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©2023 American Medical Writers Association. All rights reserved.  
ISSN 2163-5315

AMWAJournal.org     7

The John P. McGovern Award is named in honor of John P. 
McGovern and is presented to a member or nonmember of 
AMWA to recognize a preeminent contribution to any of the 
various modes of medical communication. The McGovern 
Award is presented during AMWA’s Medical Writing & 
Communication Conference.

Thank you very much for the honor from AMWA and the 
opportunity to be able to speak with you. This means a lot to 
me, not only as a science communicator, but also because 
I’ve been writing books about the geopolitics of vaccines and 
global infectious diseases. Having this kind of recognition, 
for me, is particularly special. I’m sorry I can’t be there with 
you in Denver, but please understand how important this 
honor is for me and my association with AMWA. 
 My career as an MD/PhD vaccine scientist is an interest-
ing one and has kind of a dual aspect to it. For the last almost 
40 years now, since I started as an MD/PhD student in New 
York in the 1980s, I’ve been working to develop vaccines for 
poverty-related neglected tropical diseases as well as viral 
infections. I’ll talk about our work to develop a new COVID 
vaccine now in use in India, Indonesia, and elsewhere. 
 The other side is because I have four adult kids, including 
Rachel—who has autism and intellectual disabilities—and 
wrote a book a few years back called Vaccines Did Not Cause 
Rachel’s Autism because that was kind of the phony assertion 
from antivaccine groups. Going up against them, by default, 
I became an expert not only in the vaccine science but the 
antiscience. I’ve been writing and speaking about that. 
 Today, what I want to do is speak to you about both 
aspects: the positive side and fight for developing vac-
cines for poverty-related diseases as well as coronaviruses, 
but, at the same time, increasingly I’m being called out to 
combat widespread antiscience activism and antiscience 
aggression. 
 To start out on the positive side, I’m a professor at Baylor 
College of Medicine, where I’m also the dean of our School 
of Tropical Medicine. Together with my science copartner 

for the last 20 years, we cohead the very interesting Center 
for Vaccine Development that has been making vaccines 
for parasitic infections in Africa, Asia, and Latin American 
countries, such as schistosomiasis, hookworm, Chagas dis-
ease, and leishmaniasis. Then, about 10 years ago, we started 
developing coronavirus vaccines for SARS and MERS and, 
ultimately, COVID-19. The Center for Vaccine Development 
is based at Texas Children’s Hospital (coheaded by myself 
and my science partner for the last 20+ years, Dr Maria Elena 
Bottazzi), part of our enormous Texas Medical Center, which 
is the world’s largest medical center. 
 We sometimes call our vaccines for parasitic diseases 
antipoverty vaccines because they’re vaccines for disease 
that not only affect health but also trap people in poverty 
through their effects on child development, work or pro-
ductivity, and pregnancy outcome. The vaccines also are 
a potent antipoverty tool, so we call them antipoverty vac-
cines. I first wrote about them in my first book, which is 
called Forgotten People, Forgotten Diseases.
 One of the things that we do at our Center for Vaccine 
Development—it’s not a typical academic center and is actu-

Peter J. Hotez, MD, PhD1,2,3,4 / 1Texas Children’s Hospital Center for Vaccine Development, National School of 
Tropical Medicine, Baylor College of Medicine, Houston, TX; 2Department of Biology, Baylor University, Waco, TX;
3James A. Baker, III, Institute of Public Policy, Rice University, Houston, TX; 4Scowcroft Institute of International 
Relations and Hagler Institute for Advanced Study, Texas A&M University, College Station, TX

