BOWTIED BUT UNBOWED
Houston vaccine researcher Peter Hotez takes on disinformation in his fight for science.
The antivaccine movement taught vaccine researcher Peter Hotez not to ignore conspiracy theories, no matter how scientifically unfounded. But in late spring of 2020, the virulence of the made-up stories he began hearing about COVID-19 astounded him.
One hoax held that Bill Gates had created the new coronavirus to force all Americans to be vaccinated with eensy devices that would create a sci-fi global-surveillance network. Another said that the launch of a 5G network in Wuhan, China, had spawned the virus. Some people claimed, falsely, that Gates, Hotez and Dr. Anthony Fauci stood to get rich off patents related to the COVID vaccine.
Hotez watched as the anti-vaxx movement — with its hippie roots in liberal distrust of chemicals and Big Pharma — connected with groups on the far right. “Vaccine choice” became an issue at protests that opposed mask requirements and business shutdowns. He was particularly alarmed that in Michigan, in late April
and early May, supporters of President Donald Trump, wearing camouflage and carrying guns, protested on the steps of the state’s capitol.
Worse, some of the disinformation was coming from the White House: that COVID-19 was no more dangerous than a seasonal flu; that masks weren’t necessary; that the U.S. could have a safe vaccine by October. Hotez worried that the White House might wreck the public faith in vaccines with its impossible promises. He couldn’t imagine why a president wouldn’t at least acknowledge the hundreds of thousands who’d died.
But should he say anything about that? The pandemic had made Hotez a constant presence in the media, particularly on cable-TV news shows. He has a talent for conveying science to regular people, and as a top vaccine scientist with experience with coronaviruses, his credentials are impeccable. “He’s got tremendous credibility,” says investigative journalist Brian Rice, “because he’s done a huge amount to draw attention to potentially vaccine-preventable diseases that are less of an issue in the highly developed countries of North America and Europe: diseases that are often less likely to be profitable to the drug industry but nevertheless kill a lot of people.”
On TV, his appearance is a bonus: Forever rumpled and bow-tied, he looks like a scientist from central casting. But unlike a stereotypical scientist, his emotions are on surprising display. When a grim subject transforms his usual smiley warmth into anger or dismay, the effect is potent. He doesn’t come across as a normal talking head, auto-furious about the topic du jour. He looks like a teddy bear forced into battle.
Now, Hotez was wondering just how much battle he should take on, how frankly he should speak. He worried that he’d alienate Fox viewers, leaving them with one less source of credible scientific information. He worried, too, that scientists who criticized the Trump administration might be targeted — maybe just on social media but maybe in the real world as well.
He asked his wife, Ann, what he should do.
Speak out, she said. “You don’t want to wake up in a year and see the body count and know that you didn’t do all you could to prevent it.”
Later, people would tell him that his whole life had led him to that fight.
Didn’t say ‘tall’
Hotez, 62, grew up middle class in Connecticut. His dad worked at United Technologies, and his mom stayed home with the four kids. A black-andwhite family photo shows Hotez around age 10: A bowl cut emphasizes the roundness of his face; his gaptoothed smile looks genuine; and his first real microscope is at his elbow. By the time he left home for college, he knew he wanted to study parasitic and tropical diseases.
After graduating from Yale University in 1980, he moved to New York to earn a combination M.D./Ph.D. from Cornell University and the Rockefeller University. A personal ad in the back of New York Magazine caught his eye. A woman wrote that she was in search of an intelligent man with a great sense of humor, someone who lived in New York, not New Jersey. The ad did not say “tall.” Hotez, 5 feet 4 inches, read it several times to be sure.
Ann Frifield, who worked in marketing and advertising for People magazine, responded to his earnest introductory letter. They hit it off and were married in 1987. Matthew, the first of their four kids, was born the next year.
The family moved wherever Hotez’s career took them, with Ann fully in charge of domestic life. In Boston, where Hotez had a prestigious pediatric residency at Massachusetts General Hospital, their apartment was full of mice. Because he was so busy, Ann moved them to a vermin-free place without consulting him. When she told him to come home to their new address, she says, “he didn’t bat an eye.”
Hotez had gone into pediatrics because the field is associated with vaccines, and vaccines, he thought, were one of the highest expressions of science in pursuit of humanitarian goals. He knew that researching importantbut-unsexy diseases of the global poor was not a path to riches — particularly compared to what he could make in private practice — but he and Ann were at peace with that. A post-doc at Yale paid $32,000. Ann bought the kids’ clothes at consignment shops.
For years, Emily, their second child, had two dresses: one with flowers, one with a sailor collar.
“We felt we had made a comfortable and meaningful life for ourselves,” Hotez would later write. “We thought we had it all worked out.”
‘Hard as hell’
Rachel, their red-headed third child, was born in ’92 and cried all the time — a high-pitched, piercing cry. When Ann tried to comfort her, the baby would stiffen. Eventually, a specialist diagnosed “pervasive developmental disorder” — a subset of what’s now called autism spectrum disorder. Later tests showed intellectual disabilities and ADHD as well.
