April 26, 2021

Understanding science

#159 – Peter Hotez, M.D., Ph.D.: Evolution of the anti-vaccine movement, the causes of autism, and COVID-19 vaccine state of affairs

“What started out as an anti-vaccine movement is now a movement against any kind of public health intervention and demonizing scientists and basically calling us the boogeyman.”  —Peter Hotez

Read Time 33 minutes

Peter Hotez is an internationally recognized physician-scientist in neglected tropical diseases and vaccine development. In this episode, they first follow up on the podcast episode (#158) with Brian Deer (the investigative journalist who exposed the complex and disturbing story behind the infamous 1998 Lancet paper by Andrew Wakefield linking the MMR vaccine and autism) with a broader discussion about the origin and evolution of the anti-vaccine movement. They explore some of the specific claims being made around vaccine additives, the timing of when vaccines are given, and claims about issues with the HPV vaccine specifically. Next, Dr. Hotez shares his own journey as a parent of an autistic child and speaks of the challenges of diagnosing autism, what could account for the seeming increase in the prevalence, and whether there is any support for the notion that environmental triggers play a role. They close out with a discussion on the state of affairs with respect to COVID-19 vaccination, comparing the various vaccines as well as the challenges that emerging variants of the virus may present. This episode was originally recorded on April 2, 2021.

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We discuss:

  • The stubborn persistence of anti-vaccine sentiment (3:00);
  • A closer look at claims about thimerosal and vaccine spacing causing autism (12:00);
  • The Hib vaccine: An example of the profound difference a vaccine can make (23:30);
  • The controversy surrounding the human papillomavirus (HPV) vaccine (30:45);
  • The growing anti-science sentiment, COVID vaccine hesitance, and the basis of the anti-vaxx movement (39:00);
  • The origins of autism, and Hotez’s personal story as a parent of an autistic child (1:02:45);
  • The challenge of diagnosing autism, increasing prevalence, and a potential parallel to Alzheimer’s disease (1:14:15);
  • Comparing the various COVID-19 vaccines and the impact of emerging variants of the virus (1:30:00);
  • Global vaccination challenges and “vaccine diplomacy” (1:40:45); and
  • More.

§

The stubborn persistence of anti-vaccine sentiment [3:00]

  • Brian Deer, who is not particularly a vaccine advocate but an advocate for good science, was recently on The Drive
  • There is so much deceit in the work of Andrew Wakefield, who claimed that the MMR vaccine caused autism
  • Peter wants to discuss: Why, after Wakefield was debunked, is this still an issue?
  • A 2015 poll showed that more than 20% of millennial-age Americans still think vaccines cause autism

The anti-vaccine lobby keeps moving the goalposts (4:30)

  • Began in 1998 with now the now-retracted Wakefield paper asserting that the MMR vaccine causes autism by the live virus replicating in the colon
    • robustly refuted by scientists
    • large cohort studies showed not linked, sound epidemiological data debunked the claim
  • Then switched claims
  • Each time the scientific community responds, they keep shifting arguments to maintain momentum and re-energize the movement

The focus has now shifted from pseudoscience to politics (4:30) 

  • Beginning around 2014-15, latched onto the Tea Party Movement to make it a politicized movement around concepts of health and medical freedom
  • Hotez decries the “craziness on Fox News
  • “They create these versions 1.0, 2.0, 3.0 of the anti-vaccine movement, but the autism piece never entirely left. That’s still its legacy fake assertion that still haunts us today”
  • Peter urges listeners to listen/watch the podcast with Brian Deer and to read Brian’s book for detailed information about the lack of association between the MMR vaccine and autism

“I don’t know how to say this delicately, but I think if after assimilating all of that work, you still believe that there’s a relationship between that vaccine and autism, there’s probably nothing that can be said that can dissuade you from that.” —Peter Attia

  • It was helpful that Deer was able to show not just the Wakefield’s scientific fallacy but also his nefarious intent
  • The movement has grown much larger than Wakefield
  • Now also spreading beyond the US
  • Discussing the science “won’t stop the momentum of the anti-vaccine movement because they light a fire, they cause damage and then they move on and that’s their modus operandi
  • Peter says this podcast episode is not going to stop the anti-vaccine movement but that his goal is to “help parents, who frankly are inundated with information and can’t distinguish between signal and noise”
    • Peter says it’s worth discussing thimerosal and increasing autism rates and other claims to help parents who are confused
    • He doubts he can dissuade the 20% of people who think vaccines are evil, but he wants to reach those in the middle who are undecided
  • By 2007-08, Wakefield’s claims had not only been debunked scientifically but also it was clear that he and John O’Leary had lied and manipulated data
    • The Lancet retracted Wakefield’s paper in 2010
    • Said results were no longer valid
    • referred to the medical council panel but did not mention Brian Deer’s work
    • The journal had published an institutional defense of the work in 2004
  • Peter says the lawsuits were the most damning because Wakefield couldn’t produce evidence to maintain any legal argument