2022 John P. McGovern Award Address
Global Vaccines and Vaccinations: Science Vs. Antiscience

CONFERENCE

http://www.amwajournal.org


AMWAJournal.org     8Global Vaccines and Vaccinations: Science Vs. Antiscience

ally developing the vaccines—is we use technologies, when-
ever possible, that are compatible with those used by vaccine 
producers in low- and middle-income countries (LMICs) 
that have banded together to call themselves the Developing 
Countries Vaccine Manufacturers Network (DCVMN). There 
are about 40 of these institutions in Asia, Africa, and Latin 
America. One of the common technologies that is widely 
used is microbial fermentation in yeast to make recombi-
nant protein vaccines, which is the technology used to make 
the recombinant hepatitis B vaccine. For instance, countries 
like Bangladesh, China, India, Indonesia, etc., all make their 
own recombinant protein hepatitis B vaccine. If you want to 
plug and play into the system so that vaccines could be made 
locally in LMICs, this is a pretty good technology to use. 
Another aspect is that it’s a vegan technology—no animal 
cells, human cells, animal proteins, or human proteins—so it 
has the capacity, for instance, to be made as a halal vaccine 
for Muslim-majority countries, which is also extremely help-
ful at times. 
 Our parasitic disease vaccines include vaccines for human 
hookworm infection and schistosomiasis, which is in phase 
2 clinical trials. There’s a lot of interesting science behind it 
that I won’t go into, but we’re trying to develop and distribute 
vaccines on the African continent, Southeast Asia, and Latin 
America. The point is if you were the CEO of a biotech, this 
would probably not be the map you want to have in your busi-
ness plan because most of the pharma industry and biotechs 
are focused on the Global North, meaning North America, 
Western Europe, and Japan. So, the science that we’re doing is 
interesting, but we’re also trying to identify sustainable finan-
cial models for them to recognize that the return on invest-
ment is going to be very modest compared with vaccines 
intended for North America or Europe or Japan. 
 Our vaccine for schistosomiasis, which is in phase 2, 
is also helping a major problem of women’s reproductive 
health, that is, female genital schistosomiasis, which affects 
40 million girls and women on the African continent. 
 Our Chagas disease program targets a parasitic infection 
in the Latin American region that affects about 6 to 7 million 
people living with Chagas disease, of whom about 20% to 
30% can go on to develop heart disease, Chagasic cardiomy-
opathy, which is caused by the parasite depositing, inducing 
the formation of collagen and fibrotic deposition as well as 
inflammation. This happens even despite antiparasitic che-
motherapy. Dr Kathryn Jones, who heads our Chagas disease 
pathogenesis program, has been working with our vaccine 
center to develop a new prototype Chagas vaccine that will 
go into phase 1 clinical trials in Mexico next year. 
 This gives you an example of the type of parasitic disease 
targets that we’re interested in. Of course, the problem with 
COVID-19 vaccinations was that the mRNA vaccines devel-

oped by Pfizer and Moderna were not readily available for 
LMICs. All the doses got swept up pretty rapidly by North 
American and European countries. This left a huge unvac-
cinated population gap, so huge numbers of people went 
unvaccinated on the African continent and in India and 
Southeast Asia. 
 A consequence, unfortunately, other than the obvious 
humanitarian concern, was that Delta arose out of an unvac-
cinated population in India and South Asia and Omicron 
out of an unvaccinated or undervaccinated population in 
Southern Africa. These were vulnerabilities that were cre-
ated because of this vaccine equity gap, so our plan was to 
say, “Look, we’ve developed this low-cost technology that 
we think works as well for SARS and MERS vaccines; we can 
now do the same for COVID-19.” In fact, we’ve actually done 
this now—we transferred the technology (without patents) 
to India and other countries where they’ve scaled up pro-
duction. In India, the vaccine has been produced at scale by 
Biological E, a vaccine manufacturer based in Hyderabad 
that has produced the vaccine that they call Corbevax. So 
far, it has gone into more than 75 million adolescent arms 
in India and now is being used as a booster for adults. 
Biological E owns the technology, so it’s a way of decoloniz-
ing the vaccine ecosystem by transferring ownership to an 
LMIC vaccine producer. We provide a proof of concept that 
you do not have to be a multinational pharma company to 
do big things. We did this through our academic home at 
Texas Children’s Hospital and Baylor College of Medicine, 
our Center for Vaccine Development, in partnership with 
LMIC vaccine producers. We’re hoping to hit the 100 mil-
lion–dose threshold by the end of 2022 or early 2023. 
 One of our major activities is vaccine diplomacy, work-
ing to do the technology transfer of our vaccine technol-
ogy—without a patent, in this case—to countries such as 
India, Indonesia, and Bangladesh and Botswana in Southern 
Africa. We’ve been doing this largely without a lot of public 
support in terms of the fact that we were cut out of Operation 
Warp Speed from the US government and have not really 
gotten that much support from the G7 countries; we are 
trying to do this with local governments as well as private 
philanthropy. 
 Corbevax was approved for emergency use authoriza-
tion last year and first went into adolescent arms starting 
on March 15th. As I mentioned, now we’ve reached over 75 
million doses in adolescents 12 to 14, and the numbers are 
going up; we’re hoping soon for World Health Organization 
approval. Biological E, which owns the vaccine, is now pur-
suing its possible uptake in other LMICs. In parallel, we’ve 
done a similar vaccine antigen in Indonesia with their big 
vaccine producer, BioFarma, and it was just announced that 
this vaccine has been approved for Indonesia, where they 

