On Tuesday, Sept. 30 the Department of International Health at the Bloomberg School of Public Health hosted its annual Michael Klag and Lucy Meoni Lecture, which honors their exchange of ideas during Dr. Klag’s deanship. This year’s speaker was Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine (BCM), who lectured on the topic of global vaccinations and immunizations. Throughout his lecture, he addressed how climate change, urbanization and anti-science rhetoric influence vaccine rates and creation while also sharing how his personal narrative has impacted his career.
The National School of Tropical Medicine at BCM was established in 2011 and is one of the first of its kind in North America, focusing on vaccine development and testing for tropical diseases. The relatively recent establishment of this school stems from Hotez’s proactive approach towards his realization of neglected tropical disease control.
“We do everything big in Texas,” Hotez said. “I’ve been [at the Texas Medical Center] 15 years. It’s the world’s largest medical center. [...] It’s an incredible place to work, and 15 years ago, I came here with the idea that we really could use a School of Tropical Medicine and also create this vaccine center.”
Hotez proposed the establishment of a vaccine center after witnessing the success of the Gavi Alliance, where big vaccine producers employed a multi-tier pricing business model to enhance the equity and sustainability of vaccine use in lower-income countries. However, this alliance focused more on vaccines for globally impactful infectious diseases rather than for a concentrated region.
“Certain vaccines were falling through the cracks, and those were vaccines for diseases that only occurred in low- [and] middle-income countries, and [...] the big vaccine players were less interested in [that], so that was the idea — to start making the vaccines that no one else would make,” Hotez said.
Hotez further elaborated on the financial struggles his team encountered along the way, noting that, unlike big pharma companies with Operation Warp Speed for the COVID-19 vaccine, the center heavily relies on philanthropic foundations as investors. He emphasized the major challenge at hand: Investors often do not want to fund the process of determining if a vaccine works unless they know it does. Despite these challenges, Hotez and his team have successfully developed many signature vaccines, one of which is for hookworm.
“We got close to 100% protective immunity,” Hotez said. “We’ve been working with Ruth Karron to advise us on the next steps of this.”
Aside from the hookworm vaccine, Hotez and his team also created a low-cost version of the SARS and MERS COVID-19 vaccines by adopting an unconventional business model. They made the production cell banks in their labs, sent them by world courier to vaccine producers in low and middle-income countries and then worked with those countries on scaling the production. However, although this process minimizes financial constraints, Hotez expressed that investment is still necessary, and securing financial support proves difficult for more neglected diseases like hookworm.
“The Indian government [and] the Indonesian government for COVID [were] prepared to guarantee the advanced purchase of 300 million doses or more, because it was COVID. And everyone understood the emergency, but what do you do for something like a debilitating chronic neglected tropical disease like hookworm?” Hotez said.
As previously described, the pathway to developing a successful vaccine is no easy journey. However, it is not the only journey Hotez has embarked on, as he reflected on other uncertainties he encountered through his personal and familial life.
Unbeknownst to him, his role as a father and his career as a vaccine scientist would merge. He recounted the time he received a phone call from Dr. Anthony Fauci and Dr. Francis Collins asking him to participate in a series of discussions to explain how vaccines do not cause autism, given that his daughter Rachel has autism.
“That year of discussions [...] led me to write the book Vaccines Did Not Cause Rachel’s Autism, because it required me to look up everything I could to kind of debunk [those] claims [...] it also gave me a front row seat to watch how this anti-vaccine movement has evolved or devolved over time.”
Hotez noted that, although many anti-vaccine claims have been repeatedly countered with evidence, it has been a tireless effort for him to debunk the movement entirely, given the continuous formation of new claims.
“An anti-vaccine group makes an assertion about a certain vaccine. You spend a lot of time, the scientific community does, debunking it, showing it’s not true, and then they just switch it up and change it,” Hotez said. “So it becomes this exhausting exercise.”
Hotez then discussed the complexity of addressing the anti-vaccine movement, noting that anti-vaccine groups in Texas are now receiving PAC money. It has essentially escalated into a political movement, though he and his colleagues have been trained to remain politically neutral on the matter.
To further depict the widespread impact of the anti-vaccine movement, Hotez shared some devastating statistics in regards to COVID-19 deaths in Texas that could have been prevented.
“So many Texans refused to take the COVID-19 vaccine, so that’s 100,000 deaths, 40,000 needless deaths. So this anti-vaccine activism is a killing force in Texas,” Hotez said.
Hotez has explained that this is a dangerous movement, not only on a national scale but globally. This movement is extending beyond U.S. borders, as the same anti-vaccine activism is now appearing on the African continent.
Hotez concluded his lecture by sharing how his recent book Science Under Siege: How to Fight the Five Most Powerful Forces That Threaten Our World highlights two major threats to society that the School of Public Health is collectively learning and working on. His book bridges the similarities between climate change and pandemics and acknowledges how anti-science remarks are negatively interfering with these issues.
“The top line of the book is, [our] planet faces two big existential threats: pandemics and the climate crisis. The two go hand in hand. But now there is a third leg to the tripod and this is the whole anti-science ecosystem that’s blocking our ability to respond to it,” Hotez said.
