To make sense of all these changes, I asked my colleague Dylan Scott — occasional host of this newsletter and health care reporter extraordinaire — to run through the Trump administration’s new health policies and how they affect Americans. (Dylan is also on the brink of launching Good Medicine, a new weekly newsletter for anyone trying to make sense of their health.)
There are five major pillars to watch, he said.
1) Pediatric vaccines. On Monday, the CDC slashed its number of recommended, routine childhood vaccines from 17 to 11 — an unprecedented move that won’t exactly help America’s deep-seated issues with vaccine skepticism.
Shots for measles, polio, chickenpox, diphtheria, tetanus and whooping cough, among several other diseases, are still in. But the CDC now only recommends the meningitis, hepatitis A and B, and RSV vaccines to kids deemed “high-risk,” and it’s leaving the choice to vaccinate for flu, Covid-19, and rotavirus to individual parents and pediatricians.
The agency says its new guidance will not affect vaccine availability or insurance coverage — but it could very well sway many parents not to seek out some shots. That, in turn, affects herd immunity for everyone. In most of the US, vaccination rates among kindergarteners are already too low to prevent the spread of measles.
2) The war on Tylenol: President Donald Trump this week doubled down on his September denunciation of Tylenol, writing that pregnant women and young kids should not take the drug “for virtually any reason.” The president and RFK have repeatedly suggested that Tylenol could cause autism — a claim that’s not supported by scientific evidence. (More than half of Republican voters believe it’s true, nonetheless.)
Trump’s rhetoric is all part of what Dylan calls a larger “witch hunt to find a cause for autism,” which has already ensnared a range of suspects: chemicals, molds, childhood vaccines, “mysterious toxins.” But scientists already know that the marked increase in autism diagnoses relates to better screening methods and an expanded definition of the disorder. As Dylan wrote last year, the quest to find some alternative, silver-bullet explanation just risks causing more confusion.
3) Junk food bans: Five states introduced new restrictions to their food-stamp programs on January 1, banning participants from using their benefits to buy soda, candy, and other unhealthy foods and beverages. At least a dozen more are expected to introduce similar limitations later this year, including Florida, Virginia, and Texas.
4) Dietary guidelines: The Trump administration is expected to release new dietary guidelines within a matter of days as part of a routine, scheduled update. (You may remember the “food pyramid” — in 2011, that became “MyPlate.”)
The government’s guidance for healthy eating, which directly influences the meals served in schools, day cares and other public settings, has stayed fairly stable over time. But many nutrition experts expect this year’s update to veer in a distinctly MAHA direction, perhaps by warning against ultraprocessed foods or encouraging more red meat consumption. Avoiding ultraprocessed foods could be beneficial, but Americans already have plenty of meat in their diets.
5) Fluoride in drinking water: While the Trump administration hasn’t taken concrete action on fluoridated water yet, it’s an area to watch: Several states and municipalities have already banned fluoridation with RFK Jr.’s encouragement.
For many of us, of course, this all raises some frightening questions, like: How do you navigate your personal health decisions in this environment? And if I can’t trust the CDC to tell me what shots to get my kid, who exactly should I trust?
“I always tell people the best source to ask about your personal medical decisions is your doctor,” Dylan said. “Surveys consistently find that is the person most people trust and that makes sense, they know you and your health better than anyone.”
If you don't have a doctor, or if you’d like to do some Googling of your own before talking with them, Dylan recommends looking to authorities like your state government (some of which have banded together to give public health advice), the relevant medical societies (like the American Academy of Pediatrics or the American College of Obstetricians and Gynecologists) or the Vaccine Integrity Project run by the Center for Infectious Disease Research and Policy at the University of Minnesota.
