out” can risk both maternal and fetal health.
• Medical Nuance:
  • “Uncontrolled disease is also harmful to the baby. If you have diabetes and you don’t control it because you don’t want to take diabetes medicine, poorly controlled diabetes is not only bad for the mom, it’s actually really bad for the baby.” (Ashish Jha, 13:34)
  • High fevers, untreated pain, or substituting ibuprofen (actually riskier in pregnancy) or opioids for Tylenol can be much more dangerous.
  • “All the evidence so far suggests Tylenol is exceedingly safe in pregnancy.” (Ashish Jha, 14:04)

4. What Do We Actually Know About Autism?

• Diagnostic Expansion: Rise in autism rates is largely attributed to broader diagnostic criteria—Asperger’s, more inclusive definitions, and greater societal support (benefiting families).
• Research Agenda:
  • Further research into prenatal exposures is warranted, but Tylenol does not warrant the level of alarm given.
  • Focus should also be on other environmental toxins, pollutants, and better treatments—not just Tylenol.
  • “What I’m worried about is much of that is going to get derailed because now we’re going to put all of our attention on Tylenol, and it’s going to take us years to unwind what we saw yesterday at the White House.” (Ashish Jha, 16:52)

5. Vaccines and Autism: Debunking Pseudoscience

• Trump’s Claim: Children get “too many” vaccines too early, which is supposedly a “disgrace.”

  • “They pump so much stuff into those beautiful little babies. It’s a disgrace. I don’t see it.” (Donald Trump, 17:48)
  • He also targeted newborn Hepatitis B vaccination as unnecessary.

• Dr. Jha’s Response:

  • Children’s immune systems handle hundreds of new antigens naturally; receiving a few vaccines at once is normal and safe.
  • US vaccine schedules match those of peer countries (UK, France, Germany, etc.).
  • Result: huge declines in childhood mortality and infectious disease.
  • Memorable quote:
    • “The idea that a child’s immune system can’t handle four vaccines at once is just nonsense. Of course it can.” (Ashish Jha, 18:21)
  • Vaccines are extensively studied—downsides are minimal, upsides enormous.

6. Why Hepatitis B at Birth?

• Rationale: To prevent mother-to-child transmission, which, if it occurs at birth, significantly increases risk for chronic hepatitis, liver cancer, and liver failure.
• Americans vs. Europeans: Some European countries delay Hep B vaccine for convenience; the medical difference is marginal up to a month but after that, risk increases. The US does it at birth for maximum reach and to ensure coverage.
• Contextualizing Transmission: Hep B is not just sexually transmitted; vertical (maternal) transmission is a major source.
• Key line:
  • “This is not just a sexually transmitted disease. Again, a major source of transmission is from the mom. And it’s an exquisitely safe vaccine. We have given it to literally tens of millions of babies around the world.” (Ashish Jha, 21:28)

7. The Importance of Public Health Guardrails

• Absence of Expertise: Cohn and Jha lament the lack of scientific advisors pushing back or offering oversight around Trump versus previous administrations, where experts reviewed and edited health statements before public release.
• Making Policy by Riff: The concern is that decisions are being made off-the-cuff, risking public confusion and harm.
• Behind the Scenes: Jha relays how under President Biden, as a public health advisor, he would edit, brief, and sometimes correct the president about what could be responsibly stated.
  • “Our view was that the President’s words have a lot of meaning and they have a lot of power, and they should be used very thoughtfully and carefully.” (Ashish Jha, 23:36)
  • In contrast: “No one who followed him even made a slight effort to pull back a bit. They just sort of praised him and doubled down. That felt very alien to me.” (Ashish Jha, 24:16)

Notable Quotes & Memorable Moments

• On Trump’s Recklessness:

  • “It was possibly the worst public health conference coming out of the White House I have ever seen. It made—it was worse than the bleach presser from the pandemic times.” (Ashish Jha, 02:53)

• On Evidence and Medicine:

  • “We do this all the time in clinical practice: you think through your advice...None of that thoughtfulness went into what happened yesterday at the White House. It was this blanket, unfounded recommendation…” (Ashish Jha, 15:08)

• On the Critical Role of Scientific Dissent:

  • “That was just a normal part of how we do these things...What we saw yesterday, I wonder, did anybody brief him? Did anybody tell him where—what he could not? Like the stuff he was saying was so beyond the pale.” (Ashish Jha, 23:54)

Timestamps for Key Segments

• [02:53] Dr. Jha’s reaction to Trump’s press conference
• [05:25] Trump’s Tylenol warning, Cohn’s prompt
• [06:02–09:08] Dr. Jha reviews acetaminophen/autism evidence (Swedish & Danish studies, sibling design)
• [09:45] Discussing the Baccarelli meta-analysis
• [13:23] Why caution and “tough it out” is not good medical advice
• [15:44] How and why autism rates have gone up; what future research should focus on
• [17:48] Trump’s vaccine/autism claims and debunking
• [20:37] Hepatitis B vaccine: Why it’s given to newborns
• [23:15] Jha on the role of public health staff in presidential statements

Tone and Takeaways

This episode is sober, expert-driven, and sometimes incredulous at the level of pseudoscience being mainstreamed from the highest office. Dr. Jha emphasizes humility, the importance of data-informed medical advice, and the real personal and public health consequences of misinformation from leaders. For listeners looking for clarity amid medical and political noise, this is an episode worth digesting.