NEB Podcast #31 -
COVID-19 Researcher Spotlight: Interview with Dr. Peter Hotez

< Return to NEB Podcast Home

 

Transcript

Interviewers: Lydia Morrison, Marketing Communications Writer & Podcast Host, New England Biolabs, Inc.; Nicole Kelesoglu, Labconscious Editor & Blogger, New England Biolabs, Inc.
Interviewees:  Dr. Peter Hotez, Dean of the National School of Tropical Medicine and Professor of Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine



Lydia Morrison:
Welcome to the COVID-19 Researcher Spotlight Series. Today I'm joined by my colleague, Nicole Kelesoglu, as we interview 2014 Passion in Science Award winner and now frequent guest of CNN and NBC networks, vaccine expert, Dr. Peter Hotez. Dr. Hotez is Dean of the National School of Tropical Medicine and Professor of Pediatrics and Molecular Virology and Microbiology at Baylor College of Medicine where he's also the co-director of the Texas Children's Center for Vaccine Development. Dr. Hotez, thank you so much for joining us today to share your expertise on vaccine development and distribution, particularly in light of the COVID-19 vaccines available.

Peter Hotez:
Oh well, thanks so much for having me. It's great to be here and great to get reconnected with New England Biolabs.

Lydia Morrison:
Absolutely. And we're also joined today by my colleague, Nicole Kelesoglu. Hi Nicole.

PNicole Kelesoglu:
Hi, Lydia. Hi, Dr. Hotez.

Lydia Morrison:
Dr. Hotez, I wanted to jump right in and talk to you about your new book, which is titled "Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-science". And I wanted to ask, what are some of the overarching issues you address in the book that can impede the ultimate impact of biomolecular research?

Peter Hotez:
Well, I think, one of the big issues is... I started writing the book well before COVID-19 struck and because I had seen kind of an unraveling of a lot of our past global health gains and it was not happening universally. Since 2000, we'd seen the scale up of a treatment for neglected tropical diseases, including parasitic worm infections and vaccine preventable diseases. And then starting around 2015, there seemed to be this slow unraveling in selected areas, but it was happening due to forces that we don't ordinarily think about as biomedical scientists. It was happening because of things like war and political collapse on the Arabian Peninsula or from the Boca Haram areas in Nigeria or the socioeconomic collapses in Venezuela. And it was also paralleled by things like climate change but it wasn't climate change just happening in isolation. It was working in concert with those forces.

Peter Hotez:
I was starting to hear people talk a lot about climate change and the role in promoting disease, but my observation was it wasn't just climate change acting alone. It acted in interesting and unique ways with these different social determinants. And then there was this big rise in the anti-science forces. So, I thought it'd be interesting to kind of pull all that together in a book to point out how these modern forces are bringing back disease, intended mostly for general scientific audiences to kind of in the biomedical sciences, but to introduce them to the fact that there are things going on that they never hear about in graduate school or in medical school, but to put them on notice that these are going to be the big drivers bringing back disease.

Peter Hotez:
And then, in it I was already talking about coronavirus infections and predicting this was going to be a big problem. And then bam, we learned in New Year's Day, a year ago, that COVID-19 had struck Wuhan and ultimately Hubei province and areas of China. And then it was off to the races from there. And so I wound up having to modify the book to incorporate all the new information about COVID-19 and we'd been working on a coronavirus vaccine, so it was not too difficult to do. And so the book is called “Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-science" and it kind of gives you a flavor of what you're in store for.

Lydia Morrison:
Yeah. Do you think that scientists should be concerned about the anti-science movement?

Peter Hotez:
I think we have to be. It started out as a fringe group, and the anti-vaccine movement starting in the early 2000s, but then it took this twist to the political extremism on the far right in 2015, under this banner of health freedom, medical freedom. And then parents started withholding vaccines from their kids in certain states. Especially in Texas, where I was, where Texans for Vaccine Choice and other anti-science political action committees had mobilized to convince the legislature to make it easier and easier to opt their kids out of getting vaccinations and harder and harder to vaccinate our kids. And being in Texas, I could see it firsthand because I have a daughter with autism and intellectual disabilities.

