If You Care About COVID, You Should Care About Tylenol

The Scientific Process Matters

On Monday, I listened to President Trump and HHS Secretary Robert F. Kennedy Jr. make several unscientific claims: that acetaminophen (Tylenol) causes autism, that autism doesn’t occur in unvaccinated communities, and that pregnant women should accept more discomfort.

I’m concerned not only with the inaccuracy of the statements on autism, but with what they signal for the future of long COVID. Just last week, Secretary Kennedy hosted a roundtable on long COVID and showed a special interest in low-evidence treatments. Innovation is valuable, but when paired with recent claims about Tylenol, I am worried that federal health agencies may approach long COVID with the same unscientific methods they seem to be applying to autism.

Eroding Trust

We don’t know what causes autism—it is likely a multifactorial issue. Research has found it is not caused by acetaminophen. At the same time, we know that fever and uncontrolled pain in pregnancy can be dangerous. This is why both the American College of Obstetricians and the American Academy of Pediatrics continue to affirm the safety of acetaminophen use during pregnancy and for children. When public health leaders present unproven or misleading claims as fact, as they did on Monday, the result is confusion for both patients and clinicians.

I note clinicians, because the FDA is poised to change acetaminophen’s safety labeling, and issue a notice to physicians warning of its danger in pregnancy. This kind of warning—even if it’s not supported by evidence—may discourage clinicians from recommending Tylenol to pregnant patients who need it.

Official guidance from HHS carries heavy weight in clinical practice. Long COVID patients are currently hurt by a lack of such guidance; in fact, without guidelines, many doctors are hesitant to prescribe anything. But long COVID science is evolving, and I expect recommendations in the near future. If HHS messaging on long COVID is based on misinterpreted data, doctors will be placed in an untenable position, and patients will continue to suffer.

Misallocating Resources

HHS also announced that an additional fifty million dollars has been allocated for autism research. Ideally, HHS will fund high-impact studies, ones with a reasonable chance of improving our understanding of autism. By focusing on the already-debunked claims about Tylenol, we may be siphoning resources away from more prudent studies.

Long COVID patients are well aware of this dilemma. As the RECOVER-TLC Workshop recently demonstrated, there is a lot to consider when identifying and designing trials, and it helps to have a diverse set of voices weighing in. Who are the voices in the room discussing autism at HHS, and what are they saying?

Takeaways from RECOVER-TLC 2025

Gender Bias

From my seat, I heard the voices of a lot of men (Trump, Kennedy, Battacharya, Makary, Oz), and a lot of talk about mothers.

As the new HHS Autism Fact Sheet states, acetaminophen is one of the most common medications taken during pregnancy. What it forgets to note is the reason: acetaminophen is the safest pain and fever reliever in terms of fetal outcomes, and for most pregnant people it is the only available option. HHS does not offer an alternative.

Instead, the President of the United States declared, “Tylenol is not good.” “You’ll be uncomfortable,” he said, “it won’t be as easy, maybe, but don’t take it. If you’re pregnant, don’t take Tylenol.” He went on to advise pregnant viewers to “tough it out.”

This idea reflects a longstanding problem: women’s symptoms and pain are minimized. When it comes to pregnancy, there is an added expectation that suffering is natural, is necessary, and that the fetus’ needs override the mother’s. I see this play out as an anesthesiologist when I talk to pregnant women about their pain control options, during their prenatal visits and when they’re in labor. Some deny themselves or their family member safe treatments, because they believe in unproven theories. An epidural would harm the baby, they argue. Labor pain bonds the mother to the child. People have done this from the beginning of time, it’s normal.

Toughing it out is not only unethical advice, it’s impractical. Over 70% of pregnant people work during their pregnancy, and many have at least one child already. A pregnant woman’s health and comfort are necessities, if for nothing else than to uphold existing responsibilities. Her needs must not be dismissed, especially when the order to do so is unsubstantiated.

Long COVID patients, most of whom are women, also face this kind of dismissal. It’s probably hormones, we’re told. You’re anxious. Lose some weight. This type of health messaging reinforces endurance as the solution—work harder, push through. Tough it out.

These beliefs are steeped in misogyny, and the impact is broad. Gender bias in medicine is one reason we still don’t have answers to auto-immune and infection-associated conditions like ME, fibromyalgia, rheumatoid arthritis, and multiple sclerosis. These conditions have some important overlap with long COVID, including the fact they disproportionately affect women. Millions of us with long COVID would likely have more options if these diseases—and the ones suffering—had been valued more.

Why The Tylenol Debate Matters For Long COVID

The way HHS is approaching autism sets a precedent. If leadership is willing to amplify unproven claims about autism and issue intimidating guidance to physicians, they may apply the same strategy to long COVID. That would only worsen the obstacles we’re currently facing: confusing guidance, misdirected research, and inadequate care.

If we want effective responses to long COVID, we must demand that all health policy—whether about Tylenol, autism, or emerging illnesses—remain grounded in evidence.

I’ll do my best to keep you updated.

Zeest