Dr. Peter Hotez champions low cost COVID-19 vaccines and training scientists for science communication

It was a treat to interview Dr. Peter Hotez, who has a passion for making life- saving biomedicine both understandable to the public and globally accessible. As a prominent vaccine development scientist in emerging and neglected tropical diseases, he often communicates COVID-19 science to the public on TV, radio and in newspapers. Concurrently, his research is being put into action with a project to locally produce a SARS-CoV-2 vaccine in India. In his new book, Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-science, Dr. Hotez urges all scientists to adapt to a new era.

Few outside the field had the foresight of Dr. Peter Hotez. Since winning the New England Biolabs Passion in Science Award for humanitarianism in 2014, Peter Hotez, M.D., Ph.D., has tirelessly worked to bring the benefits of biotechnology to clinics worldwide. He is well suited to this role. Hotez is a pediatrician, Co-director of the Center for Vaccine Development at Texas Children's Hospital, and Dean of the National School of Tropical Medicine at Baylor College of Medicine. Hotez also served as a U.S. Science Envoy. Before the alarming death toll of the COVID-19 pandemic, his coronavirus research was categorized within emerging tropical diseases. Warnings were being published in the field that there were dangerous gaps in our preparedness, even considering the knowledge gained since its emergence as SARS in 2003. One paper described it as a “time bomb “ waiting to happen. On March 5, 2020, Dr. Peter Hotez testified to the United States House of Representatives Science, Space, and Technology Committee that we could have had a vaccine ready to go. He explained that scientific hurdles were not the problem.  There was just no system to fund this type of research and bring it over the finish line into the clinic.

Unfortunately, for society, hindsight is 2020.

Safe, effective, and accessible COVID-19 receptor- binding domain (RCB) vaccines

Today, Peter Hotez supports vaccine diplomacy in the form of an international plan to deliver SARS-CoV-2 biomedical resources all over the world. He is amplifying this message in both words and deeds, with a special focus on vulnerable populations.

Hotez recently co-authored several commentaries and scientific reports on COVID-19 resources for several highly vulnerable populations. Close to my heart is the commentary in the Lancet, Prioritizing COVID-19 vaccinations for individuals with intellectual and developmental disabilities, which urges planning for anticipated hurdles to vaccinations and the higher risk faced by many who live in group care homes or institutions. Perhaps due to genetic susceptibility and / or living circumstances, Latinos are suffering more from COVID-19. Hotez and co-authors Jorge A. Huete-Perez and Maria Elena Bottazzi call for urgent strategies to combat the higher risk faced by Latinos in the paper, COVID-19 in the Americas and the erosion of human rights for the poor. Also in the Lancet, the insurmountable challenge of complex mRNA vaccine production, cold storage infrastructure, and the lack of financing to purchase vaccines is laid out in Urgent needs of low-income and middle-income countries for COVID-19 vaccines and therapeutics. The reality is that mRNA vaccines are unlikely to reach most people in the world. That increases the drift potential for SARS-CoV-2 mutations of concern and future outbreaks. Poignantly, this leaves all of humanity vulnerable. 

The big picture is that mRNA vaccines are a triumph, but low-cost vaccines are a necessity. Hotez worried during our podcast interview hosted by Lydia Morrison about low and middle-income countries. There are too few vaccine options. The only accessible vaccines, not currently delayed in development, are the Johnson and Johnson vaccine, the AstraZeneca and Oxford University vaccine, and the recombinant subunit vaccine based on his research at Baylor University in collaboration with The New York Blood Center and the University of Texas Medical Branch.