Peter Hotez:
That's when I wrote my first book on this subject called "Vaccines did not Cause Rachel's Autism". And one of the themes, both in the last book and this book is the fact that these anti-vaccine groups, which are now full on anti-science groups because they glommed on protests against masks and social distancing in 2020. The same groups that were anti-vaccine before now were full on anti-science because there was not only just vaccines, but against everything else related to COVID prevention. I really started to feel that a lot of this was happening because they were enabled. They were enabled because scientists were silent.

Peter Hotez:
We're so focused on our experiments and our grants and our papers that doing things like public engagement and refuting some of the claims of the anti-science groups are not seen as front and center of what we should be doing. And I think more and more, it's going to have to be if we're going to take this on because we've seen the dangers of what anti-science groups do. And it's the fact that we now have 400,000 Americans who've lost their lives, is not only because of COVID-19. It was COVID-19 in the context of vast sections of the US population who believe COVID-19 is a hoax and the deaths are due to other causes and a lot of this. And that masks don't really work. And they believe that hydroxychloroquine does. And all of this came out of a deliberate disinformation campaign from the White House. And I was uniquely poised to go after that because I'd been going up against anti-vaccine groups for so many years.

Peter Hotez:
I think a key message from my recent writings has been, 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's going to have to be another piece to this.

PNicole Kelesoglu:
It is certainly troubling. Dr. Hotez, does a useful framework exist that can help scientists to improve their own scientific communication skills?

Peter Hotez:
Well, there are bits and pieces of things out there. The Alan Alda Center and AAAS has definitely stepped up to put on a lot of programming. And in Boston, the American Academy of Arts and Sciences has been looking at this, but it's not really ingrained in our training. And I think that's going to be another important element. I wrote a piece in PLOS Biology that basically said, "I think we have to provide that training." Because there is a way to do this. And you know that because you see all the mistakes that the White House Coronavirus Task Force did in 2020. The disinformation aside from specific individuals, the others who were well intentioned, made one of two major mistakes. One, they would lapse into jargon and charts that nobody could interpret. But the more common mistake was they talked to the American people like they were in fourth grade or sixth grade because some expert in communication said, "You have to talk to the American people like they're in the fourth grade or sixth grade." And it was very off putting.

Peter Hotez:
And one of the reasons I think I've been effective is I don't do that. I try to take the time to explain complex ideas, but do it in steps. And to my happy surprise, people seem to like it. People don't mind the complexity. They really want to understand and they want to understand so they can protect themselves and their family members and their friends. And that may be is one of the modest silver linings in COVID-19 is people realize they like to hear from scientists and they don't want it all pre-digested and filtered and be spoken to like they're in the fourth or sixth grade. And so that provides a little window of opening. The problem is this, we don't offer that kind of training right now really in doctoral or postdoctoral education.

Peter Hotez:
I think the young scientists would love it. The commitment among young people to public service is at an all time high despite what they say about, you guys, the truth is I can tell you firsthand from dealing with young scientists that they're all in. They want to be out there engaging. But the other problem, aside from the lack of training in the doctoral and postdoctoral level is that you're not encouraged to do it by the academic health center or the university. They're still very oftentimes dominated by offices of communication that see this as a risk. They're very risk adverse and they don't like their docs and their scientists speaking out necessarily. And they're all about protecting the reputation of the institution and they often see that as a threat so it's not often not really encouraged.

Peter Hotez:
The fact that you're speaking out as a scientist about social justice or combating anti-science, that's not their thing. And so that kind of puts you in conflict, so that's an issue that needs to be resolved. Also, right now it doesn't contribute towards your career advancement. For instance, I get evaluated as I'm a professor and a dean. I get evaluated like everybody else. And what's on my annual evaluation form? It's my grants and my scientific publications. There's nowhere on there for an OpEd piece that I've written for commentary or much less the daily appearances on MSNBC and CNN and subliminal or not so subliminal messages what I'm doing to engage the public is not really valued and don't do it.