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AMWAJournal.org     9Global Vaccines and Vaccinations: Science Vs. Antiscience

call it IndoVac. Because it’s a vegan technology, this will be 
one of the first halal vaccines for Muslim-majority coun-
tries, which we’re extremely excited about. 
 Now, that’s the good-news aspect of the story. The not-
so-good news is the fact that, because of 21st century social 
determinants as well as climate change, we are slowing, 
halting, or, in some cases, even reversing our global gains, 
both for control of neglected diseases as well as vaccine-pre-
ventable diseases. I’ve written about this in my last book, 
called Preventing the Next Pandemic: Vaccine Diplomacy in 
the Time of Anti-science. One of the forces I’m particularly 
concerned about is the rise in antivaccine/antiscience activ-
ism, which is really turning out to be aggression. 
 Let me give you an example that we’ve seen in this time 
of COVID-19. The official number of deaths for COVID is 
roughly around 5 to 6 million, but some estimates from the 
Institute for Health Metrics and Evaluation, The Economist, 
and others say up to 20 million deaths. The World Health 
Organization is now saying 15 million deaths. In the United 
States, we’ve had 1 million deaths, second only to India. The 
figure shows the familiar pattern of deaths that many people 
will recognize that goes through various peaks and valleys 
as we course through the pandemic. 
 The first peak was 2020 in New York, followed by the 
summer in Texas and the southern states; the big Alpha 
wave was in that terrible winter of 2021, and the Delta wave 
was in the last half of 2021, followed by the Omicron wave; 
then, there’s a big blue arrow in the figure. That big blue 
arrow points to May 1, 2021, which is the date that the Biden 
administration announced that anyone who wanted to get a 
COVID vaccine could do so, but you can see that the deaths 
continued afterward. These were individuals who were defi-
ant and refused to get vaccinated because they were victims 
of antivaccine activists. 
 My estimate is around 200,000 Americans needlessly 
lost their lives because they refused the COVID vaccine and 
became tragic victims to these new, very dark antivaccine 
activist forces. I want to go there next to explain what’s hap-
pening with antivaccine/antiscience activism and aggres-
sion because people too often think it’s just some random 
events that occur on the internet or social media, but it’s far 
more deliberate than that. Let me take you through how I 
see that the antivaccine/antiscience ecosystem has evolved 
or devolved. 
 Again, I got involved in this being the parent of four 
adult kids, including Rachel, who has autism and intel-
lectual disabilities, and explaining why vaccines did not 
cause autism, which was version 1.0 of the movement. 
Then, about 7 or 8 years ago, it became more of a political 
movement rallying around this banner of health freedom/
medical freedom, and now it’s become a full-on globalized 

