‘I think we’re in for it’: Researcher sees surge
New vaccines are on the horizon — but is it too late to blunt the pandemic’s winter surge? And why could a traditional-method vaccine be better for kids?
To answer these questions, we once again check in with vaccine researcher Peter Hotez, one of the country’s best explainers of COVID-19 science. He’s a professor and dean of the National School of Tropical Medicine at Baylor College of Medicine, and he co-directs the Texas
Children’s Hospital Center for Vaccine Development, where his lab team is developing COVID-19 vaccines.
This interview was edited for length and clarity.
Q: There’s been a lot of news about vaccines recently. What are your thoughts?
A:
There’s good news in that we’ll have at least two vaccines that look like they have excellent efficacy.
But we’re not going to be able to vaccinate the
U.S. population on the two mRNA vaccines, Pfizer and Moderna, alone. The technology is still too new, in terms of scaling up, production and a few other issues.
So we’re going to need other vaccines. To vaccinate a significant percentage of the U.S. population, I think we’ll need at least four or five.
Those other vaccines are coming as well. There were issues around the AstraZeneca-Oxford vaccine, so the FDA may want to see additional trials. There’ll be the Johnson & Johnson vaccine. There’ll be Novavax vaccine. And the vaccine from our lab looks really promising. In India it’s being scaled up for production and tested.
One of the advantages of our vaccine is, it might be especially suitable for kids because it’s a proven technology. We’ve made vaccines this way for almost 40 years. That technology has been used for decades to vaccinate children against hepatitis B, so there’s a known safety profile, and parents might feel more comfortable using it. Our lab is exploring how we can get our vaccine not only to lowand middle income countries, but also for use in the U.S. and Europe as well.
So this a very exciting time.
Q: Could you explain the difference between the kind of traditional vaccine your lab is working on and the mRNA vaccines?
A:
Ours is a very old, tested vaccine technology, the same one used to make the hepatitis B vaccine all over the world. It’s a recombinant protein made through fermenta
tion technology and yeast. You grow yeast in a bioreactor, and it’s genetically engineered to release the recombinant protein, and then you purify it. It’s a very successful technology, one of the most widely used vaccines in kids for decades with no untoward effect. So that’s exciting that we have that vaccine.
Also, our vaccine will be very low-cost, around a dollar a dose, so we’re hoping it really comes in to be used globally. But we don’t see why it couldn’t come into the U.S. at some point, particularly for kids — or maybe as a booster shot if the other vaccines, like the mRNA or the adenovirus-based vaccines, do not have much in the way of durability of protection.
The only thing we don’t know is the durability of its protection. Does it protect for three months or three years or 30 years? We don’t know. We also don’t know if there are going to be any long-term safety issues.
Q: Including kids, what percentage of the U.S. population do we need to vaccinate?
A:
We did some studies
with City University in New York that show it’s pretty high. We need 60 to 80 percent of the population vaccinated.
In the U.S., we still have a significant number of people who are saying they’re holding off or waiting or may not take it at all. I think you’re starting to see a number of opposing forces come into play. On the one hand, as people hear about the high levels of efficacy of these vaccines, and they see colleagues get vaccinated without any ill effects, the percentage of people who are willing to get vaccinated will increase.
On the other hand, the U.S. doesn’t have any real communication plan about the vaccines, so when people hear about things like those two allergic reactions without much explanation, a lot of people are going to decide to hold off. The number of people willing to get vaccinated is going to go up and down with the news cycle.
Q: Don’t vaccines usually take much longer to develop than these have? Hasn’t the COVID-19 vaccines’ development been different than, say, development of the measles vaccine?
A:
Our schistosomiasis vaccine is more typical of vaccine timeframes. Our lab started working on that in 2004, and it’s only now in Phase Two trials. Part of that time is due to resource constraints: It never got financed to move as quickly as we could have.
But I like to keep on pointing out that this idea that we developed the SARS-CoV-2 vaccine in five months is a false narrative perpetuated by the pharma companies or out of the White House. I mean, Operation Warp Speed is a great program. Don’t get me wrong. But it’s the culminating event of a 17-year program.
Q: I wanted to get you to give us an overview of how the U.S. and Texas are doing right now as far as the spread of COVID. What are you keeping an eye on?
A:
Nationally, we’re doing terrible. COVID-19 is now the single leading cause of death in the United States on a daily basis. This is a public health calamity of the worst order. Texas is one of the states worst affected. I think right now it has the largest number of COVID-19 cases of any state in the country. We’re not No. 1 in deaths in part because of that terrible early epidemic in New York, where so many people died. Now it’s looking dire in West Texas and up in the Panhandle. At the hospitals in far western Texas, El Paso, and Lubbock, it’s really terrible, and I would imagine it’s going to get pretty bad in the Dallas-Fort Worth area and in Austin.