Rachel’s autism has nothing to do with vaccinations, Hotez has long maintained. It was determined before she was born.
Rachel grew harder to handle. She threw stuff: food across the room, toys into the toilet, her new Stride-Rite sneakers out the car window and onto the highway. She frequently ran away, sometimes covering a lot of distance or even breaking into a neighbor’s house. Often, when Ann or one of the older kids caught her, she’d have to be restrained.
Hotez, as usual, was working long hours. His fellowship had grown into a tenure-track job at Yale, and he commanded his own lab, where he was developing a hookworm vaccine.
So most of Rachel’s care fell to Ann. She’d planned to return to work, but managing Rachel made that impossible. It was hard to find sitters or take family trips, and the specialists and therapies that Rachel needed made the family’s financial stress even more acute. Ann struggled with depression.
Rachel, Hotez and Ann frequently admitted to each other, “was hard as hell.”
Now 28, she sometimes still is. Hotez and Ann speak of Rachel in warm tones, saying they once dreamed that she’d be able to live independently; they’re still trying to figure out how she’ll live after they can no longer care for her. Before the pandemic shutdown, she loved the two-hour-a-day job they found for her, sorting clothes at the Westheimer Goodwill, and she loved walking through Montrose, chatting with cashiers at her regular haunts. But she doesn’t tie her own shoes, and she can’t count money: She pays for her bagels or tuna sandwiches by handing over a fistful of ones and accepting whatever change is returned.
When COVID lockdowns began, both Rachel and her father were suddenly forced to spend their days at home, in their Montrose townhouse. Ann hurriedly set up a Zoom-worthy work spot for Hotez in a bedroom, taping his old sports T-shirts over a window to cut the glare. The family settled into a routine for his TV interviews. About 15 minutes before one was scheduled, Ann would first make sure that Rachel was occupied in her bedroom but not hogging the WiFi that her dad would need. Then Ann would go outside and, if necessary, use cash to buy the silence of any worker wielding a leaf blower.
One day recently, though, Ann was out of the house as Hotez gave a virtual talk to between 500 and 600 people. Rachel, done with whatever she’d been entertaining herself with, began pounding on his door. “Dad!” she kept yelling. “Dad!”
When Ann returned home, she saw tears in her husband’s eyes.
“Threading that needle is stre in science communication — how to keep the science above the politics as Dr. Peter Hotez
‘Battleground for the anti-vaxxer movement’
It’s possible that Hotez coined the phrase “anti-vaxx.” Ann doesn’t like it. Even though the movement directly opposes everything her husband stands for, she thinks the abbreviation is disrespectful. Mainly for her sake, Hotez tries to give his adversaries the benefit of the extra syllable. “Antivaccine,” he says when he remembers.
The anti-vaxx movement, he was alarmed to discover, was particularly strong in Texas, the state he and Ann enthusiastically adopted in 2010. To lure Hotez to Houston, Baylor College of Medicine launched the United States’ first School of Tropical Medicine, where he’s dean; and Texas Chil
dren’s offered him and his longtime research partner, Maria Elena Bottazzi, a lab with far more resources than the one Hotez had run previously at George Washington University.
In 2016, Hotez launched his first salvo against the anti-vaxxers. In the essay “Texas and its Measles Epidemics,” published in the journal PLOS Medicine, he noted that almost 45,000 Texas children had been opted out of schools’ vaccine requirements for nonmedical reasons, a 1,900 percent increase over 2003. At both extremes of the political spectrum — both in liberal Austin and the conservative Panhandle — low vaccination rates were putting schools in danger of measles outbreaks.
In part, Hotez blamed Andrew Wakefield, a British expatriate living in Austin. In 1998, while living in London, Wakefield had been the lead author of a now infamous Lancet paper that appeared to link vaccines to autism. Using fraudulent data from a small study, he suggested a non-existent link between autism and the vaccine for measles, mumps and rubella. Bigger, better studies found no such link. And in 2010, after a crusading investigative reporter uncovered significant wrongdoing by Wakefield, the Lancet retracted the article, and the U.K. stripped him of his medical credentials.
That didn’t stop Wakefield from pushing the same theories in Austin, though. And he frequently joined forces with Texans for Vaccine Choice, a political action committee based in Keller.
“Sadly,” Hotez wrote, “the Texas anti-vaxxer movement has become conflated with fringe political elements to create a dangerous and toxic mix of pseudoscience and conspiracy theories … . I worry that, as the second-most populated state in the U.S., Texas is seen as a battleground for the anti-vaxxer movement.”
After that, Hotez advocated for childhood vaccinations in editorials for the Houston Chronicle, the New York Times and Scientific American.
In 2018, he published a book — half memoir, half scientific explainer — called “Vaccines Did Not Cause Rachel’s Autism.”
For his efforts, he soon joined Paul Offitt, head of the Vaccine Education Center at Children’s Hospital of Philadelphia, as a focus of anti-vaxx protests and death threats. He began to figure in baseless anti-vaxx conspiracy theories, wrongly accused of making millions off his lab’s vaccine research.