Peter Hotez:
I think that's a problem. And God forbid there should be something on the annual evaluation form for followers on Twitter and things like that.

Lydia Morrison:
Yeah, that might be asking a lot.

Peter Hotez:
That might not happen till the glaciers come back in Quebec. We've got a lot of work for us. The whole ecosystem needs to change and it has to change because the anti-science movements are becoming so dominant right now. And so what was a fringe element coming out of Texas and Oklahoma, there are now national groups committed to this. And now those national groups are exporting this to Western Europe. All during the summer of 2020, you had rallies, anti-mask, anti-vaccine rallies in Berlin and London and Paris. That all came out of the anti-vaccine groups that started accelerating in 2015. And it's taken awful turns, not only to political extremism on the right, but even to QAnon. And on top of that, you've got the Russians that have implemented a program of what we're now calling weaponized health communication on the internet.

Peter Hotez:
And you see it, if you follow me on Twitter, you'll see the stuff coming out of Russia put on Twitter. And so this is an international problem. Anti-science is becoming as dominant as science. And what do we do about it? How do you explain it to people? And this is one of the things I'm struggling with now, because I start talking about far right wing extremist groups and QAnon and Russians and the Murdoch Media empire. And you start sounding like somebody who throws things at the TV at night. How do you start saying it in a credible way that's believable? Even though it's all true, I still haven't found the right way to really explain it all. And it is a threat. I've been writing about this and I've been deliberately have written some of it in the lay press, but I'm trying to write a lot in scientific journals. PLOS Biology and PLOS journals have been good about letting me write about this and microbes and infection also.

Lydia Morrison:
Well you certainly are doing a good job sharing that information on Twitter. And just so everybody knows you are @peterhotez on Twitter, so they can find you there. And to stay on the thread of...

Peter Hotez:
And Twitter I've mixed feelings about as well. One of the things I don't do on Twitter is get into Twitter arguments or discussions. I find it could be a real time sink. Lady Gaga who sang today at the inauguration said, one of the great quotes she called social media, "The toilet of the internet." And she's partly right. Lessons learned from Lady Gaga. I use it as a vehicle for my writing to get it out there and to make important statements but I tend not to go into the hole of getting into arguments with people. And it's just, it can be really be a time sink.

Lydia Morrison:
Yeah. And emotionally draining as well, I think.

Peter Hotez:
Yeah. And the cyber bullying from the anti-vaccine groups is of course brutal. But then again, I try to use that as a teachable moment. One of the things that I do is I get heavily attacked both from the far right wing extremists groups, linked to the anti-vax homegrown groups in the US and then the Russians and when I can figure out what it's coming from, I try to highlight it and point it out and I find that's very teachable also, so people can see what's actually going on with disinformation. That's become such a dominant thing. I'm sorry. I interrupted you with that Lady Gaga diversion.

Lydia Morrison:
No, that's absolutely very important. Thanks for sharing that message. I wanted to stay on sort of the subject of altering the status quo. And to that end, how does the COVID-19 pandemic, do you think, demonstrate that investments in non-moneymaking vaccines against emerging diseases can help us prepare for future outbreaks?

Peter Hotez:
Yeah. We still haven't fixed the business model. It's interesting, when you look at the big vaccine companies, the sort of the old blue chip companies.... Merck and company, GSK, Sanofi, they're not really in it in a big way. Most of them are either Moderna is certainly not a vaccine company. Neither is AstraZeneca and Pfizer. They definitely are doing vaccines as well, but a lot of this, I think the driver was a great way to get, I think there's definitely a humanitarian drive among the scientists, but I think a lot of it also for the company is it's a great way to accelerate the mRNA technology and the adenovirus technology and to get government financing for it. It was a great economic stimulus plan.

