Fighting for Science

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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning again, everyone. I'm joined now by the "infamous" Dr. Peter Hotez. At least that's what Fox News host Laura Ingraham calls him, infamous, for insisting vaccines are safe and save lives. He's become a right-wing target as anti-science has become part of the anti-Democratic Party agenda and got even more famous after Joe Rogan tried to get him to debate RFK, Jr., on his podcast. We'll ask him about that.

Dr. Hotez is an MD, PhD, the founding dean for the National School of Tropical Medicine, the co-director of the Texas Children's Center for Vaccine Development, and professor of pediatrics and molecular virology and microbiology, all at the Baylor College of Medicine in Texas. He's got a new book, The Deadly Rise of Anti-Science: A Scientist's Warning. Dr. Hotez, good to have you back on the show. Welcome back to WNYC.

Dr. Peter Hotez: Oh, thanks so much. You forgot the most important part of the introduction, which is I did my MD and PhD in New York City at Rockefeller and Cornell 100 years ago.

Brian Lehrer: All right, so you know your way around Manhattan at the very least.

Dr. Hotez: Yes, exactly.

Brian Lehrer: What's the difference between anti-science and descent among scientists with a minority view?

Dr. Hotez: Well, in the book, people ask me that quite a bit actually. In the book, I even go so far as to define anti-science so we know what we're talking about because, otherwise, people make up what I'm saying. I'm seeing stuff from the far-right on Twitter and other social media platform just making up things that I've never said. I define anti-science as the rejection of mainstream scientific views. I'm reading from the book actually. "Anti-science is the rejection of mainstream scientific views and methods or their replacement with unproven or deliberately misleading theories," and this is an important part, "often for nefarious and political gains. It targets prominent scientists and attempts to discredit them."

Brian Lehrer: I think anti-vax groups are as old as vaccines. You're right about the shift from the 20th century when being saved from polio, for example, gave vaccines and the science that produced them hero status until that turning point when a doctor got published in The Lancet with a later repudiated study linking the MMR vaccines to autism. Can you talk about that shift a little before we dig in-

Dr. Hotez: Yes, absolutely.

Brian Lehrer: -on what happened with COVID?

Dr. Hotez: I use a similar benchmark for the start of the modern version of the anti-vaccine movement, phony claims that vaccines cause autism that came out of that paper. The goalpost kept moving. First, they said it was the measles-mumps-rubella vaccine, and then Robert F. Kennedy, Jr., came out and said, "No, it's thimerosal preservative that used to be in vaccines."

This is one of the reasons I don't debate them because the goalpost keep changing or you're playing this sort of pyramid game of whack-a-mole, then spacing vaccines too close together than alum in vaccines. Then there was false claims about the HPV vaccine for cervical cancer, saying it would cause autoimmunity or infertility, and then claims that vaccines cause something called chronic illness.

It became this exhausting exercise of always asking the scientific community to come up with the evidence as it's the case. Always, the evidence shows in large cohort studies that kids who get the MMR vaccine or the other things don't acquire autism at any higher rate than kids who don't. Similarly, kids on the autism spectrum are no more likely to have gotten a vaccine than kids not on the autism spectrum.

That should be the end of it, but you keep on cycling this stuff. Then what happened about 10 years ago, Brian, there was a shift, I think, in part because the scientific community, myself, and colleagues were taking some of the wind out of their sails. The evidence was so overwhelming that there's no link between vaccines and autism or any of these other things that they were alleging.

They needed a new thing. The new thing, which is not something I would've predicted, would be linking themselves to the far-right extremists. I think it started in Texas around-- because I was there in Texas and watching this unfold, the Texas Tea Party. There were PACs. Political action committee started funding anti-vaccine groups. It relied heavily on propaganda on this concept of health freedom, medical freedom, "Hey, you can't tell us to do what we want to do with our kids."

You started to see the steep rise in the number of kids being denied access to their vaccination. 100,000 kids in Texas were not getting their full complement of vaccines and this didn't even address the 300,000 homeschooled kids. We had no idea what was going on there. That's what came off the rails during COVID-19 and where I really started to get profoundly upset and said, "No, this is a killer movement."