empire. I want to 
finish up by taking 
you through ver-
sions 1.0, 2.0, and 
3.0 to help you 
understand what’s 
happening with 
antiscience (Box 1). 
 Version 1.0, vaccines associated with autism itself, has 
a lot of complexities. The original assertion, back in a paper 
published in The Lancet in 1998, claimed that the measles/
mumps/rubella (MMR) vaccine had the ability to replicate 
in the gut of kids, and then that led to autism—or what, at 
that time, was called pervasive developmental disorder. 
The scientific community responded in a big way, showing 
that kids who got the MMR vaccine were no more likely to 
acquire autism than kids who didn’t. 
 That was very, very important for debunking the asser-
tion, and you would have thought that would be the end 
of it. But antivaccine groups grew in strength and size and 
kept on switching up or moving the goalpost in terms of 
what the actual assertion was; they switched it over to thi-
merosal preservative in vaccines, spacing vaccines too 
close together, and alum in vaccines. For a while, they even 
switched out of autism and said it was the HPV vaccine for 
cervical cancer or other cancers that was causing infertility 
or autoimmunity. 
 If that sounds familiar for COVID-19 vaccines, that’s 
where they got it from—they just copy/pasted the false 
assertion onto COVID-19 vaccines. As I said, I got involved 
in this, having Rachel as my youngest daughter, and I detail 
this in the book, Vaccines Did Not Cause Rachel’s Autism, 
which was published by Johns Hopkins University Press. 
It does a deep dive explaining the science of vaccines and 
the evidence showing there’s no link with autism, but also 
what autism is and how it begins in early fetal brain devel-
opment through the action of autism genes. Through Baylor 
College of Medicine Genetics we actually did a whole-ex-
ome genomic sequencing on Rachel, and my wife and I and 
were able to identify Rachel’s gene associated with autism; 
it’s involved in neuronal communication, which makes a lot 
more sense for something like autism. 
 Of course, I was heavily targeted by antivaccine activists 
because of that. They began calling me the OG villain—I 
had to look it up—the original gangster villain. I think it did 
have some effects on taking some of the wind out of the sails 
of antivaccine groups, but they found a way to reenergize 
about 9-10 years ago in a way that I not necessarily would 
have predicted. It began in Southern California, where so 
many parents had opted their kids out of getting vacci-
nated that, not surprisingly, it led to a large breakthrough 

Box 1. The Antivaccine Ecosystem in 
the United States

V.1.0 Vaccines and Autism
V.2.0 Vaccines and “Health Freedom”
V.3.0 Globalization

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AMWAJournal.org     10Global Vaccines and Vaccinations: Science Vs. Antiscience

measles epidemic in 2014–2015. The California legislature 
responded appropriately by shutting down vaccine exemp-
tions, and I supported that, but it also led to a backlash 
under this banner of medical freedom and health freedom, 
with people saying, “Hey, you can’t tell us what to do in 
terms of vaccinating our kids.” 
 That was fairly disturbing, but it’s what took off, espe-
cially in states like Texas, where this idea of health freedom 
or medical freedom got adopted by the Republican Tea 
Party, and they formed their own political action commit-
tee around not getting vaccinated. There was pressure put 
on the state legislature to make it harder and harder to vac-
cinate our kids and easier and easier to opt out. As a result, 
we’re up to almost 100,000 kids not getting all their vaccines 
in the state of Texas, especially around the Austin area, and 
this doesn’t even account for the more than 300,000 home-
schooled kids. We have a huge problem now in states like 
Texas, where too many kids are not receiving their vaccines 
required for school entry. 
 It’s taken this very dark turn in Texas and elsewhere. At 
one point, antivaccine activists paraded with yellow Jewish 
stars at rallies and actually, in my opinion, mocking the 
Holocaust and using words like NO VAX in letters that look 
like Hebrew letters. I think it’s incredibly offensive and divi-
sive, and yet this is what’s been going on here in Texas and 
elsewhere. And now, in this time of COVID-19, it’s accel-
erated even further among this banner of health freedom/
medical freedom to protest social distancing, contact trac-
ing, and wearing masks. We’ve had some podcasters weigh 
in, and it’s created quite a dark environment around getting 
vaccinated, and, of course, this has extended now to COVID 
vaccination. 
 In Texas, COVID vaccinations have higher rates along 
the border and some of the cities of the Texas triangle, but in 
the conservative areas of central Texas and the panhandle 
of east Texas, there are some of the lowest vaccination rates 
in the country. It mirrors the political map of Texas. The 
higher-vaccinated areas are in the more liberal/Democratic 
areas, whereas the low vaccination rates are in the more 
conservative/Republican strongholds. It’s really quite strik-
ing, and this is what we’re seeing now happening nationally. 
 Studies from Charles Gaba, the health analyst, as well 
as The New York Times, Axios, National Public Radio, and 
other groups show how in the last half of 2021, the deaths 
are overwhelmingly in red states, and the redder the county, 
the lower the vaccination rates and the greater the deaths, 
so much so that The New York Times actually calls it “Red 
COVID.” This partisan divide of politicization of people not 
getting vaccinated is something, for me, that’s been one of 
the hardest things I’ve ever had to talk about because all our 
training, as physicians and scientists, says you’re not really 

