Q&A: Peter J. Hotez, MD, PhD, DSc, to address vaccine disinformation in AAAAI keynote

As COVID-19 has transformed everyday life over the past 3 years, Peter J. Hotez, MD, PhD, DSc, has become a household name.

Co-director of the Texas Children’s Hospital Center for Vaccine Development, dean of the National School of Tropical Medicine and professor of pediatrics and molecular virology and microbiology at Baylor College of Medicine, Hotez has been on the frontlines in developing new vaccines for COVID-19 and other emerging infections, while leading a fight against disinformation pertaining to the COVID-19 and other vaccines.

Next, Hotez will take his campaign to the American Academy of Allergy, Asthma & Immunology Annual Meeting in San Antonio, where he will present the keynote address, “Global Vaccines and Vaccinations: The Science vs. the Antiscience,” on Saturday, Feb. 25.

Healio spoke with Hotez about the safety of COVID-19 vaccines, what drives disinformation and what attendees can expect from his lecture.

Healio: Could you tell us about the COVID-19 vaccine technology developed by you and your colleagues at the Texas Children’s Hospital Center for Vaccine Development?

Hotez: It’s a recombinant protein vaccine made through microbial fermentation in yeast, a technology similar to the hepatitis B vaccine. Because this technology is widely used to make hepatitis B vaccines in low- and middle-income countries, we successfully transferred it with no patent to vaccine producers in India (Biological E. Limited) and Indonesia (Bio Farma). So far, almost 100 million doses have been administered in those two nations. We provided proof of concept that you don’t need to be a multinational pharmaceutical company to still achieve important milestones.

Healio: Why did you also decide to become involved in vaccine advocacy?

Hotez: I have an adult daughter with autism and intellectual disabilities, and a few years ago I wrote the book, Vaccines Did Not Cause Rachel’s Autism. I did this because there was a vacuum, and as a vaccine scientist and parent of a child (now adult) with autism, I felt that if I didn’t do it, then who would?

Now I’m doing the same, horrified at the fact that I estimate at least 200,000 Americans needlessly died because they refused a COVID-19 vaccine. They were victims of antivaccine activists, especially where I live in Texas where I estimate 40,000 Texans needlessly lost their lives. I have a new book about this coming out this summer entitled The Deadly Rise of Anti-science with Johns Hopkins University Press.

Healio: What is the current consensus in the medical community regarding the safety of the COVID-19 vaccines?

Hotez: In general, the safety profile of COVID-19 vaccines both in the U.S. and globally has been pretty sound and strong. In the United States, the mRNA vaccines have saved an estimated 3 million lives, according to research by Meagan C. Fitzpatrick, PhD, of University of Maryland School of Medicine, and her colleagues, including Alison P. Galvani, PhD, professor of epidemiology at Yale University School of Public Health. Having said that, there have been a lot of lives lost when people have refused COVID-19 vaccines, and that has been really devastating.

In terms of the impact of COVID-19 on allergies or autoimmune disease, there has not been a lot published in the literature. There are some anecdotal reports but, overall, the safety profile has been strong. My lecture will be more general, not specifically as it relates to allergy and immunology, but rather giving the attendees the big-picture overview of what has happened with COVID-19 vaccines, global vaccinations and a rising tide of antivaccine sentiment.

Healio: What challenges do these vaccines present in allergy care?

Hotez: There are certainly reports about people having reactions because of the polyethylene glycol used in COVID-19 vaccines, but these reactions are extremely rare. One of the issues around COVID-19 vaccines is that they are reactogenic. They do have a lot of minor side effects, which some people confuse with allergic responses.

Healio: How are these reactions being misrepresented?

Hotez: I think one of the biggest misrepresentations is the false claims that COVID-19 vaccines are causing sudden deaths, stroke or heart attacks and things like that. It has been pretty well documented that that’s not happening.

Healio: How does myocarditis fit into these claims?

Hotez: Myocarditis is real. It happens between one in 12,000 to 16,000 vaccinations, with rates that are a little higher among young adult men. But the evidence clearly shows that the benefits of COVID-19 vaccination far outweigh the risk of getting the actual virus, because the virus is not only causing myocarditis, but it also is causing myocardial infarctions due to thrombi forming in the coronary artery or microangiopathy in the lungs, causing strokes. One of the things we have to realize is that the COVID-19 virus itself is causing a lot of thromboembolic events. We need to remember that COVID-19 is a killer virus, and more than 1 million Americans lost their lives to it, including at least 200,000 whose lives could have been saved if they would have accepted COVID-19 vaccines.

Healio: So, what is driving the spread of the disinformation that is out there?

Hotez: There’s a whole antivaccine ecosystem that’s politically motivated, being amplified on some news outlets at night, coming even from members of Congress. There are also dedicated antivaccine groups. The watchdog organization Center for Countering Digital Hate finds about a dozen or so groups are responsible for 65% of the antivaccine disinformation.

Healio: Why are these organizations spreading this disinformation? Are they simply mistaken?

Hotez: No, I think a lot of it is intentional. In some cases, they’re monetizing the internet by selling autism cures or nutritional supplements. Books on vaccination are overwhelmingly antivaccine, COVID-19 conspiracy books. It’s a whole industry that’s monetizing the moment, and the Center for Countering Digital Hate has documented that.

In addition, people promote antivaccine sentiment for political control, and that’s been really adopted by conservatives. Speakers at the Conservative Political Action Conference, for instance, say that first the government is going to vaccinate us, and then it will take away your guns and your Bibles. As ridiculous as that sounds to us, a quarter of the country accepted it with a lot of loss of life as a consequence.

This message is then amplified on extremist news outlets and even by elected members of the House of Representatives, the Senate and some governors. It’s the hardest thing to talk about, because all of our training says we’re not really supposed to talk about politics. But what do you do when it’s all coming from one side?

Healio: Should doctors talk about this disinformation with their patients?

Hotez: In the past, you could talk to parents about their sources of disinformation and why vaccines are safe for their children. Usually, they would vaccinate their kids. Now, it has become much harder, as it has been linked to political leanings, so it has become much more difficult.

But, more often than not, people still trust their doctor, so it’s worth trying to have these conversations. The most important thing is for doctors themselves to get familiar with information about the safety and effectiveness of vaccines.

Healio: What can the medical community do to ramp up the fight against disinformation?

Hotez: Have a better description of the antivaccine ecosystem, because people don't quite understand how it is politically motivated, or they never really understood that in the first place. In my remarks I will describe the antivaccine ecosystem and help people to understand where this is coming from.

References:

• The disinformation dozen. https://counterhate.com/wp-content/uploads/2022/05/210324-The-Disinformation-Dozen.pdf. Published March 14, 2021. Accessed Feb. 15, 2023.
• Fitzpatrick MC, et al. Commonwealth Fund. 2022;doi:10.26099/whsf-fp90.
• Hotez P. PLOS Glob Public Health. 2022;doi:10.1371/journal.pgph.0001173.
• Hotez P. Vaccines Did Not Cause Rachel’s Autism. Johns Hopkins University Press; 2018.
• Pinna M, et al. Sci Rep. 2022;doi:10.1038/s41598-022-20350-0.