As COVID vaccines became widely available in the spring of 2021. By May 1, the Biden administration announced, "Anyone who wants to get a COVID vaccine could freely and widely available." What you saw was almost as many deaths occurring after the vaccines became available as before because so many Americans refused to take a COVID vaccine, especially in my state of Texas and other southern states, mostly conservative states.

The numbers show that in Texas, 40,000 Texans needlessly died because they refused a COVID vaccine during our Delta and BA.1 wave the last half of 2021, early 2022, 200,000 Americans overall. That's why we have to talk about it because, too often, this is being pitched as some sort of just bizarre things as though it's another aspect of America's culture wars or woke-isms. It's nothing to do with that.

This is about saving lives. I became a vaccine scientist 40 years ago at Rockefeller and Cornell. The hookworm vaccine I worked on for my MD-PhD thesis. I was in phase 2 clinical trials, which is about the right time frame for vaccines. We made two COVID vaccines reaching 100 million people in India and Indonesia. No patent, no strings attached. That's why I became a vaccine scientist.

Now, I realize that's the first part. The second part now to also save lives, we have to combat this rising anti-vaccine activism because it is now a killer movement. 200,000 Americans needlessly losing their lives. The last thing I'll say then before we continue. It's not that I care about people's conservative views or even extreme conservative views, but somehow we have to delink this one because it is such a killer movement and it's just so profoundly tragic.

Brian Lehrer: Listeners, we can take some questions for Dr. Peter Hotez. His new book, The Deadly Rise of Anti-Science: A Scientist's Warning. 212-433-WNYC, 212-433-9692, call or text. I think we should point out that you acknowledge in the book that you have a personal stake in this too because you're the parent of an adult daughter with autism, right?

Dr. Hotez: Yes, that's how I got into this in the first place. I have four adult kids, including Rachel, who has autism and intellectual disabilities. That's how I became public enemy number one or two with the anti-vaccine groups is because I'd written this previous book called Vaccines Did Not Cause Rachel's Autism, which provided the evidence, showing there's no link between vaccines and autism, what autism is, how it begins in early fetal brain development through the action of autism genes.

We did the whole exome and genomic sequencing. Rachel and my wife Ann and I, and we actually found Rachel's autism gene, which was similar to the hundred others that had been sequenced by the Broad Institute of Harvard and MIT. With Baylor Genetics, we had identified Rachel's. It was involved in neuronal communication. The point is, there's an alternative narrative there.

There's also a very interesting side story of girls and women on the autism spectrum, how they get underdiagnosed because they're more verbal. That's also interesting. That's when the attacks really revved up because that was interfering with the bottom line. There's a dozen or more of these groups monetizing the internet, selling phony autism cures or nutritional supplements or anti-vaccine books on Amazon, and hurting their bottom line.

Brian Lehrer: There's a profit motive in the anti-vax movement, not just the political motive?

Dr. Hotez: That's right. The game-changer, Brian, was in the past, it was purely the profit motive. Now, it's different. Now, this has been adopted by the Republican Party or the extreme elements of the Republican Party. Because when you look at those 200,000 deaths, and these are data generated by Charles Gaba, the health analyst confirmed by The New York Times and Axios and National Public Radio and Kaiser Family Foundation and others, what it shows is those deaths overwhelmingly occurring in red states.

Red being Republican, blue being Democrat. The redder the county, the more Republican voters, the lower the immunization rate, and higher the death rate, so much so that David Leonhardt of The New York Times just called it "Red COVID." I think he's right. You really see it. You go into place. I gave, for instance, medical grand rounds at one of the new medical schools in East Texas, a very conservative part of the state.

Everyone you talk to when you go there has lost a loved one who's refused a COVID vaccine. Brian, it's the hardest damn thing to talk about because all of our training as physicians or scientists says, "You're not supposed to talk about politics. You're supposed to be politically neutral. You're not supposed to talk about Republicans and Democrats and liberals or conservatives."

I have a whole section of the book devoted to that. I haven't found a way to talk about it other than to talk about it. I talked about it or I wrote about it. It's painful to talk about because these are people's lives at stake. What I say is these are some of the kindest, most remarkable people you've ever met, but they were targeted. They were victims of specific targeted political aggression.

