Vaccines dominated the news this week, as the White House announced Operation Warp Speed, an initiative that aims to develop and manufacture hundreds of millions of doses of COVID-19 vaccines by the end of 2020.
Also this week, the company Moderna Therapeutics announced encouraging results for its vaccine in a small human-safety trial. The news sent Moderna’s stock soaring, and its valuation to $29 billion — amazing for a company that has yet to release a product, and which has yet to publish its data.
To discuss vaccines, and the novel coronavirus in general, we turned once again to vaccine researcher Dr. Peter Hotez. He’s a professor and dean of the National School of Tropical Medicine at Baylor College of Medicine, and co-director of the Texas Children’s Hospital Center for Vaccine Development. His lab is among the most prominent of the hundred or so, around the globe, that are scrambling to create a coronavirus vaccine.
In this week’s interview, he discusses his alarm that the Houston area doesn’t yet have the public-health troops it needs to reopen; his worries about the anti-vaccine movement; and a surprising new funder of his lab’s coronavirus vaccine research — Tito’s Vodka.
Texas is loosening coronavirus-related restrictions and reopening the economy. What are your thoughts about that?
I understand the importance of opening up the economy. The worry that I have is that we haven’t put in place a public health system — the testing, the contact tracing — that’s commensurate to sustain the economy.
Some models show fairly dire predictions for Houston. I’m referring to the Children’s Hospital of Philadelphia model that shows that by the summer, if we’re only at about 50% of the social distancing, we’re doing now, Harris County could see a steep surge in the number of patients coming into the hospitals and intensive care units.
It’s a model. It’s only as good as the assumptions that it’s based on, and we know the assumptions are not robust. But it gives me pause for concern that unless we have that health system in place, we could be looking at an epidemic that’s far greater than the one we’ve gone through.
Let’s say we’re opening up as as we are now. The way a surge works is, it’s not as if we’re going to see a gradual increase in cases. The models say things will look good for weeks. At first, it’s a flat curve, then it’s flat, it’s flat, and only after all that do you start seeing a steep, steep increase.
That’s what worries me. In those flat weeks we’ll get this sense of complacency, and then people are going to start going into the bars. Forget about one quarter occupancy in the bars. Poison Girl, on Westheimer, is going to be full. And so are all the other places all across Houston.
So: How do we fix that? I think it’s having a health system that’s larger and more extensive than what’s being proposed. We’re going to have to do extensive testing in the workplace so that you’d know if your colleagues have COVID-19 — especially asymptomatic COVID-19.
The number of contact tracers has to be far greater than the numbers that I’m seeing. Gov. Abbott says that Texas has around 2,000 and plans to hire 2,000 more. But consider that Gov. Cuomo in New York State is hiring 17,000 contact tracers. A state that’s quite a bit smaller is hiring a much larger number.
We also still don’t have that syndromic-monitoring system in place that you and I have talked about — an app that would allow Houstonians to report how they’re feeling, or that would track temperatures, like the Kinsa electronic thermometer app.
We should be bringing in our best engineering minds out of the oil and gas industry, out of NASA, out of the Texas Medical Center to put in place an app-based system — maybe make a hybrid between the kinds of things being put out there by Apple or Google or Kinsa, or the kinds of things they’re doing in Australia. We can design one that works for our culture, works for our system. But we’re not assembling the engineers to put that in place.
We don’t even have an epidemiological model for the city of Houston. There’s one for Dallas, put out by UT Southwestern and the University of Texas. Austin’s put out one. But I haven’t seen one for Houston.
So I’m worried that if people are going to start piling into bars and restaurants, and we don’t see the numbers going up, within a couple of weeks from now, it’ll be business as usual. Everybody will feel good, will be saying, “Hey, I’m not seeing the cases go up.”
And it’s going to really accelerate starting in the fall. This is not only true of Houston; it’s true of cities across the U.S. It would happen right before the 2020 election, so I worry about a lot of instability and how we mitigate that.
What are your thoughts on all the recent vaccine developments — the White House’s new Operation Warp Speed, the Moderna announcement and everything else?
I’m optimistic we will have several vaccines for COVID-19. As we’ve talked about before, actually making a COVID-19 vaccine is not that complicated. You need to make an immune response against what’s called the “spike protein,” the protein part of the virus that interacts with the host’s tissues.
Now we know from recently published animal studies that we need high levels of what are called “neutralizing antibodies.” It’s not just the amount of antibodies; it’s the amount of that special type of antibody. That’s what our lab’s vaccine is focused on.
In fact, it’s what most of the coronavirus vaccines are focused on, although they use different approaches. We use a recombinant protein approach. Others use inactivated virus or RNA or DNA or adenovirus. Which ones are going to work best is hard to know. That will take time.
