As a wave of anti-science sentiment sweeps the globe, scientists need to speak up, says paediatric vaccine scientist Dr Peter Hotez in an interview with The Microbiologist as he launches his new book.
They say you should never talk religion, politics or money in polite company - but increasingly science is becoming a fraught subject as well. Spend too long on any social media platform and you’ll soon find people decrying the science of climate change, vaccines, Covid and many other disciplines.
The temptation as a microbiologist might be to keep your head down and keep your own counsel - but Dr Peter Hotez thinks otherwise.
In his new book, The Deadly Rise of Anti-Science, he outlines how an anti-vaccine movement became a dangerous political campaign promoted by elected officials and amplified by news media, causing thousands of deaths around the world.
Over the last decade, he has been speaking up about the rising anti-vaxx movement and has come in for a lot of aggro as a result.
“It’s not fun sounding so apocalyptic about things, but I think too often our community of scientists is unaware of some very real external threats to science and scientists. Of course, I understand that we want to get on with our making our observations and our discoveries and write our papers and present our scientific meetings - and more or less want to be left undisturbed to do that,” he says.
“But I worry that there are dark forces both lurking and accelerating. It is targeting science but also targeting the scientists and I think we’re going to need protections.”
The famously bowtied scientist became a familiar face at the height of the Covid pandemic, going without sleep and working around the clock to develop a nonprofit low-cost COVID-19 vaccine for global health and to keep the public informed.
During that time, he became one of the most trusted voices on the pandemic and was even co-nominated for a Nobel Peace Prize for his selfless work. He also became one of the main targets of anti-science rhetoric that gained traction through far right or extremist conservative news media.
His new book is an eyewitness story of how the anti-vaccine movement grew into a dangerous and prominent anti-science element in politics, wreaking devastating impacts on health and lives.
Weaving his personal experiences together with information on how the anti-vaccine movement became a tool of far-right political figures around the world, Dr Hotez opens readers’ eyes to the dangers of anti-science and explains how anti-science became a major societal and lethal force in the first years of the pandemic.
With an MD degree and PhD from New York’s Weill Cornell Medical College and Rockefeller University, and now working at the Texas Medical Center, the home of Baylor College of Medicine and Texas Children’s Hospital, Dr Hotez says he had always wanted to apply cutting edge molecular technologies to making vaccines.
As a PhD student, he started working on a human hookworm vaccine and 40 years on, that vaccine has reached phase two clinical trials.
“We started developing Coronavirus vaccines 12 years ago and used that technology to make a low cost COVID-19 vaccine technology that has reached 100 million people in India and Indonesia,” he says.
“So we’ve provided a proof of concept that you don’t have to be a big pharma company to still do big things. Our vaccine technology led to the Corbevax (produced by Biological E) in India and IndoVac (produced by Biofarma ) in Indonesia, which is one of the first halal Covid vaccines.
“It has been very meaningful and fulfilling, but it never occurred to me that this would be twisted and or flipped on its side and made out to be something nefarious and I was so disturbed by that, that it prompted me to write this book.”
It was his interests as a paediatric vaccine scientist - and his experiences with his own family - that first drew him into the sights of the anti-vax movement.
“I’m a paediatric vaccine scientist and developing new vaccines for global health was always the plan, but the unplanned part that had never occurred to me 40 years ago was that I would ever have to defend vaccines against this kind of rising and politically charged aggression,” he says.
“I have four adult kids now, including Rachel who has autism and intellectual disabilities, and a few years ago I wrote a book called ‘Vaccines Did Not Cause Rachel’s Autism’ (Johns Hopkins University Press), which does a deep dive explaining why there’s no link between vaccines and autism, and what autism is, as well as how it begins in early fetal brain development, well before an infant’s first immunization.
“We did whole genomic sequencing on Rachel, and my wife and I, and ultimately Baylor Genetics found Rachel’s autism gene.
”But launching a narrative book on that also made me public enemy number one or two of the anti vaccine crowd because I had taken the wind out of their sails. Their original charge was that vaccines cause autism, so that also gave me a front row seat not only for the vaccine science, but the vaccine antiscience, and I watched how this movement evolved from phony stuff around false claims around autism to now in the United States becoming more of a political movement linked to far right extremism.”