Peter Hotez:
Also, it helped get that technology through the regulatory pipeline and in a way that they probably wouldn't otherwise. So now going to be able to turn it around for cancer vaccines and gene delivery technologies, which is totally fine, but it also points out the fact that we still don't have now vaccines still for low and middle income countries. Those mRNA vaccines are unlikely to really filter to the LMICs anytime soon, the technology is still expensive and it's clunky, it's complicated, in terms of scale of production. And then you've got sort of the Russians and the Chinese sort of bypassing WHO prequalification, although now they're trying to get re-engaged, which is good.

Peter Hotez:
When you look at the vaccines that are out there for low and middle income countries, there's not a lot out there. There's the Johnson and Johnson adenovirus vaccine that was originally developed by Dan Barouch at Harvard Medical School. There's the AstraZeneca Oxford vaccine, of course, at Oxford. Then there's our recombinant protein vaccine that we're scaling up production for in India now. And that may be it. There's not that many options out there. The Sanofi one is delayed. The Queensland one got delayed because of the HIV sequences in there and one of the clamps that they use. And so that's going to slow or derail it. I'm quite worried about the LMICs.

Lydia Morrison:
And how are things going with your vaccine?

Peter Hotez:
It's good. With Baylor, we did a license, a non-exclusive license to Biological E. in India, which one of the big producers. And they said, they're making a billion doses, which is amazing. We've never made a billion of anything before. Although somebody pointed out when we put the yeast into the fermenter, that's a billion or more. Literally that's true. Now testing across India so it's a great honor to be able to make that impact, but we really had to struggle to get that funded. We're not part of Operation Warp Speed because we're not a pharma company. One of the hardest things I did in 2020, and I'm still doing it is, is desperately seeking funds to do it. Because even though we had made the SARS1 vaccine, we were fine tuning it to make it, we still needed funding to move this along. We got some support from interesting sources. Tito's Vodka came to the rescue for us.

Lydia Morrison:
That's amazing.

Peter Hotez:
Next vodka drink, anyone who's listening, it must be Tito's.

Lydia Morrison:
Well, maybe I'll have one in your honor today.

Peter Hotez:
Yes, we all will. Also celebrate the inauguration too. And then, JPB Foundation, the Kleyberg Foundation and MD Anderson Foundation and a little bit of NIH money, but it's amazing how far you can get. When you work on neglected diseases, as you know from New England Biolabs, a couple of million dollars goes a long way and we were able to really stretch that.

Lydia Morrison:
Yeah, it sure does. Could you tell listeners how you define vaccine diplomacy?

Peter Hotez:
Yeah. This concept originated, the way I like to think of it, it actually started with Edward Jenner who made the first vaccine. He was called upon to mediate prisoner exchanges between the British and the French during the Napoleonic Wars but because he was giving his vaccine to the Europeans and ultimately sent his vaccine to the US where it was used in the Lewis and Clark expedition in the interior. But the modern form is really, I think I attributed to Albert Sabin who developed the oral polio vaccine jointly between the Russians and in the US. The Soviets and the US at the height of the Cold War, right after the Sputnik launch. And the two countries put aside their ideologies to work together to really shape that oral polio vaccine. Sabin sent his oral polio strains to the USSR and that was first scaled to immunize 10 million children in the USSR. That's an extraordinary story.

Peter Hotez:
And the question is, can you bottle that? Can you franchise it? Can you make this happen on a regular basis? And I was given that opportunity in the Obama administration. I served as US science envoy focused on the Middle East and North Africa to build vaccines jointly in the US and in Middle Eastern countries. Really exciting. With some successes, more failures probably than successes, but it was a very exciting time. And I think that's really important because the opportunity to do international science, to build new vaccines, drugs, diagnostics together is so important, especially now. In the last year, we went in the wrong direction with the Russians and the Chinese taking their vaccine of uncertain quality and then making one off deals with countries in a very sort of old Cold War fashion. Even there's a new term that's been coined for it, it's called vaccinationalism, and it's the opposite of vaccine diplomacy.