I think a lot of these vaccines, including the Moderna vaccine, and maybe our vaccine will start entering what are called “Phase Three clinical trials,” large clinical trials. I think Moderna will be the first, and over the next year to 18 months we’ll have a better idea of whether we can have a safe and effective COVID-19 vaccine.
I don’t know that any particular vaccine has an advantage over the other. But unfortunately some of these companies are putting out press releases. You have to remember who the press releases are intended for. They’re not intended for you or me or for CNN. They’re intended for shareholders, for investors. And unfortunately, they’re written in a way that’s tone-deaf.
I spoke on CNN about my concern about that particular press release that Moderna put out. Given that there’s no real data, you can interpret it either way: that it’s a good news story or that it’s a bad-news story, that it may not be working. People were surprised to hear that.
I’m trying to stay focused on organizations that actually publish their data so the scientific community can see it. Even if you don’t want to wait for the full peer review and publish in a journal, you can get things out there so people can see it. You can use pre-print servers — bioRxiv and metArXiv — to get the data out there.
I’m basically not reading any press release or any press announcements. I’m gonna treat anybody who does that like hydroxychloroquine at this point. [Laughs]. It’s got the same status.
But I do think we will have vaccines. Our lab is seeing some promise in laboratory animals. We put out some of our information on our vaccine on bioRxiv this week because we are able to achieve significant levels of neutralizing antibodies. Then it’s all about showing that we can reproduce that in people, and do it in a way that’s safe.
I worry about some of the language being used, both by the White House — calling it “Operation Warp Speed” — and also by biotechs, in these irresponsible press releases. It makes it seem like we’re rushing vaccines, or we’re doing things that may not be safe.
That’s a central tenet of the anti-vaccine movement. They say that vaccines are rushed, they’re not safe, that there are cozy relationships between the pharma companies and government, that they hide data.
They also say that vaccines cause autism, and I’ve gone up against that. I’m a vaccine scientist and also the parent of an adult daughter on the autism spectrum. I wrote a book, “Vaccines Did Not Cause Rachel’s Autism.”
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So when companies put out these press releases saying that we’re going to have stuff in weeks or “You don’t need to look at the data, just take our word for it,” that is really dangerous. Studies are going to come out to indicate that a significant percentage of the American population will not take COVID-19 vaccines even if they’re available because they’re so convinced by the anti-vaccine movement, which has been energized by the misinformation and misleading press releases.
We have a partnership with a group at City University of New York that is looking at what percentage of the American population has to be vaccinated to interrupt transmission. We don’t have that answer yet, but I think it’s going to be a pretty high percentage of the population.
So even if a COVID-19 vaccine is out there, if we feed into the anti-vaccine movement and Americans start refusing to take the vaccine, it may not achieve its purpose. We might not be able to interrupt transmission because not enough Americans are vaccinated.
I’ve been pushing hard on the White House and the National Institute of Health to adopt a communications plan — to put the kibosh on companies issuing press releases, and to have someone who’s articulate explain how the vaccine program works, why we’re not rushing it, why we’re doing certain things.
In March, I was floored when you mentioned that besides running a lab, making media appearances and keeping up with fast-breaking research, you were also spending a significant amount of time raising money to support your research. I’d assumed that as one of the leading coronavirus-vaccine labs in the country, and with that vaccine such a high global priority, that its research would have been fully funded already. What’s the status of that?
We’re trying to move one of our vaccines into clinical trials and engaging the FDA — that’s a lot of work. And we have a second vaccine also that we’re trying to scale up.
So everybody’s working very hard at the same time as we’re trying to raise money for this. Myself and my science co-partner for 20 years, Maria Elena Botazzi, we’ve been on lots of calls, working with with Baylor and Texas Children’s Hospital teams.
We’ve got some federal money, and also some private money. We announced last week $1 million from Tito’s Vodka. So now, when you order your vodka martinis, you have to order Tito’s. Do not order any other vodka. It’s all Tito’s! [Laughs.]
I like bourbon myself, but they haven’t given us money yet. If you can send this to the people who make produce Maker’s Mark, that would help me a lot. [Laughs.]
Wow. I don’t think of booze companies as major supporters of critical medical research. How on earth did you hook up with Tito’s?
They contacted me! This is why I do podcasts.
I did an interview with this very interesting, very smart West Coast physician, Peter Attia, who does an in-depth podcast on health issues. I talked about the urgency to raise adequate funds to move this into clinical development. I think Tito’s heard my podcast with him.
What else do Houstonians need to know this week?
We’re a resilient city. We have great strengths.
The one thing that I’d like to see move ahead faster is that app for syndromic surveillance. I don’t understand why we haven’t convened our great engineers in oil and gas and NASA and the Texas Medical Center.
Why aren’t we building on our strengths? We could do something in Houston that no other city could do.
This interview has been edited for length and clarity.