 

A closer look at claims about thimerosal and vaccine spacing causing autism [12:00]

Thimerosal

  • Thimerosal is no longer in most childhood vaccines
  • If have a multidose vial of vaccine, risk of introducing bacteria every time you’re introducing a needle into the vial through a rubber stopper
    • Need a preservative that’s nontoxic to humans but will kill the bacteria
    • Was an advance that allowed vaccination of large populations
  • It was taken out of vaccines because of all the bad publicity swarming around it
    • There was no scientific evidence that it is harmful, but the thinking was that it was unnecessary because single dose vials could be used instead, so take it out to increase vaccination rates
    • Thimerosal is still in some flu vaccines in US, although they can also be given as a single dose
  • No association between thimerosal and any adverse health effect was ever established
    • Bobby Kennedy made thimerosal his cause
    • He is an environmental lawyer who probably thought of Minamata Disease when he saw that thimerosal contained mercury
      • Decades ago, Japanese people were exposed to high levels of methylmercury in fish
      • Developed neurological symptoms that came to be called Minamata Disease
    • Thimerosal does not cause autism, which is associated with prenatal events
    • But Kennedy got involved and a couple of books made that claim
  • Gained momentum as Wakefield’s claim had
  • Hotez addressed these claims in his book Vaccines Did Not Cause Rachel’s Autism
  • Peter clarifies the difference between thimerosal and methylmercury
    • Thimerosal is ethyl mercury, an organic mercury
    • Methylmercury, which causes the toxicity we get from eating fish, is also an organic mercury
    • Minamata disease resulted from the industrial release of methyl mercury, a different compound from thimerosal / ethyl mercury 
    • Methyl mercury accumulated in fish and caused a congenital neurologic disease with gait and motor disturbances and other problems including coma and death
  • In 2001, a journal called Medical Hypotheses published a paper suggesting that thimerosal could be linked to autism
    • Thimerosal was a common preservative but was eventually removed from vaccines
    • But after it was taken out, the rates of autism did not decrease
  • Large cohort studies did not show any link between autism and thimerosal      
  • Peter points out that the 2001 paper was not unreasonable at the time; it was formulating a hypothesis by looking at plausible associations 
  • The problem comes later “after the scientific community goes to great lengths and great attempts to seek the truth and publishes paper after paper after paper in mainstream scientific journals” when anti-vaccine groups don’t acknowledge that work and “cling to their debunked hypothesis”
    • Say that scientists or journals must be paid off by pharmaceutical companies
    • Resort to conspiracy theories instead of showing intellectual curiosity about what actually causes autism
  • “continually discount the massive amount of scientific work that’s gone into really uncovering what autism is”
  • Peter says there are people who are “very influenced by data, they can think probabilistically, they can think in terms of uncertainty, they can accept and reason their way through these things” and others who “cling to a belief in the presence of emerging data that refute that hypothesis and they’ll continue to come up with an excuse”
  • Anti-science sentiment is growing
  • The process of removing thimerosal from vaccines began around 1999

Vaccine Spacing (19:45)

{end of show notes preview}

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Peter Hotez, M.D., Ph.D.

Peter J. Hotez, M.D., Ph.D., is Dean of the National School of Tropical Medicine and Professor of Pediatrics and Molecular Virology & Microbiology at Baylor College of Medicine. He is also the Co-director of the Texas Children’s Center for Vaccine Development (CVD), Texas Children’s Hospital Endowed Chair of Tropical Pediatrics, and holds numerous other positions as a professor and fellow at both Baylor and Texas A&M. He is an internationally-recognized physician-scientist in neglected tropical diseases and vaccine development.  As head of the Texas Children’s CVD, he leads a team and product development partnership for developing new vaccines for numerous diseases, including SARS/MERS/SARS-2 coronaviruses, while championing access to vaccines globally and in the United States. In 2006 he co-founded the Global Network for Neglected Tropical Diseases to provide access to essential medicines for hundreds of millions of people. Dr. Hotez has authored more than 500 original papers and is the author of four books. He has won multiple awards, served in government in several capacities, and appears frequently in major media outlets.  In 2017, he was named by FORTUNE Magazine as one of the 34 most influential people in health care. He obtained his undergraduate degree in molecular biophysics from Yale University, a Ph.D. degree in biochemistry from Rockefeller University, and an M.D. from Weil Cornell Medical College. 