We have to stop calling it misinformation or infodemic as though it's just some random junk on the internet. It's nothing to do with that. It was the CPAC conference in 2021 in Dallas. First, they're going to vaccinate the conference of conservatives. First, they're going to vaccinate you, then they're going to take away your guns and your Bibles. As ridiculous as that sounds to us, people accepted that, and then--

Brian Lehrer: Making those issues seem related.

Dr. Hotez: That's right. Then the CPAC conference featured prominent anti-vaccine activists. It became a platform of the far-right. Then you have members of the House Freedom Caucus, Marjorie Taylor Greene calling people like me "medical brown shirts," using Nazi paramilitary analogies, or Jim Jordan or Senator Ron Johnson of Wisconsin holding vaccine injury roundtables, and Senator Rand Paul and Governor DeSantis, of course, bringing in prominent anti-vaccine activists. Then also very hard to talk about amplified every night on Fox News.

This was documented by two groups, Media Matters, a watchdog group, as well as a research group out of ETH Zürich, the federal university of science and technology of Zurich, where Einstein actually studied. It's like the MIT of Europe. They found that during that Delta wave as Americans were now refusing vaccines every night, Tucker Carlson, Laura Ingraham, you mentioned Laura Ingraham, Hannity, falsely discredited the effectiveness and safety of vaccines and brought on talking heads prominent from the anti-vaccine community. This became a killer. You mentioned Laura Ingraham calling me infamous.

I think that was in 2021. She had Governor DeSantis on. They were mocking me for predicting a wave was going to hit Florida in a couple of weeks. Sure enough, it did. That's when the Delta wave hit Florida. That get targeted a lot by Fox News. The next year and last year in 2022, the day I got co-nominated for the Nobel Peace Prize for work on low-cost COVID vaccines for global health, Tucker Carlson really went on a rant against me. Unfortunately, I'm a regular target of Fox News. It's scary at times because then people actually believe this stuff. I get the emails and the stalkings saying the army of patriots is coming to hunt me down.

Brian Lehrer: I want to come back to DeSantis in a minute because he's in the news again in the last few days urging most Floridians under age 65 not to get the new COVID vaccine. Do you think that the anti-vax movement has jumped from one side to the other politically speaking? My kids, were little before COVID and getting them vaccinated, got sometimes a little pushback from people we knew who were much more in the alternative medicine, more left-leaning political space who thought, "You know, maybe we shouldn't get our kids vaccinated." RFK, Jr., arguably not a red-stater, we know his political roots, maybe represents that camp to some degree today. Did it jump from more left to more right?

Dr. Hotez: Well, in the old days, meaning more than 10 years ago, we used to say it was the two extremes. It was the far left and the far right. The far-left side, we have to be careful what ingredients are going into vaccines and that sort of thing. That may still be around, but overwhelmingly now, this is morphed into very much a far-right component to it. The leaders are elected members of Congress and governors and the Senate and the House, even a couple of federal judges very much connected to Fox News and far-right podcasters that are pushing this agenda.

Brian Lehrer: Do you think there's a crunchy-to-alt-right pipeline as some headlines have called it?

Dr. Hotez: Yes, it's interesting you say that. There may be. We need this even better studied because we don't like to talk about it. It is under investigator. We also don't know who's paying for this stuff, right? Where's the money trail coming from? I tried to look into it and you can see stuff when you google it on the computer, but I couldn't verify it, so I didn't want to say it unless I had more evidence for it.

Brian Lehrer: On this moment when Joe Rogan invited you and was urging you to debate RFK, Jr., on his podcast, Rogan, I guess, leaning more toward the RFK, Jr., position and you refused and you gave us the beginning of the reason a few minutes ago why you refused, but I want you to go more into it.

Because on the vaccines-cause-autism-in-children fake claim, for example, you gave, a couple of minutes ago, such a clear, simple description of the facts and the lack of correlation, those with autism haven't gotten vaccinated at any higher rate than people without autism, and a few simple ones like that. Couldn't you bury a conspiracy theorist with actual studies and sources and the clarity of language that you're obviously very good at and weaken the anti-vax, anti-science movement?

