In the preface of the new book by vaccine expert and pro-science crusader Peter Hotez, there are several acknowledgments of a kind that may never have appeared before in a book like it.
There, Hotez expresses gratitude to the Houston Police Department, the Texas Medical Center Police Department and the security force of the Texas Children’s Hospital and Baylor College of Medicine.
These are all places where Hotez plies his profession. He thanks all those departments “for keeping my family and me safe during this time of aggression.”
The health sector and the scientific sector don’t quite know what to do because this is a politically driven attack, coming from extremist elements of the Republican Party.
— Pediatrician and vaccine scientist Peter Hotez
These words tell a story all their own: how the anti-vaccine and anti-science movements have incorporated physical threats into their despicable arsenals. I wrote nearly two years ago that, unable to produce scientific support for their views,to discourage critics.
Things have only gotten worse since then, as Hotez reports in his new book,A professor of pediatrics and molecular virology at Baylor and a courageously outspoken advocate for public health, Hotez documents how agitators on the extreme right have graduated from trying to sow mistrust in science to targeting individual scientists such as himself.
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The heart of his book is a call for government agencies and professional organizations to wage an aggressive battle against anti-vaccination and anti-science propaganda. What’s needed, he says, is something akin to an interagency task force to address the problem, because the scientific community as it’s currently organized can’t do so on its own.
“The health sector and the scientific sector don’t quite know what to do because this is a politically driven attack, coming from extremist elements of the Republican Party,” he told me. “What you see instead are responses that skirt around the edges. You’ll see public health agencies step up their pro-vaccine messages, and sure, that’s important, but it doesn’t get to what’s really driving this.”
Hotez identifies several reasons for scientific organizations’ ineffective response to the spread of scientific misinformation and disinformation. “They don’t have the skill set or the background to know how to deal with this,” he says.
Then there’s their traditional commitment to political neutrality. “They say, ‘We’re a scientific or health organization, we have to be politically neutral.’” He cites the observation by Elie Wiesel that “, never the victim.”
On Oct. 13, Hotez received the inauguralfrom the Infectious Diseases Society of America for his long public campaign against anti-science propagandists. The battle came at a considerable personal cost.
Online trolls have compared Hotez to Hitler and Stalin. He has been “doxxed” through the publication of his email address and office phone number, and showered with email threats calling for his torture or public execution. Many threats were larded with antisemitism.
Hotez is not alone. “I get hate mail, I get physically harassed, I’ve gotten three legitimate death threats that have had to be investigated by the FBI,” Paul Offit, a prominent vaccine scientist in Philadelphia, recounts ina new documentary by Scott Hamilton Kennedy about the damage done to public health by anti-vaccine propaganda. (The documentary will open at the Angelika Film Center in New York on Nov. 2 and the Laemmle Glendale in Southern California on Nov. 17.)
The film includes a clip of Del Bigtree, a leading anti-vaxxer, addressing an audience with the words: “Do you think it’s a good idea to let the government own your baby’s body? Anyone that believes in the right to bear arms to stand up against your government, I don’t know what you were saving that gun for then.”
Hotez’s book and the film both trace the evolution of vaccine science, starting with the discovery by Edward Jenner in the 1790s that people exposed to cowpox via inoculation would be rendered immune from the much more dangerous smallpox, and the evolution of the anti-vaccine movement.
“As both a pediatrician-scientist who develops vaccines and a parent of an adult daughter with autism,” Hotez writes, “I have had a front-row seat on the modern anti-vaccine movement in America.”
Anti-vaccine activism had existed almost for as long as there were vaccines, but the movement got an enormous shot in the arm, so to speak, from a notorious article in the Lancet, a respected British medical journal, in 1998. The paper by a team headed by British physician Andrew Wakefield purported to identify a link between the measles-mumps-rubella (MMR) vaccine and autism.
The Lancet retracted the paper in 2010. After an investigation,. Countless subsequent scientific studies have established that there is no connection between the MMR vaccine and autism.
Nevertheless, Wakefield’s paper promoted an almost immediate plummet in MMR childhood vaccinations in Britain and its claim remains central to the anti-vax movement to this day — a movement that continues to lionize Wakefield, who now lives in the U.S., as a truth-teller.
The historical roots of the anti-science movement date back more than 100 years, Hotez writes, to when authoritarian regimes such as Stalin’s recognized that discrediting scientific experts assisted their path to personal power. Its appeal to the modern Republican Party has much to do with economics — challenging the scientific consensus on global warming, for example, allows the GOP to serve the anti-regulation interests of its Big Business patrons.