Website: peterhotez.org

Twitter: @PeterHotez

Facebook: Peter Hotez 

Instagram: @peterhotez

Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.

21 Comments

  1. Peter:
    Interesting podcast.

    It’s ok that Dr. Hotez has his opinions about the Republican Party and the Trump administration regarding Covid / vaccines. His right. Unfortunate however is his own repeatedly politicization of conservatives with extremist groups flawed his argument. If the good Dr. can’t see the CDC / Dr. Fauci mix messages and broader misrepresentations over the past year he will himself continue to get resistance. All the American public just wants is honest answers .. maybe science don’t know at times what they are. For Dr. H to suggest that science / CDC / Fauci has been clear over the past year is laughable. As recently as 3 weeks ago Dr. Fauci and the CDC were saying 2 opposite things regarding Covid.
    Unfortunately Dr. Hotez on your podcast used his time to do just what he’s accusing others of doing… attack a party, newscasts and insinuate the race component.
    A disappointing podcast for there was no challenges to Dr. H. assertions. However I believe your podcast does a good job avoiding politics. I’m a but a big fan of your cause but the podcast miss the mark today .

  2. Enjoyed this, but is it really accurate to lay all of the anti-vaccine/anti science misinformation at the feet of republicans? Isn’t there a significant contingent of people on the left politically who are also antivaxxers? I guess Robert F. Kennedy would be the first name that comes to mind. I don’t know the percentage breakdown of conservative vs liberal antivaxxers.

    • Agree totally. Plenty of left wing people are against vaccinations too, albeit for different reasons. Conservatives will tend to distrust governments and authorities (CDC, FDA etc), but the left wing will tend to distrust massive multinational corporations motivated by profit. Funnily enough, both the government and those companies have given us plenty of reasons not to trust them in the past.

      Let’s not forget that left wing people have their fair share of interest in “alternate” treatments – homeopathy, acupuncture, healing crystals, therapeutic touch and other pseudoscience. If you look at the low vaccination hotspots in the US, they are highly conservative or very left wing areas. Hotez simply ignoring that unfortunately shows his own bias, and it was a shame that he had to inject his personal political viewpoints into this.

      I love this podcast and I’ve been a premium subscriber for a while now, but this one really missed the mark. It felt like an opportunity totally wasted. I would have loved to hear Hotez talking about the current vaccines, and more about the decision-making processes, EUA by the FDA, differences between nations (UK embracing AZ but US not approving yet), and of course discussing the newly-detected blood clotting issue with some of the vaccines. I feel that would have been useful in educating people.

  3. When discussing the issues around vaccine schedule I’m curious as to why 2 developed countries Canada & USA have different schedules? The US seems to offer more vaccinations and earlier (before 8 weeks old) than Canada when we largely have the same disease prevention concerns?

  4. Dr H is using politics to affirm his point of view. At the same time criticizing others for using politics to influence vaccines. I am conservative Republican and not anti vaccine. I have gotten the CV 19 vaccine. So Dr H is making assumptions too. I am retired Med Tech who did research at pharma company. BUT I still want medical freedom. I had measles as a child and survived without problems.

    • So the Doctor interpets criticism of science for causing fewer vaccines and tires this resistance to conservatives/Republicans while pointing out Democrat Robert F. Kennedy 5 times as sitting the anti vaccine stew. While noticably absent are mentiones of VP Kamala Harris and Pres. Joe Biden telling Americans not to trust the ‘Trump’ vaccines. As a white vaccinated Republican (newer populist version) married to a woman of color he should use caution in painting with such a broad brush! The attribution to Trump that CV19 seems so clumsy as to be a lie of deliberate ignorance….
      If he thinks science is immune to mistakes blunders and criticism then he should explain Dr. Fauci’s direct involvement and investment in ‘gain-of-function’ research in China after it was ceased here! But then moved to the same Wuhan bio lab that dissented CV19 having been manipulated through GOFunction work there….
      He says it was not science that encouraged the failed lock downs but never is able to dissociate from it.
      Too bad he has such blinders.

  5. I agree with Hotez on most of the claims in this episode. However, he exemplifies the hubris, condescension, and political tribalism that puts some people off institutional science:

    – Constantly implies his intellectual/political opponents are deranged and nefarious. People who fear vaccines trying to persuade others of their beliefs is “targeting” them. OK.
    – Sacred victim groups get a pass: helpless blacks/latinos (excuse me, “black and brown communities”) don’t “target” each other to spread anti-vaccine narratives, no, they are “targeted” by evil anti-vax white Republicans.
    – Conflates “science” the abstraction with “current commonly held opinion among scientists”.