Peter Hotez:
And so hopefully we have to get back now to vaccine diplomacy. And then you had the US pull out of the WHO, that will be rescinded now and pulled out of the COVAX sharing facility. And then you had that very odd executive order from President Trump that basically declared eminent domain over all vaccines for the US, which I don't know how that's supposed to work when a lot of the Pfizer vaccines are made in Belgium and in Germany and elsewhere. But hopefully we'll get back on track now with this concept of a vaccine diplomacy. And what CEPI is doing to finance, CEPI is the Coalition for Epidemic Preparedness Innovation, it's associated with the Wellcome Trust and the Gates Foundation and WHO and Gavi and the Norwegian government, the Indian government, and a few other partners.

Peter Hotez:
And hopefully that's helping to finance our vaccine somewhat now for India. And hopefully we'll start seeing more of that vaccine diplomacy flourish now. Just in time. I think one of the things that I took for granted, and I don't anymore is how important US leadership is for health diplomacy and for global health. And when the US went on this go it alone strategy, it really hurt our ability to provide access for essential medicines and vaccines for COVID-19. And it just screwed up the global governance. Create those vacuums bad stuff happens and that's what happened with vaccinationalism.

PNicole Kelesoglu:
Sounds like you can't end a pandemic unless you end it everywhere. You need vaccine diplomacy.

Peter Hotez:
Absolutely. Absolutely.

Lydia Morrison:
Do you have an example of a hurdle to delivering COVID-19 support to poor countries or even poor communities within rich countries that could be addressed by currently available biotechnologies?

Peter Hotez:
Yeah. This is one of the important themes of COVID-19 that it's been disproportionately affecting the G20 nations. US, England, the European countries, Brazil have been hit really hard, but especially in the low income neighborhoods. And that's been true in the Hispanic neighborhoods across Texas really hit very hard because the illness causes higher death rates in people under the age of 65. 35% of the deaths among Hispanic communities from COVID-19 are in people under the age of 65, some people, mothers and fathers in their fifties and early sixties. And so that's another book that I wrote called Blue Marble Health, which is about widely accepted, I think it's around an important theme, but people don't generally accept it or talk about it much.

Peter Hotez:
And it says the following, when we think of global health problems, the paradigm is developed versus developing countries or poor versus a wealthy countries and when you actually add up the number of poverty related neglected diseases, what I find overwhelmingly is that in looking at whether it's worm infections or leishmaniasis or leprosy or dengue or tuberculosis, it's the poor living in G20 nations that mostly accounts for it and I gave it this new name called "Blue Marble Health" to just brand it differently from traditional norms of global health. And I think that COVID-19 is going by the same playbook.

PNicole Kelesoglu:
Is there one achievable action that society could take as a whole today that would really help most vulnerable people in this pandemic?

Peter Hotez:
Well, aside from the socioeconomic levers, which I know is a big component of that 1.9 trillion stimulus coming out of the Biden administration, I think it's trying to prioritize some of the more traditional vaccines is going to be very important. I think we went pretty heavy on the innovation and it's exciting technology, but I think it's still too new and too immature to put all of our eggs in the mRNA and adenovirus vectored basket. Certainly the mRNA basket at this time. Bringing on some more oldies but goodies in terms of traditional technologies, like our recombinant protein vaccine, maybe some of the inactivated virus vaccines.

Peter Hotez:
I think we have to pivot towards some of those as well and be able to scale those up more because they tend to be more durable in terms of how hardy they are and keeping it at refrigerator storage. And they tend to be low cost. I think ours, we're going to try to cost it up at a $1.50 a dose. It's really inexpensive. This is yeast fermentation technology, you do a 3,000 liter fermentor run, you can make a lot of it. And it's the same technology uses to recombinant hepatitis B vaccine that's used all over the world. It's been given to kids for the last 40 years so I hope that ours can get up there pretty soon.

PNicole Kelesoglu:
Yeah. Well, a $1.50 is a lot less than $20 a dose.