On Twitter, where Hotez is active, many of his trolls follow the lead of Robert F. Kennedy Jr. or his anti-vaxx group Children’s Health Initiative. Once, on Facebook, Kennedy called Offit and Hotez “OG villains.” (Hotez had to look up “OG.” He’d never been called an “original gangster” before.) A meme circulated with scientists’ faces pasted onto the bodies of the rap group N.W.A: Offit, Hotez and other vaccine advocates were proclaimed “Straight Outta Merck.”
Other times, the harassment isn’t as funny. In November 2019, during an infectious-disease conference in New York, anti-vaxx protesters surrounded him, pelting him with questions related to vaccine hoaxes. Hotel security whisked him out of the building.
‘Threading the needle’
Hotez first read reports of the novel coronavirus on New Year’s Day 2020. The Wuhan Municipal Health Commission had disclosed a mysterious “pneumonia of unknown cause” to the World Health Organization. It wasn’t yet a big deal. Only a handful of cases were reported, many connected to a seafood market, and the Chinese investigative team hadn’t found evidence that the disease could spread from one human to another. But any new outbreak catches Hotez’s attention, and the respiratory problems associated with this one hinted that a new coronavirus might be to blame.
Hotez’s lab had created vaccines for previous coronaviruses, SARS and MERS. Maybe, he thought, they’d need to swing into action for this one, too.
He was way ahead of most Americans.
And even so, he had no idea how much his life was about to change.
The vaccine lab kicked into high gear, and relevant new coronavirus research seemed to appear hourly. At the same time, he embarked on what amounted to another full-time job as a media commentator. As a coronavirusvaccine researcher who was both willing and able to explain the latest science to nonscientists, he was in high demand on CNN, MSNBC and
Fox.
Hotez thought it was important for scientists to speak to the entire nation, not just Republicans or Democrats. That spring, he tried to thread the needle on those appearances, conveying scientifically accurate information in a way that each network’s audience would accept. For Fox, he looked for legitimate reasons to praise the Trump administration; for MSNBC, just the opposite.
“Threading that needle is stressful,” he said in April. “It’s also a great lesson in science communication — how to keep the science above the politics as much as possible.”
He worked seven days a week, in Zoom meetings from early morning until late. Terrible as COVID was, Hotez saw it as a chance to educate Americans all across the political spectrum about both science and vaccines. The urgency to develop and administer a COVID-19 vaccine, he thought, would capture the country’s attention, and growing understanding of vaccine science would spell the end of the anti-vaxx movement.
Slowly, it began to dawn on him how wrong he was.
‘In a dark place’
On CNN and MSNBC, Hotez became the first scientist to talk about the broad anti-science movement afoot — and particularly, afoot in the White House. Academics usually speak in nuanced shades of gray, but Hotez called, full-throated, for measures that would cut the COVID death rate. On Twitter and TV, his anger sometimes flashed.
The Twitter trolls showed up in force. Fox stopped calling him.
At first, Hotez felt very alone. In August, when an enormous rally in Berlin attracted RFK Jr., QAnon supporters, right-wing extremists and hippies, he realized that the anti-vaccine movement he’d seen break out in Texas had spread worldwide and mutated into something even more dangerous. “I was in a dark place,” he says.
Later, the country’s large scientific organizations would join him. In July, more than 1,200 members of the National Academy of Sciences signed a letter rebuking Trump’s “denigration of scientific expertise” and calling to “restore science-based policy in government.” In October, an editorial in the New England Journal of Medicine labeled the political response to COVID “consistently inadequate,” andNature’s editors endorsed Joe Biden for president.
Now, in late February, his world is brighter.
One of his lab’s COVID vaccines is on track to be widely distributed in India. On March 2, he will publish a book, “Preventing the Next Pandemic,” which makes the case for “vaccine diplomacy,” multinational efforts to tackle disease. And Houston po’ boy chain Antone’s has just announced plans to name a sandwich after him. “You can’t walk into Antone’s and order a Tony Fauci!” he laughs. (Fauci does, however, have an eponymous pale ale: Atlanta-area brewery Wild Heaven Beer makes Fauci Spring.)
Though Hotez worries about the new coronavirus variants, he likes that infection rates are falling across the U.S. He, Ann and Rachel have all had their second doses of vaccine, which has allowed Rachel to return to her beloved job at Goodwill. If the COVID rates remain low in March, Peter will take his first days off in more than a year, and the three of them will fly to Tucson, Ariz., to visit family.
Despite his vacation plans, Hotez is braced for bigger battles. In late January, in the journal PLOS Biology, he warned scientists to beware “an antiscience confederacy” composed of U.S. “medical freedom” initiatives, Russian disinformation and far-right extremist groups in Western Europe. By halting vaccination and prevention programs, he wrote, that alliance
“may have already led to tens of thousands of deaths in the U.S. and other G20 nations.”
It’s time, he asserted, for scientists to take a stand.
“Our messages too often are messages in bottles floating in an ocean of disinformation,” he wrote. “We need to address the ocean.”