To Prevent the Next Pandemic, Fight Antiscience Beliefs, Hotez Says

While low- and middle-income countries remain desperate for a COVID-19 vaccine, the United States has entered a dangerous new phase of the pandemic, where antivaccine forces are exporting their antiscience beliefs to other countries, according to a keynote speaker at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.

While a session earlier in the American College of Allergy, Asthma & Immunology Annual Scientific Meeting described how allergists can educate patients in the face of health misinformation, Peter Hotez, MD, PhD, FASTMH, who researches and creates vaccines for struggling countries, went a little further, calling it antiscience aggression.

During a morning plenary session about vaccines and therapeutics, Hotez addressed the antivaccination sentiment that began not with COVID-19 in 2020, but before that, due to a book he wrote about his daughter, who has autism and intellectual disabilities. The book, Vaccines Did Not Cause Rachel’s Autism: My Journey as a Vaccine Scientist, Pediatrician, and Autism Dad, earned him the OG (original gangster) moniker from antivaccination groups.

Hotez, a professor of pediatrics and molecular virology and dean, National School of Tropical Medicine, Baylor College of Medicine, and codirector, Texas Children’s Hospital Center for Vaccine Development, focused his talk on 2 main areas of concern: delivering vaccines to low- and middle-income countries and countering false beliefs about science.

Lamenting not only the loss of 750,000 Americans due to COVID-19, but also the 100,000 that have perished in 2021 even as free vaccines became available, Hotez called it “one of the most demoralizing and tragic things that I've seen as in my life as a physician scientist.”

Meanwhile, in other parts of the world—Southeast Asia, Africa, and most of South American and Centra America—9 billion COVID-19 doses are needed immediately.

Hotez described how he and his codirector of the Center for Vaccine Development, Maria Elena Bottazzi, PhD, took their years of research into coronaviruses and other diseases and shifted their efforts into developing an inexpensive vaccine against COVID-19 once the genetic sequence was made available online in January 2020.

Their vaccine, Corbevax, is a conventional recombinant protein vaccine, similar to the hepatitis B vaccine, in contrast to the mRNA vaccines or adenovirus vectors encouraged by Operation Warp Speed, which focused on innovation and fast development.

Corbevax is finishing phase 3 trials in India, where the government has committed to buying 300 million doses once it is released through emergency use, which is expected in the next couple of weeks, Hotez said; he hopes Indonesia is next.

Hotez said “as low- and middle-income countries realize that mRNA and adenovirus vector vaccines are not coming, really all they have access to are the whole inactivated virus vaccines from China, or the Russian Sputnik V vaccine; there's increasing desperation for vaccines.” To that end, the Center for Vaccine Development is working to technology transfer their production cell bank and help with development.

“We do not file a patent. We are not looking to make money. We’re looking to provide access to global health,” he said.

Forces and Fears Behind the Next Pandemic

His latest book, Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-Science, focuses on new drivers that are working to undermine and destabilize global health, not only ones like war, poverty, and political instability, but also urbanization, deforestation, climate change, and antiscience, said Hotez.

In his view, the antivaccine/antiscience movement has progressed through 3 phases and is continuing to expand, and as such, it needs a stronger counteracting. However, Hotez conceded that his is not a popular opinion among fellow academics and medical professionals.

Version 1.0 of this activity, he said, revolved around the now-retracted and debunked study involving vaccines and autism (and what inspired him to write the book about his daughter). Antivaccine groups, he said, then “moved the goalposts” to incorporate other false beliefs about the human papillomavirus vaccine and autoimmunity.

Starting around 2013 the second wave began in Southern California as antivaccine efforts became more politicized around the concept of “health freedom." This has led to a growth in nonmedical vaccine exemptions in states like Texas and Oklahoma; Hotez pointed out that in Texas, more than 70,000 children did not receive recommended vaccines by 2020 compared with about 2300 in 2004.

We are now in V 3.0, he said, as places that have not previously had this kind of activity are witnessing it, fueled by a conspiracy fringe group and the far right.