Dr. Hotez: Well, I actually had tried. Not many people know this, but back in 2017, Robert F. Kennedy, Jr., came out and said that he was going to be appointed ahead of a vaccine commission right before President Trump was to be inaugurated. That worried a lot of us and I remember my assistant saying, "Dr. Hotez, Dr. Francis Collins and Anthony Fauci are on the phone. Would you mind speaking with them?" I said, "Okay, sure."

They said, "Peter, we'd like you to talk with Robert F. Kennedy, Jr. because you have a daughter with autism. You can explain why vaccines don't cause autism." They had it brokered by a third-party neutral person. This is back in 2017. 2018, I had a series of conversations with him, email exchanges, and it was just unproductive. He just kept on jumping all over the place and he wasn't listening to anything I had to say. I had already experienced trying to have a reasonable discussion with him. It just never went anywhere. He was too dug in.

What happened this time around was, actually, I knew I was in trouble because Steve Bannon, of all people, was publicly declaring me a criminal out of the blue on the internet. When Steve Bannon called you a criminal, you know that's pretty serious stuff. I said, "All right, something's coming." Then Robert F. Kennedy, Jr., was on Joe Rogan's podcast and says the usual garbage about me that I'm connected to the pharma companies, even though I don't take any money from pharma.

We've made two COVID vaccines for the world with no strings attached. We made them for $2 to $3 a dose. 100 million people got immunized, showing there's an alternative to the pharma companies. Not to demonize the pharma companies, but also showing we provided proof of concept that there's a way to bypass the pharma companies. All that was ignored and then I retweeted an article written by Anna Merlan in Vice magazine with a comment on it.

She was critical of RFK, Jr., and I retweeted that. That was the smoking gun, I think, that Joe decided he wanted to make a cause célèbre out of this and have me on with debating Robert F. Kennedy, Jr. That's when I said, "No, that's not what we do," and then Elon Musk waited. I forget exactly what he said. It's something to hide or something like that. On Twitter, you got Elon Musk tag team with Joe Rogan, with Robert F. Kennedy, Jr. Every follower on Twitter or every follower is not following Taylor Swift.

Brian Lehrer: I guess there's still a part of me that thinks, "Well, you would just win. You would win." It would get a lot of attention and then you would win and you would help save a lot of lives.

Dr. Hotez: Well, here's the reason. It's counterproductive in a number of ways. One, he would just keep on going all over the place. I don't think Joe would be a neutral broker after all, even though he had me early on in the pandemic. Then by 2021, he was having anti-vaccine activists on after anti-vaccine activists and pushing ivermectin, which was very damaging. I didn't think he'd be neutral. Then I said, "It also sends Americans the wrong message because this is not how we do science."

As scientists, we have lab meetings. We write scientific papers and they get heavily reviewed and criticized. You have to do major revisions and oftentimes go back and do more experiments. Sometimes it can take six months or a year to get a scientific paper published after you first submit it, and then we present our findings in front of critical audiences of peers. Science is not something that's publicly debated typically like 18th-century enlightenment philosophy or politics.

I can't think of an instance where science was really advanced through debate. Maybe in the early '20s, Niels Bohr have famous public discussions with Einstein, but it wasn't really so much of a debate. It was a public discussion to equal peers committed to the truth. This was something else. I think, one, it's important for the public to know. This is not how we do science. I don't think it would advance the cause. Then you saw right afterwards, all the crazy stuff he started saying about Jews.

I forget what he said, Jews inventing the COVID virus or the vaccine. I didn't want to be a part of that and I didn't want to help him. I thought that was another underlying political agenda, why people like Steve Bannon are backing Robert F. Kennedy, Jr. They want a third-party candidate according to people like Molly Jong-Fast to take votes away from Biden and make him a legitimate contender. By having a prominent US scientist sitting there with him discussing this, that sends a very powerful message that I didn't want to send either.

Brian Lehrer: Dr. Peter Hotez, our guest for another few minutes, professor of pediatrics and molecular virology and microbiology at the Baylor College of Medicine, and author of a new book, The Deadly Rise of Anti-Science: A Scientist's Warning. David in Brooklyn, you're on WNYC with Dr. Hotez. Hi, David.