    Rejecting a particular person/institution’s claim to scientific authority and legitimacy is not a rejection of science as such (even if they are right!), any more than rejecting some claim to moral authority is a rejection of morality. There are many good reasons to distrust the medical establishment, especially on any politicized issue. The system is rife with conflicts of interest, perverse incentives, groupthink, and hubris. It is highly imperfect in its pursuit of evidence-based medicine.

    “Believe guys like me who went to Yale, wear a gratuitous lab coat on a video podcast, and carefully use the latest woke language” is not a scientific precept. Hotez seemed more interested in expressing his exasperation at ignorance and political virtue-signaling than in persuading anyone who doesn’t already share his beliefs. This is contrasted by Peter’s attitude on this episode, which seems genuinely empathetic and interested in communicating science in a way that is likely to persuade.

  6. “What started out as an anti-vaccine movement is now a movement against any kind of public health intervention and demonizing scientists and basically calling us the boogeyman.” —Peter Hotez

    Perhaps the movement against “public health intervention” is a result of a harried population being bludgeoned to death by professionals with an agenda, as in this podcast. Many of us are constantly seeking answers for ourselves and families by paying to read professional information (as in this site) . In my opinion this entire podcast should be erased, I personally get a visceral contraction upon just glancing back at it.

  7. The first interviewee I’ve heard on the Drive podcasts that makes no attempt at balance in his thought process. Is he a left wing politician or a scientist?

    Heard more about “far right extremists” than constructive information.

    But, the best Podcasts do have controversial figures. Would be interesting to revisit this topic with some balance at some point.

  8. Very disappointed in this podcast. Good grief, if you’re going to charge that the (Trump) White House put out a disinformation campaign and toot your own horn as the martyr who had to save us, you ought to at least get your damn facts straight. Even Snopes agrees that Pres. Trump didn’t call Covid a “hoax”. And of course he failed to mention the origins & primary driving force of the anti-vax movement is the political left.

    Is it any wonder growing numbers of Americans are increasing skeptical of what the science leans toward when folks like Peter Hotez utilize political smear, false facts and rancid opinion to broad brush an entire political party which is at least half of the Country. C’mon Peter, let’s do better.

  9. I have to say I was somewhat surprised by this podcast. Politics are usually avoided and I understand why. I thoroughly enjoyed the vaccine info but to draw the conclusion of why people are not getting vaccinated and only pointing out Tucker, Newsmax, and the Republican Party was shortsighted. Isn’t it Kamela Harris that first said she wouldn’t get a vaccine under the Trump Administration, that she wouldn’t trust it? I am pretty left but have moved more right during this pandemic. I am a pediatric physical therapist and small business owner in PA and not sure my business will bounce back due to all our shutdowns and restrictions. I also have a teenager that has been in a mental hospital twice during this pandemic. I quickly got vaccinated and so are my teenagers but this crisis is more than just the science of the vaccine.

  10. The medical community is doing this to themselves. In looking at how America has gotten to the standard American diet from which we are trying to heal, the keto community has gone back and found the inconsistencies and influences that skewed the information and research in previous medical “science” and consensus. Were there people like us “keto” folk who were questioning things as they were unfolding and were they treated with the same disrespect that were hearing on this video?

  11. There is mistrust on both the left and the right of vaccines, and it usually come from people down the socio economic ladder where there is a huge mistrust of government. The populist right believes the government is trying to take away their constitutional freedoms, while the poor urban left lives in neighborhoods that often feel like police states. If you have access to qualified scientist who can explain how the vaccines work you are much more likely to be willing to be vaccinated than if the only time you see a Dr is in the emeregency room for which you recieve a $6,000. bill. I was a bit surprised that the 76 swine flu vaccine that caused a few cases of Guillain Barre syndrome was not discussed as I always thought that was the origin of the Anti Vacc movement.
    Per the Anti science movement I feel it has been caused by too many things being labeled science that clearly are not. Political Science, Economics, Psychology , Nutrition may use scientific frame works try and answer questions but they ae unable o find predictive results from those findings at this point. I also believe that a certain part of the scientific community became so aggressively atheistic that they turned off a lot religious folk. “if you wont believe in God, I wont believe in science!” Plus as Peter likes to say all truths have a half life which has made lot of folk suspicious of scientist that are absolutely certain they are right.
    Lastly lets not be so sensitive about our political beliefs. We are all probably wrong in the long run.

  12. Great podcast. Every adult in the world should listen to it, because of the importance of the interviewed and the importance of the content and the questions. Well done.

    It’s a shame you did not talk about the lobbying of vaccine/pharma and the incredible law protection that the industry has acquired.