The anti-vaccine movement was in many respects a natural fit. Its invocation of shibboleths such as— coded justifications for opposition to vaccine mandates — led to its getting “picked up by the Republican Tea Party in Texas,” Hotez says.
“It was mutually reinforcing,” he told me. “The anti-vaccine groups were getting attention and PAC money that they never had before, and the far right got a new set of adherents and a new faux outrage to rally the base. It just became part of the canon.”
The anti-vaccine and anti-science movements exploit and amplify the lay public’s ignorance about the scientific method and the technical aspects of how vaccines work.
“Vaccines were compelling because vaccine-preventable diseases were compelling,” Offit explains in the documentary. Smallpox, polio and measles were recognized nemeses when they ranged the world untreated. Smallpox alone took the lives of an estimated 500 million people over the centuries, but thanks to vaccination it was judged eradicated from the world by the late 1970s.
The introduction of the polio vaccine in 1955 and the measles vaccine in 1963, accompanied by public mass vaccination campaigns, dropped the number of U.S. deaths from those diseases to zero by the early 1980s. Since then, those diseases have recurred only in discrete communities where vaccine resistance reigns, and among the unvaccinated.
Yet “vaccines are a victim of their own success,” Offit observes. “When vaccines work, nothing happens. I think that’s what makes them a little less compelling. People don’t really see what they’re doing.”
When once-common photographs of children hobbling on crutches, confined in an iron lung, or consumed with the bright red measles rash, much less perishing from the diseases, disappear from news reports, people forget how devastating the diseases once were.
“I understand how easy it was to appeal to the notion that vaccines are doing more harm than good” — a common feature of anti-vaccine hysteria — “because we weren’t seeing the vaccine-preventable diseases and their harm,” Offit says.
When the affiliated anti-vaccine and far-right movements turned their firepower on the COVID-19 vaccines introduced in 2021, the consequences were dire. Hotez estimates the unnecessary toll at 200,000 American lives lost because of vaccine refusal and.
The partisan character of this outcome is manifested in a distinct divide in COVID vaccination rates between blue and red counties, with the latter having. The partisanship is curious, given that Donald Trump has boasted that the development of the COVID vaccines was spurred by his own Operation Warp Speed. But COVID vaccine resistance has also been spurred by his persistent efforts to minimize the severity of the pandemic.
Despite his own efforts and those of other science advocates, Hotez sees only minor glimmers of hope that the trend toward science skepticism can be beaten back. Medical boards have fallen woefully short in enforcing their own regulations against physicians spreading misinformation and disinformation.
In California, Gov. Gavin Newsom just signed a repeal of one of the very few state-level regulatory initiatives — a law passed only a year ago that empowered the state medical board to treat COVID misinformation as an element of professional misconduct. The original law’s critics argued that the board already had the power to discipline doctors for spreading misinformation about COVID — and the law had beenon grounds that it infringed on doctors’ free-speech rights.
On the federal level, debate over science policy has been ceded to the Republican right wing, which has held hearings to try to humiliate scientists who have done unrefuted studies identifying the origin of COVID as a natural outbreak from wildlife to humans, debunking the factually unsupported partisan myth that it was produced in a Chinese government lab.
“They’re not even pretending at anything other than political theater,” Hotez says. Even moderate Republicans shy away from questioning the GOP right’s position.
“I don’t see mainstream Republicans coming to the defense of science,” he says. “But we’re not really hearing from the White House Office of Science and Technology Policy. The Health and Human Services agencies are pretty quiet.” He says he’s had conversations with like-minded scientists “about how we get organized better to respond to this. But it’s slow going.”
The real danger, as Hotez sees it, is that anti-science politics will become globalized. “It’s not going to stay in the U.S. We export movies, we export music, we’re going to export this stuff.”
In the past, he says, a sort of social auto-correction counteracted anti-vaccine activism. In the past, if vaccine resistance led to an outbreak of measles or pertussis, word would spread across the community, creating pressure on resistant parents to vaccinate their children.
“I don’t see that, even after 200,000 lives lost. These were victims of a predatory disinformation campaign,” Hotez says. Instead, the vaccine opponents “are doubling down, just telling a bigger lie, blaming the vaccine and the scientists. I don’t see that getting any better, at least until the 2024 election. And what happens after the election is anybody’s guess.”