David: Hi, thanks for taking my call. I'm a new grandfather. My grandson is about four and a half months old now.

Dr. Hotez: Congratulations.

David: Thank you. Thanks a lot.

Dr. Hotez: I wish my adult kids would deliver also, but that's a different discussion for a different day.

Brian Lehrer: Oh, stop pressuring children to have children.

[laughter]

Brian Lehrer: Go ahead, David.

David: My daughter has made the decision to give vaccines to Elias, my grandson, but to space them out on a monthly basis. The reason for this is that there's a concern that there is aluminum in the vaccines. I don't know if that's true. The purpose of it if there is one, maybe that the body can uptake the medicine in a better way. Could you just talk a little bit about the components in the vaccine such as aluminum, and the logic, the reasoning of spacing out so that the child doesn't get multiple vaccines in a single doctor visit?

Dr. Hotez: Yes, I talked about it in the last book. This is one of the anti-vaccine tropes that want to equate vaccinations with aluminum poisoning. There are aluminum salts in some childhood vaccines, but the amount is miniscule and has been shown to be safe. This is used to stimulate the immune response. There's no upside to spacing vaccines apart. There's a minimum amount of aluminum being injected, certainly not enough to cause any neurodevelopmental issues.

The other reason that the anti-vaccine people push this, as they say, you've got to not overstimulate the immune response, which is also wrong because an infant's immune system is stimulated by hundreds or thousands of new antigens a day through ingestion or through inhalation. The gut in the respiratory tree is a very powerful organ of antigen presentation. There is a downside. The downside is vaccines without alternative schedules have not been tested in terms of whether they produce the same immune response as the ones that were tested.

The childhood immunization program that's recommended by the Centers for Disease Control is after decades of careful testing and looking at the vaccines in combination to make sure one doesn't interfere with the other. The more you jiggle with it, the more you try to create alternative schedules, the less and less data there is to support that it's going to be as effective as you would have it. I know a lot of parents think that way, but the evidence doesn't support it.

Brian Lehrer: Bret in Brooklyn, you're on WNYC with Dr. Hotez. Hi, Bret.

Bret: Hi, thank you for taking my call. My question is, why did the guidance on masks change at the beginning? Then we were told at first not to wear them, then to wear them. Even now with the new current wave of COVID, we're not being told to wear masks. It's very confusing. I am trying to follow the science and the scientists giving contradictory guidance was equal amounts of confidence. I'm not sure how to resolve that.

Dr. Hotez: No, it's a fair question. A couple of pieces to this. First of all, when COVID-19 first emerged, I think many in the scientific community thought it was going to be transmitted similarly to the other coronaviruses or other respiratory viruses like flu, which is more droplet contact on surfaces. If you remember all the DoorDash packages that people were scrubbing down and that sort of stuff. It turned out that aerosolized transmission was far more important.

As we learned more, the science changed. It soon became clear that this was, first and foremost, an aerosolized virus and masks were the best way of non-pharmaceutical interventions, meaning something other than a vaccine of preventing you from getting sick. There was a learning curve. That's one thing. The other thing that happened, though, was remember when the vaccines were first rolled out, the mRNA vaccines.

Everyone was very excited that they induce more than 95% protective immunity against serious illness. The Israelis had subsequently done studies during the Alpha wave showing, "You know what? It's also interfering with virus shedding." Not only was it interfering with symptomatic illness but also halting infection 90%. I think that's why the CDC then first said, "Masks come on," because they learned it was aerosol, then masks don't come off because, now, it's interrupting infection.

Then during the Delta wave, there was a mutation and you lost some of that infection-protection function. I think the problem with the messaging was that something that I would do when I would do the cable news channel hits is I would go into a fair bit of detail and say, "These are my underlying assumptions." I think, too often, the health and human services agencies were a bit paternalistic and would just give the summary conclusions without justifying the basis for why they were saying things and had a different type of communication.

When I started talking to public audiences, the message was from the professional communication people. You have to talk to the American people like they're in the fourth grade or the sixth grade, which is what the CDC was still doing. I said, "You know, that doesn't work for me." What I'm seeing is, if you're all in and want to keep yourself and your family safe, you want all the information you can.