    Also, you did not talk about real failures of the vaccination approach and failures in restoring damages.

    Could the extensive show notes made public? It’s important for all the public to count with the mentioned information about scientific proofs about safety of vaccines in general and in the very specific vaccines mentioned, safety of vaccination programs, CDC proofs of safety and efficacy, and the non increase of authism.

    Many thanks. Well done Peter and team, thank you so much.

    (And, as I always ask, please interview Prof. Valter Longo!)

  13. In 1976 the swine flu vaccine was halted after 40 million doses of vaccine were administered and a reported 500 people came down with Guillain Barre Syndrome of which 25 died. So far, VAERS has reported over 86,000 adverse events from the Covid 19 vaccinations which include over 3,000 deaths, and 26% occurred within 48 hours of vaccination. Additionally there were 92 cases of Guillain Barre Syndrome and 820 cases of Bells Palsy. What’s more astounding is that Harvard Medical School did a study that said only 1% of the cases are reported to VAERS.
    The only reason that I can think of for the stoppage of the swine flu vaccine and the continuance of a clearly dangerous Covid 19 vaccine is the elimination of manufacturers liability that took place for vaccine manufacturers in 1986. By eliminating the medical and legal checks and balances that existed before with regard to rigorous vaccine safety we now live in a bizzaro world where the vaccine companies, operate with impunity and gaslight anyone who thinks they have been injured by the vaccine. Dr. Hotez, your criticisms of RFK Jr. remind of the kid in the playground who would kick someone in the shins and then run away. If you feel that strongly that RFK Jr. is wrong about an issue, then you should debate him face to face. If you aren’t willing to do that, then you should vaccinate yourself for pompousness.

    With regard to autism: Dr. Hotez, simply saying that since autism can’t be visualized on a MRI doesn’t mean there isn’t an inflammatory reaction taking place on a cellular level that can’t be seen on an MRI. Even Parkinsons disease cannot be visualized on an MRI until it’s later stages. Lastly, in some cases the U.S. government has already linked autism to vaccines. The vaccine injury compensation board set up to replace the excessive litigation vaccine manufacturers faced have already paid out billions to families in the past 35 years who could prove an injury resulting from a vaccine. The catch is the government calls it a “mitochondrial defect” instead of autism placing the causality on faulty genes rather than the toxic adjuvants in the vaccines that injured those susceptible childrens mitochondria.

  14. I agree with those that found this podcast mostly a one-sided rant. Hopefully we can get back the the spirit of:

    “I would rather have questions that can’t be answered than answers that can’t be questioned.”

    ― Richard Feynman

  15. It ok to question the science and the people behind it all. Its naïve to think everything in the world no matter what it is ia always on the up and up and for the betterment of all not just a few. There are a people in the world that want it a specific way and that’s not hidden. Gates, and the like are who im talking about and he is involved in our health care as much as possible. So some information on issues out there may be proven wrong ok but don’t try and force down my throat that all is rite in the world its not.

  16. I’m in the UK where the healthcare system is state-run and -owned and the pro-vaccine propaganda is more OTT even than the USA. But if you get blinded or paralysed or have other severe side-effects, at least we have free healthcare to treat you for the rest of your life. As usual, the vaccine producers have negotiated a legal indemnity. I do find it somewhat shocking that in the USA, those most damaged by vaccines and perhaps losing their jobs may then find themselves unable to afford health insurance.

    UK vaccine deaths are not even being discussed in normal print media or on BBC TV, but from reports in less than mainstream media there seems to be around 1 death per 31,000 jabs. For younger age groups, especially female, the death risk from COVID is less than this, or much less if you have no comorbidities; see https://www.qcovid.org/. I assume for the moment that side effects are distributed equally among the age ranges.

    What on earth are we doing, vaccinating people who are at less risk if they get this disease? Moreover, most people probably already have had the disease, given that the virus arrived here in Feb 2020 or earlier and, due to innate immunity, some people will apparently never get it anyway (see the unintended Diamond Princess ‘experiment’, also the UK Chief Medical Officer’s remarks in 10 Downing St. briefing on 11 May 2020). Why too are we doing vaccinating pople who have had COVID? They acquire immunity.

    Vaccines should be reserved for lethal diseases or ones where cheap alternatives such as Ivermectin, HCQ or other treatments do not exist. The ‘medical industrial complex’ seems to have other ideas.

  17. Love the good MD’s comment “what is the down side” – that we know of? Unfortunately we do know all. The downside is typically determined by looking in the rearview mirror ,eg fat causes you to become fat, thalidomide, etc. Do you want to take that chance/experiment with your child?

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