San Antonio Express-News (Sunday)
Peter Hotez and the fight for science
The bow-tied vaccine researcher has heard it all — and his work to advance awareness hits close to home
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 globalsurveillance network. 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 antivaxx movement connected with groups on the far right. “Vaccine choice” began to be protested alongside prevention measures such as mask requirements and business shutdowns.
Worse, some of the COVID 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.
Since the novel coronavirus outbreaks had begun, Hotez, as a vaccine researcher, had been highly visible in the media — a plainspoken, bow-tied scientist who was as likely to appear on Fox News as on MSNBC.
“He’s got tremendous credibility,” said investigative journalist Brian Rice, “because he’s done a huge amount to draw attention to potentially vaccinepreventable diseases that are less of an issue in the highlydeveloped 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.”
Hotez was wondering whether it was time to risk some of his credibility — and maybe even his safety. He worried that scientists who criticized the Trump administration might be targeted. 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.”
He’s just written a new book, “Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-science,” that makes the case for multinational efforts to tackle disease. It will be released Tuesday.
It seems his whole life had led him to this fight.
Humanitarian from the start
Hotez, 62, grew up middleclass in Connecticut. His dad worked at United Technologies, and his mom stayed home with the four kids. A black-and-white family photo shows Hotez around age 10, 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 in 1980, he moved to New York City to earn a combination M.D./ Ph.D. from Cornell University and the Rockefeller University.
He then married Ann Frifield,, and in Boston, Hotez had a prestigious pediatric residency at Massachusetts General Hospital.
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 important-but-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.
‘Hard as hell’
Rachel, their third child of four, 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” — 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. She frequently ran away. Often, when Ann or one of the older kids caught her, she’d have to be restrained.
Rachel, Hotez and Ann frequently admitted to each other, “was hard as hell.”
Now 28, she sometimes still is. But she helped inspire and shape his fight against antiscience.
Anti-vaxxer movement It’s possible that Hotez coined the phrase “anti-vaxx,” a movement —
he was alarmed to discover —that 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 Children’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 paper in The Lancet that appeared to link vaccines to autism. Using fraudulent data from a small study, he suggested a nonexistent 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 UK 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 most 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 — halfmemoir, 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, death threats and baseless antivaxx 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 NWA: Offit, Hotez and other vaccine advocates were proclaimed
“Straight Outta Merck.”
‘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 coronavirus vaccine 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 about that.
More battles ahead
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.
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, his book is about to release 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.