Peter Hotez:
Makes a difference, because right now, if you look at the Central American countries, they don't have access. Most of the Latin American countries don't have access to vaccine. Some of the poor Asian countries may not or they're making deals with the Chinese. And right now COVID-19 is not a huge problem in Sub-Saharan Africa, for reasons I never really fully understand. And all the reasons given just don't add up to me. Now that we have the UK variant, now the new variant coming out of Manous Brazil, the South African variant, what happens when that starts racing through Sub-Saharan Africa? This could be a real slaughter. I'm really worried about that as well. And we're going to need to have low cost, non-fussy, durable vaccines for the African continent and pretty soon.

Lydia Morrison:
Yeah, to that end, do you support the goal of locally produced COVID-19 vaccines?

Peter Hotez:
We try. There's a network that actually calls themselves the Developing Country Vaccine Manufacturers Network. And so we did a license to BIAWE in India, but the network extends to countries like Indonesia, Vietnam and Brazil and Cuba.

Lydia Morrison:
Do you believe that there is an area of infectious disease research that more biologists should be taking on today? Or which biomedical problems do you think need an influx of scientific talent?

Peter Hotez:
Well I think the needs are pervasive, for not only infectious diseases, but how you deal with cancer in Africa or sickle cell disease, diabetes racing through Africa and India now. What our definition of global health, I get a lot of young people who say, "Hey, Dr. Hotez, I want to be like you studying tropical diseases." And I say, "Look, it's great if you want to do that. But now we've got everything all over the world and I think the key is just to get well trained as a scientist." And I have a paper came out a couple years ago in PLOS Biology that talks about how the needs to do RNA-seq and all the systems biology. We need to apply that to illness in low and middle income countries. There's a huge need for that. And so the key is to get well trained in rigorous thinking and do a deep dive in technology or deep dive in thinking through a problem. And that will equip you well, when you want to start applying it to solving problems across the world.

Lydia Morrison:
Absolutely. Thank you so much for joining us today, Dr. Hotez.

Peter Hotez:
Well, thank you. And thanks to New England Biolabs for all of your encouragement and for what you're doing for the world is so important.

Lydia Morrison:
Thank you. And we've been so happy to get to know you and continue to watch you succeed at your work and continue to watch you really bring vaccine awareness and education, as well as scientific communication to the forefront of your messaging. And we really appreciate that.

Peter Hotez:
Thank you so much.

PNicole Kelesoglu:
Thanks for being the voice of reason.

Peter Hotez:
It's tough. For me, one of the hardest things in 2020 was going up against the White House and the Coronavirus Task Force. Because the message as a scientist, again from your bosses and everyone else, "Hey, just Peter, fine. You want to do that? Go ahead. But just stick to the science, stick to the science." And then what you saw was how the White House was deliberately tying anti-science to political allegiance on the far right. And the only way to disentangle it was to call it out. It wasn't that it was being political, but you couldn't just pretend that it didn't exist. And my wife Ann saw how upset I was getting, and finally said just go for it. Because you don't want to wake up months from now and realize the death toll from COVID-19 and realize that you didn't do all you could have to stop the death and destruction. That's what I did all through 2020. And in retrospect, I'm really glad I did it. And I think it did help save lives, and no question, it took a pretty big emotional toll on me and family.

PNicole Kelesoglu:
Well, thank you to Ann as well.

Lydia Morrison:
Yeah, Thanks to Ann and the rest of your family for supporting you. And thank you for taking a stand. It's important time to do it.

Peter Hotez:
Yeah. And marry for love. That's another piece of it.

PNicole Kelesoglu:
That's the best advice.

Lydia Morrison:
That is wonderful life advice. Thanks so much.

Lydia Morrison:
Thanks for joining us for this episode of the COVID-19 Researcher Spotlight Series. Join us next time when I interview Todd Camenisch, Professor and Chair of the Department of Pharmaceutical Sciences at St. John Fisher College in Rochester, New York. Todd has been spearheading wastewater surveillance testing at the institution and we'll discuss how the program works and how results are guiding the precaution and mitigation efforts as well as further testing at the school.

Loading Spinner
"