Research Comms Podcast: Dr Peter Hotez on Vaccines

Having the title of ‘Public Enemy No. 1’ with the anti-vaccine movement makes me in demand!’ Dr Peter Hotez on his outspoken stance on the importance of vaccines.

Peter Hotez poses with his daughter, Rachel, in their Montrose home. (Credit: Copyright 2017 Brian Goldman/Goldman Pictures)

Peter Hotez poses with his daughter, Rachel, in their Montrose home. (Credit: Copyright 2017 Brian Goldman/Goldman Pictures)

Dr Peter Hotez is a pediatrician and vaccine scientist at Baylor College of Medicine in Texas. More recently he has also become an outspoken and prominent advocate for vaccines in the face of the growing anti-vaccine movement. In this episode Dr Hotez opens up about why he is so angry with those spearheading the anti-vaccine movement and he talks about his new book 'Vaccines Did Not Cause Rachel's Autism' which debunks some of the most prevalent anti-vaccine myths, as well as telling the story of his life as the father of a daughter with autism.

The below is a short excerpt of my interview with Peter Hotez. For the full interview download the podcast.

What’s the latest in terms of the measles outbreak that’s hit America? [NB: this interview took place in early May 2019, and the numbers have increased significantly since then]

Where we're at, in terms of the US side, is that we're now up to around 700 cases, and that number is significant because it's now the most cases that we've had in the US since measles was declared eliminated almost 20 years ago. So, the thing that's worrying everybody is, does this mean measles is coming back? And are we reaching a tipping point where we can no longer say measles has been eliminated? I don't think we're there yet but I do think what we're seeing is that this problem is not going away.

Measles is becoming a new normal in America because of the anti-vaccine movement and, sadly, I've been predicting this since the beginning of 2017, when I wrote an op-ed piece in The New York Times called ‘How the Anti-Vaxxers are Winning’. I've been telling anyone who will listen that measles is returning and that the anti-vaxxers have gained ascendancy, and I've had some source of frustration around that because our public health leaders in this country are still treating this as though we're back in the early 2000s, when the anti-vaccine movement was kind of a fringe group. They’re not recognising what I've been seeing, that anti-vaccine groups now dominate the internet and that they've really become their own media empire. So, you have Fox News, you have MSNBC, you have CNN, and you have ‘Anti-Vaxx World’. By some estimates there are almost 500 anti-vaccine websites, they've figured out a way to amplify their message on social media, even monetize it. They've also taken over the Amazon site. So, my book ‘Vaccines Did Not Cause Rachel's Autism’ is one of the highest-ranked pro-vaccine books on Amazon, that's the good news, the bad news is that it's behind twenty other anti-vaccine misinformation books, so Amazon is now the single largest promoter of phoney vaccine misinformation. So this is what I mean by them ‘dominating the internet’ and now, because our public health leadership in this country has been so silent for so long and so enabling for so long, we've got a problem that now we've got to figure out how to put this all back, and it's not going to be easy. It's doable but it's it's not going to be easy.

Some might think that so long as they’re vaccinated and they’ve had their kids vaccinated they’ll be safe but it doesn’t work like that does it? Can you explain this concept of ‘herd immunity’?

Let's remember how how these measles outbreaks are playing out. Let's say you have a school where a large numbers of kids are not vaccinated, the vaccinated kids in the school will be protected against measles but the unvaccinated kids will not be and the measles will circulate among the unvaccinated kids. But remember, what happens in a closely knit community is that those kids are going over to each other's houses, playing in each other's houses and in those houses are siblings and siblings under one year of age are not yet old enough to get their first measles vaccine. And that's who winds up in the hospital, so it spreads throughout the community, it strikes pregnant women, it strikes infants not old enough to get vaccinated and that's where you have this epidemic. So, the minute you have any kind of decrease in percentage of kids vaccinated in a community, measles is often the first one you see because it's one of the most highly contagious viruses known. So, as you drop below around 90 percent vaccine coverage measles is what you see first, and it's all the infants in the community who are the ones who are winding up in intensive care units.

It seems that in many cases people have forgotten how series an illness measles is?

That's right, so one of the things the anti-vaccine movement is doing is circulating children's books claiming that measles is a benign illness and nothing more than a rash, you can get them on Amazon (where else?), and they ignore the inconvenient truth that up until a couple of decades ago measles was the single leading killer of children in the world and also a killer of pregnant women. Those are the two populations that are the most vulnerable because they die from measles pneumonia, measles encephalitis, it produces permanent injury, like hearing loss and intellectual deficits, and that's what we're seeing unfold right now in New York. When I last looked there were five children in the intensive care units and in New York a quarter of them have been hospitalised so, for sure, measles is a bad actor and a very serious disease. It’s one of the great killers globally and, again, that's a public health communications failure not to get that information out.

Tell us about your latest book ‘Vaccines Did Not Cause Rachel’s Austism’

In some ways it's a unique genre of book. It’s a science book that debunks links between vaccines and autism but it's also a personal story and I think we need more of those stories because I think one of the problems is we're seeing that Americans increasingly can no longer identify with scientists, we're nameless, we’re invisible, and there are some studies conducted by Research America and other groups that bear that out, that the vast majority of Americans cannot name a living scientist. And that's partly our fault because we don't try to do that public engagement work. We've lost our interest or even our ability to speak to the public and we're just focused on writing and speaking for each other. So, this book tries to break out of that mould

In terms of the science we can break that down into two pieces. The first is the overwhelming evidence showing there's no link between vaccine and autism, and this is based on epidemiological studies, now conducted in over 1 million children, showing that kids who get vaccinated are no more likely to get autism than kids who aren't vaccinated. And then the second science piece is to explain what autism is and how we have at least ninety-nine genes identified, all involved in early fetal brain development. The point is that it’s happening during early on in pregnancy, well before kids ever see vaccines and I highlight that in order to point out the lack of plausibility that vaccines cause it. So the processes begin in early pregnancy even though the full clinical expression doesn't happen until usually 18 to 20 months of age. So, if you're hypothesising that vaccines cause autism then you have to counter all the massive scientific evidence that says otherwise.

But often the science itself isn’t enough to convince people that vaccines are safe, is it? Especially when on the anti-vaccine side you have powerful stories from parents convinced that vaccines have harmed their kids?

Yes, and it doesn't help that the scientific community is largely invisible because we're all writing and speaking for each other, so there's no counter voice out there saying “okay this is what the science is really saying” and many scientists are themselves parents or husbands or wives and and so we need to be out there telling our personal story.

What we're going to start needing, as a central component of scientific training, is public engagement in science communication . We have to build that into the DNA of how we train our young scientists. You know, back when I was getting my medical degree it was just the opposite, the statement was ‘You don't engage the public, you don't talk to journalists’. That was seen as self-promotion or grandstanding and I think that was a huge mistake. That attitude was very enabling for all these anti-science movements to crop up, not only the anti-vaccine movement, it's also why we have climate denial, it’s why we have anti GMO anything, it's why we have a whole generation of scientists who are largely unable to communicate.

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Peter Barker is the Director of Orinoco Communications, which he started in 2016, having spent over ten years working in broadcast television as a documentary producer/director. 

He specialises in the digital communication of research in science, the social sciences, humanities and arts.