People really appreciated all the underlying assumptions I provided to justify my statement so that if you then had to backtrack and say, "Wait, this has changed, but here's what I said before. Now, this has changed," and people understand the basis of it. That itself was empowering. I think it was the type of messaging the HHS agencies tended to use, which was to dumb it down and simplify. Simplify it to the point when the science did change, it was very hard to justify.

Brian Lehrer: The bottom-line answer to his question about masks today?

Dr. Hotez: Well, there is a lot of transmission going on. The hospitalizations are going up with an asterisk because they're starting at a much lower level. Here's what I'm doing. I flew here from Houston, Texas. I'm at the Texas Medical Center. When I was on the airplane or in crowded airports, I always had a mask on. Then I took the Acela train from DC to New York. When I was in Union Station, Washington, and Penn Station, New York, I had a mask on. When I was on the train, I had a mask on. If I'm outdoors, I don't wear a mask.

If you see me walking on the streets of New York, you probably will see I won't have a mask on. If I'm in very indoor crowded areas with a high concentration of people, I'm still wearing masks. Equally important and more important was I got my XBB annual immunization on set last Saturday. That's what we really need people to do is to get that annual immunization because it specifically targets the specific variants that are circulating right now.

Brian Lehrer: Two last questions and we've got about a minute left. On that specifically, I'm sure you've seen that Governor DeSantis is contradicting the CDC recommendation and the one you just gave and telling people younger than 65 not to get the new COVID vaccine. Is that just political or is that based on any kind of scientific descent? Also, I don't know if you also look at treatments, but a few people have been asking me about metformin in addition to Paxlovid as a possible treatment for people with COVID that helps prevent long COVID. I don't know if you have an opinion about that.

Dr. Hotez: Well, in terms of what the governor and his surgeon general are doing, first of all, it's incredibly audacious of them to think that the Florida Health Agency has the horsepower of the Centers for Disease Control to give an alternative recommendation. Just the level of scientific expertise at the CDC is orders of magnitude. After all, that's why you're paying for it. I'm paying for it.

$15 billion of taxpayer money going to the CDC, you're paying for that expertise. Use it. The idea that the Florida State Health Department can come up with something better is just so audacious. I'm very disappointed that that happened. The answer is no. The evidence for the XBB annual immunization, they prefer not to call it a booster at this point, is very strong. Ignore what the Florida surgeon general and the governor has to say. They have another agenda and we've seen that over and over again.

Brian Lehrer: They're saying the risks to people under 65, especially younger males, outweigh or at least compete with the benefits.

Dr. Hotez: Remember, one of the problems is they're only looking at death rates and so, yes, the death rates in younger people is lower than it is in older Americans, but the death rate is still significant. More kids, for instance, die from COVID than they do from influenza. Don't forget all of the long COVID. The long COVID can occur after any COVID infection. Statistically, the risk is higher if you have severe COVID. Vaccination is not only preventing you from going to the hospital or losing your lives but also getting long COVID. Now, even in the kids we're seeing COVID-19 may be an additive factor in causing type 1 diabetes, so vaccination could help prevent against that as well.

Brian Lehrer: Real quick, metformin and long COVID if you have an opinion.

Dr. Hotez: If I have one minute, I'll just say we're not getting enough seniors getting on Paxlovid. That concerns me. What's happening is somebody older has a runny nose, feels crummy, takes a COVID test, is positive, they talk to our internist, "Well, let's wait and see." The problem with that is Paxlovid only works at the very early phases of the illness because it interferes with virus replication.

Once virus replication goes on for a while, induces inflammatory response, then the effectiveness of Paxlovid goes way down. We're seeing too many seniors go into the hospital or even losing their lives because of the delay in taking Paxlovid. Metformin, I've not seen a lot of strong evidence for it, but the message is have your Paxlovid ready. If you start getting COVID, go on that.

Brian Lehrer: Dr. Peter Hotez, his new book, The Deadly Rise of Anti-Science: A Scientist's Warning. Thank you so much for sharing it with us.

Dr. Hotez: Thank you so much, Brian, for the opportunity.

 

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