The Baylor College of Medicine National School of Tropical Medicine has partnered with the biopharmaceutical companies Biological E. Limited and Dynavax Technologies to run local clinical trials for a SARS-CoV-2 receptor binding domain vaccine in India. Besides using a proven production platform, another notable advantage of this vaccine is its safety profile. Its recombinant subunit immunogen avoids risks for post- infection eosinophilic cellular immunopathology and suboptimal antibodies that may aid viral cellular entry. Both risks can be associated with SARS virus vaccinations that use viral vectors, whole virus immunogens, or even whole spike protein immunogens. Happily, the clinical trials for the RBC- based vaccine are going well! Production is already scaling up. Most of this vaccine will go to the COVAX initiative serving 190 countries. The information for this biotechnology is available with a very affordable, non-exclusive license from Baylor University for use by more production-capable organizations.

Baylor has received some research and development funds from humanitarian donors, but funding continues to be the biggest struggle. Donors include the JBD Foundation, the Coalition for Epidemic Preparedness Innovations (CEPI), the Bill and Melinda Gates Foundation, the World Health Organization and Tito’s Vodka (Cheers!). Dr. Hotez commented, “It’s a great honor to be able to make that impact. But we really had to struggle to get that funded. I’m still desperately seeking funds.” Hopefully, more will step up!

Public engagement training for scientists

This is a new era and as scientists, we don't have the luxury anymore of just staying focused on our grants and papers and lab meetings, as important as that is, there is going to have to be another piece to this.

The speed of development for SARS-CoV-2 vaccines is a victory that has paradoxically become a weakness due to fearful public sentiment. What is happening? What is clear is that good science communication is desperately needed for engaging the public in solutions. Hotez attributes the deaths of tens of thousands of Americans from COVID-19, measles, and other vaccine-preventable diseases to the anti-science movement. Most recently, in PLOS Biology, Anti-science kills: From Soviet embrace of pseudoscience to accelerated attacks on US biomedicine, he warns that the anti-science movement must be countered or biomedical solutions will not halt COVID-19.

Dr. Hotez’s new book shares his analysis of how we got here, to help us consider what comes next. When we asked about vaccine diplomacy and the anti-science movement, Hotez explained, “A key message from my recent writings has been that this is a new era and as scientists, we don't have the luxury anymore of just staying focused on our grants and papers and lab meetings, as important as that is, there is going to have to be another piece to this.” His own experience is proof of concept. The book covers high-level examples from his work in international diplomacy. Yet, perhaps the most searing evidence for this challenge is domestic. Hotez underwent a sort of baptism by fire in the early days  of the anti-science movement, trying to get the message out that vaccines do not cause autism. The preventable infectious disease outbreaks coming from vaccine misinformation campaigns fortified his resolve – but public engagement was not part of his training as a scientist.

In our interview, Dr. Hotez shared some great tips for science communication along with some concerns. One good resource is the AAAS Communication Toolkit. He explained that, at a minimum, talking down to the public, or using jargon and charts that no one can interpret, are very off-putting. As often showcased in his television appearances, his technique is to take the time to explain complex ideas, but to do that in steps. This method of communication is effective because people want to understand the complexity. They want to protect themselves and their loved ones from COVID-19.  It turns out that people like to hear directly from scientists in this manner.

Dr. Hotez pointed out the unfortunate situation that no real training for effective communication exists in doctoral or post-doctoral education, nor is there an established career path for public engagement by scientists in research institutions. Hotez remarked  that “…the ecosystem has to change because the anti-science movements are becoming so dominant right now.” Life science should take heed. As biotechnology advances to improve modern life, so does its conceptual complexity. COVID-19 vaccine hesitancy is merely a microcosm of anti-science challenges. Scientists need to prepare clear science communication to see that hard won solutions can be put into practice.

Biomedicine as the peacemaker

Initially, I was interested in speaking to Hotez because of his experience and foresight as a SARS virus researcher. I came out of our conversation impressed by his comprehensive view on the interplay between the pandemic and anti-science. He earns the public’s trust with the spirit of an educator. My sense is that his open recognition of the dire economic impacts of COVID-19 and his push for practical vaccines enhance that relationship. After all, a hungry stomach has no ears for science. Please enjoy listening to the podcast of Dr. Peter Hotez to learn how biomedicine can act as a peacemaker in a harrowing time.