That anti-vaxx sentiment reached a high-water mark with the arrival of the Covid pandemic.
“The reason I wrote this latest book, ‘The Deadly Rise of Anti Science’ is that I watched both aghast and astonished during the Delta and BA.1 Omicron waves as 200,000 Americans needlessly perished after vaccines were widely available - because they refused to get a COVID vaccine,” Dr Hotez says.
Organised and politically motivated
While misinformation is often dismissed as random junk on the internet, he says, that ignores another reality, which is that “it was organised, it was deliberate, it was politically motivated, it was well financed, and it killed 200,000 Americans”.
“This is the hardest book I’ve ever had to write because it talks about something terrible that’s happened in the US, but now I see it globalising into Canada, into the UK, into Europe and now even low and middle income countries.”
It wasn’t always so, he explains - back in the 1950s when Salk and Sabin each developed their own version of the polio virus, this was recognised as something that would change lives for the better.
“Parents lived in dread as we headed into the summer months, that their children would wind up paralysed or even lose their lives from polio - and that no longer had to be a fear. It was so liberating for parents and this led to a string of other vaccines for diseases such as rubella, which Stanley Plotkin developed, or measles that Sam Katz and John Enders developed,” he says.
“There was a string of successes and it was widely understood that this was an extraordinary development because it would save so many lives, and then it became a matter of scaling it up to make those vaccines accessible for low and middle income countries.”
Meanwhile, the launch of the millennium development goals in the GAVI Alliance (Global Alliance for Vaccines and Immunisation) represented another major step forward to make vaccines widely accessible.
“It’s been an incredible public health triumph in terms of we’ve seen - almost a 90% reduction in measles deaths between 2000 and today, and similar numbers for pertussis (whooping cough), for tetanus, for diphtheria, influenza type B, meningitis, so there is no question that these are the most impactful public health technologies that we have.
“I wanted to be part of that … because there are gaps there. There are vaccines that the pharma companies are not going to make because there’s no hope for a financial return for parasitic disease vaccines.
“So we adopted low cost technologies to do these in collaboration with vaccine producers in low and middle income countries - they actually band together and call themselves the Developing Country Vaccine Manufacturers Network, and the technology that was most widely used was yeast fermentation technology - it’s recombinant proteins that are expressed in yeast. That’s how the hepatitis B vaccine that most of us gave to our kids came about.”
But in tandem with this remarkable progress came the sinister rise of science denialism.
The benchmark moment for Dr Hotez was the day in 1998 when a notorious paper was published in The Lancet claiming that the MMR vaccine (measles, mumps and rubella) led to live virus vaccine replicating in the gut and this led to what was then known as Pervasive Developmental Disorder, or autism. Although the paper was ultimately retracted, its message proved alluring and took on a life of its own.
“Anti-vaccine groups started growing in strength and size and sort of monetizing the internet, selling fake autism cures or nutritional supplements or anti vaccine books. And so my first attempt to debunk that was the book ‘Vaccines Did Not Cause Rachel’s Autism’ and I wrote a series of articles around that - and I think we had some impact,” Dr Hotez says.
“But then around 10 years ago, I think the anti vaccine groups needed a new thing, and the new thing was to enmesh themselves in American politics, especially on the far right with the Republican tea party.
“You started to see PAC money going to anti vaccine groups in states like Texas and Oklahoma, around this concept of health freedom, medical freedom - basically saying ‘you can’t tell us what to do with our kids’. And that was dangerous also because you started to see local increases in the number of kids who weren’t getting their full complement of vaccines.
“I sounded the alarm about that in an article I wrote in 2017 in The New York Times called ‘How the anti vaxxers are winning’ and I actually got rebuked for it by the public health authorities, saying by calling them out I was giving them too much attention. And I said they’ve already got all the attention they need - this is a dangerous force.
“And that proved to be right, because during the Covid-19 pandemic, this concept of health freedom, medical freedom got full on adopted by elected members of the Congress on the far right, including some members of what we call here the House Freedom Caucus, as well as at least two members of the Senate, and all of this was amplified nightly on Fox News during the Delta wave.
“So in the book I go into detail explaining how two groups, Media Matters and a social science research group ETH Zurich, monitored Fox News’s nightly broadcasts, especially (for Media Matters) during the Delta and the BA.1 wave, starting in the summer of 2021 when vaccines became widely available.