supposed to talk about Republicans and Democrats or lib-
erals or conservatives. But I’ve not found a way to talk about 
it other than to talk about it in a quest to save lives. 
 Everyone’s entitled to their conservative views, but 
please don’t adopt this one because it’s leading to my 
estimate that 40,000 Texans (and possibly up to 200,000 
Americans) may have died unnecessarily during this Delta 
wave, and the numbers are continuing among the unvacci-
nated in the Omicron wave. It’s extending now to all child-
hood vaccinations. There’s a survey looking at how the 
distrust of COVID vaccinations along the partisan divide is 
extending to all childhood vaccinations, so I’m quite wor-
ried about the return of measles and pertussis and other 
childhood infections. 
 Another big concern I have with this is not only the rise 
of antivaccine activism, but how it parallels antisemitism as 
well; this has been reported by multiple outlets with people 
circulating antisemitic flyers blaming Jews for COVID-19. 
Because I’m Jewish, I’m aware of it more than others, and 
I’m frequently targeted not only for being a scientist but in 
particular for being a Jewish scientist. The emails that I’m 
getting are pretty frightening, and they often take a very vio-
lent tone, such as that I’ll be charged with treason and other 
crimes against humanity and many expressing their desire 
to see me executed by various measures. There is also a lot 
of Nazi imagery. I’m sometimes compared to Dr. Mengele, 
the infamous Nazi doctor who experimented on humans. 
 This has been present not only with me but also my 
other colleagues—this idea that not only the science is 
being targeted but the scientists themselves. It’s incredibly 
offensive stuff, very racist, and white supremacist in nature, 
with threats the army of patriots will come and hunt me 
down, very much leaning toward political extremism on the 
right. This is the new aspect of antivaccine activism—this 
adoption by far-right extremists—but it’s also coming out of 
the Conservative Political Action Conference (CPAC). We 

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AMWAJournal.org     11Global Vaccines and Vaccinations: Science Vs. Antiscience

heard it multiple times that first they’re going to vaccinate 
you, then they’re going to take away your guns and your 
Bibles (https://www.newsweek.com/madison-cawthorn-
says-door-door-vaccines-could-lead-taking-guns-
bibles-1608503). 
 As ridiculous as that sounds to us, there’s a segment 
of the country who believes it, or members of the House 
Freedom Caucus and the US Congress comparing people, 
like myself, whom they call medical brown shirts, using Nazi 
paramilitary analogies. Of course, it’s revved up every night 
on Fox News by the nighttime Fox News anchors specifi-
cally targeting scientists, and these kinds of threats tend to 
ramp up every time. I’m particularly targeted on Fox News. 
They target Dr. Fauci a lot, of course, but when they get tired 
of beating up on Tony, I tend to be Fauci Lite. These are the 
kinds of threats that I’ll often get after a prominent conserva-
tive news site picks this up or if it’s amplified on Fox News. 
 So, the question is, what are we facing? What can we 
do, and what can AMWA’s contribution be? Well, it’s not 
easy, because this really does go outside the health sector. 
It’s become a political problem. But I think it’s important 
that we at least recognize the problem and its potential for 
unraveling our biomedical infrastructure. It’s not only vac-
cines; it gets to COVID origins and COVID conspiracy the-
ories, and we need to recognize that it’s not an academic 
discussion—lives are being lost—and this goes way beyond 
just a theoretical discussion. Science and scientists are 
under attack, and it’s deliberate and organized. These are 
not random events on the internet. 
 Proposing solutions, as I’ve mentioned, is not so 
straightforward, because so much of this has gone beyond 
the health sector. The US Surgeon General has tried to 
address this by talking to social media companies, such as 
Meta and Twitter, and I think that’s useful, but it doesn’t 
really get to those generating the content, and that’s the 
problem. I think we need expertise in political science and 
other disciplines outside the traditional biomedical sciences 
to get some help. 
 Unfortunately, now it’s going global. We’re seeing this 
extend up into Canada and into Western Europe. The New 
York Times and BBC report it has been linked to QAnon and 
even neo-Nazi groups. This is a globalizing force. My worry 
now is that with the disruptions from the COVID-19 pan-
demic, we have seen a decline, for the first time, in child-
hood immunizations. We saw the largest drop in the last 30 
years, and we’re even seeing breakthrough polio cases in 
New York and elsewhere. My worry is that we’re not going 
to come back to baseline—that something permanent and 
wrenching has happened. 