“Those nightly broadcasts falsely discredited the effectiveness and safety of vaccines, so it was this kind of ecosystem of elected leaders in the Congress, governors, it was even in some cases federal judges - it was Fox News and all the talking heads that they brought on to give it a sort of pseudo academic or pseudo science cover, who convinced Americans by the thousands not to take a Covid vaccine.
“And they paid for it with their lives. 40,000 Texans died because of this.”
One difficult aspect was the observation by health analyst Charles Gaba - and backed by the New York Times, AXIOS and National Public Radio - that the redder the county measured by voters (red meaning Republican, blue Democrat), the lower the immunisation rates and the higher the death rates.
As a scientist, Dr Hotez says, you’re supposed to remain apolitical and not talk about liberals or conservatives - “But what do you do when the anti-science rhetoric is so partisan in nature and being amplified by one group?”
“There’s a whole section of the book on how do you even talk about this, and I basically say, I don’t know how to talk about it other than to talk about it. Not that I care about your political leanings, but somehow to say, don’t adopt this one… because it’s killing too many Americans. That’s a hard needle to thread and it’s a hard book to write because of it.”
Scientists under fire
Dr Hotez warns that things are getting worse on two fronts - not just vaccine misinformation, but a groundswell that also targets the scientists themselves, with revisionists claiming that Covid was created by scientists.
“You’re seeing this play out in the house hearings right now, the far right groups in the house are basically holding these hearings and trying to revise history and say no, it was the vaccines that killed Americans or the scientists that invented Covid. So that’s concerning,” he says.
The book also questions whether there has been any historical precedent for these attacks on biomedical scientists - “The answer is yes, we saw this in Stalinist Russia and Soviet Russia during the 30s, when they portrayed scientists as public enemies, and in that case sent them off to gulags. It was a similar idea - a means of authoritarian control.
“So I tried to draw parallels to what’s happening now with what happened historically with other regimes and what’s happening with other authoritarian regimes, such as in Brazil with the Bolsonaro regime, similar kinds of tactics by Orban in Hungary.
“It unfortunately brings us to a very dark place and I always bring it back to the reason why we have to talk about it - because it is a killing force and being a vaccine scientist is not only about making vaccines, but now about countering the anti-vaccine and other anti-science rhetoric, as unpleasant as it is to do it.”
Dr Hotez fears the anti-science movement will get worse before it gets better, ramping up as the 2024 Presidential Election approaches in the US, but also being exported.
“We saw this with the freedom convoys in Canada. You have elements of it in the European continent, you see it with far right groups in Germany and Austria, but also in low and middle income countries. You can’t always do a National Library of Medicine PubMed search, put in search terms like anti-vaccine together with Kenya, Uganda, or others LIMICS and pick it up - you got to go look through what’s in the local press. So it’s hard to find.
Declines in vaccination
“I worry that America is exporting this stuff and I met with Dr. Tedros from the World Health Organisation last year to warn him that I think this is going to expand to all vaccination programmes, including childhood vaccination programmes.
“So we have to get ready because we could start seeing local declines in vaccination and maybe this could help bring back measles or polio - now we’ve had polio in the wastewater detected in London as well as in New York.
“I am concerned that there’s been this kind of tear in the matrix, that something wrong is happening in our whole vaccine ecosystem and it may be for all of biomedical science - so that’s why the second half of the book title is called A Scientist’s Warning.
“The question I’m often asked is okay, what are you going to do about it, Dr. Hotez? And the answer is I’m not sure I really know because I think the health sector or our community of biomedical scientists in general doesn’t know what to do, because this is a political movement.”
There’s a stark warning for the scientific societies who, he says, tend to not want to get involved because it means talking about politics.
“Again, it gets back to this deep seated commitment that we have to remain politically neutral, but I said, look, at some point neutrality favours the aggressor or tormentor, to paraphrase Desmond Tutu, or Eli Weisel,” he says.
“I think we do have to take this on and even if the scientific societies don’t want to do the actual hard work of this, we need to at least inform our elected leaders to seek their help and advice on how to do this.”
The Deadly Rise Of Anti-Science: A Scientist’s Warning by Dr Peter J Hotez (Johns Hopkins University Press) was published 19th Sept 2023, HB, £20.50.