 The targeting of scientists, from my view, increasingly 
looks like what we saw during the ’30s and ’40s in the Soviet 
Union under Stalin—this kind of targeting of individual sci-
entists seen as enemies of the state. And finally, I think this 
US-style antivaccine activism—and I’ve written about this in 
Nature Reviews Immunology—could start reversing global 
gains and global goals for vaccinating the world’s children. 
I think this is starting to happen now on the African conti-
nent and elsewhere. I think we’re going through a very dark 
period, with a lot of it coming from authoritarianism on the 
far right in the United States, but we’re also seeing some of 
this now among authoritarian regimes in Brazil, Hungary, 
and elsewhere. 
 This is a time to recognize the politicization of health, 
but it’s much more than that. It’s specifically the targeting of 
scientists and, in the United States, prominent US scientists. 
I know it’s not the happiest note to end on, but I think it’s an 
important one. Until we can describe it and put our arms 
around it, it’s hard to combat it. I think, for too long, we’ve 
seen this as random events on the internet or not really 
having a huge public health or geopolitical impact, and it’s 
clear that now it does. 
 Thank you, again, for the recognition and the opportu-
nity to speak with you. I look forward to a long association 

with AMWA. Thank you so much. 

Acknowledgment
I thank Kelly Byram, Writer, Editor, and Founder of Duke 

City Consulting, LLC, for her help in bringing the transcript 

to the page. 

Author declaration and disclosures: The team of scientists 
at Texas Children’s Hospital Center for Vaccine Development 
including its co-director, Professor Peter Hotez, is a co-inventor 
of a COVID-19 recombinant protein COVID vaccine technology 
owned by Baylor College of Medicine (BCM) that was recently 
licensed by BCM non-exclusively and with no patent restric-
tions to several companies committed to advance vaccines for 
low- and middle-income countries. The co-inventors have no 
involvement in license negotiations conducted by BCM.  Similar 
to other research universities, a long-standing BCM policy pro-
vides its faculty and staff, who make discoveries that result in a 
commercial license, a share of any royalty income. To date, BCM 
has not distributed any royalty income to the co-inventors on the 
COVID-19 recombinant protein vaccine technology.  Any such 
distribution will be undertaken in accordance with BCM policy.  
He is also an inventor on non-revenue-generating patents for 
neglected tropical disease vaccines.  Prof. Hotez is also the author 
of several books published by Johns Hopkins University Press 
and ASM-Wiley Press and receives royalties from those books.  

Author contact: hotez@bcm.edu

http://www.amwajournal.org
https://www.newsweek.com/madison-cawthorn-says-door-door-vaccines-could-lead-taking-guns-bibles-1608503
https://www.newsweek.com/madison-cawthorn-says-door-door-vaccines-could-lead-taking-guns-bibles-1608503
https://www.newsweek.com/madison-cawthorn-says-door-door-vaccines-could-lead-taking-guns-bibles-1608503



