Peter J. Hotez (Johns Hopkins University Press)
WHEN I posted a of The Deadly Rise of Anti-science: A scientist’s warning on Twitter/X and said I was reading it, the result was a very unpleasant set of replies. But they were a pale reflection of those received by its author.
It is hard to see why anyone would dislike Peter Hotez. A US doctor and researcher, he has helped develop vaccines against , and other conditions: tropical diseases neglected by the pharmaceutical industry. Most recently, he was one of the leaders of Corbevax, a project to develop a cheap covid-19 vaccine to give away patent-free. His work has saved thousands of lives.
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Yet he is hated by some. “You will hang for crimes against humanity” is one of the milder emails Hotez has received. His “crime” is to have developed new vaccines and extolled their virtues in public.
His book, often harrowing and deeply alarming, covers his experience of the US anti-vaccine movement, especially during the covid-19 pandemic, when Hotez was often on TV and radio encouraging people to get vaccinated. He uses the term “anti-vaccine”, but many practitioners prefer “vaccine hesitancy” as less condemnatory and implicitly acknowledging that public health providers must build trust, especially among marginalised communities.
Hotez’s main contention is that the US anti-vaccine movement has metastasised. What was a fairly fringe position a few decades ago is now a well-funded campaign that resists not only covid-19 vaccines, but other medical interventions too.
It has also found a political home in Donald Trump’s Republican party. One of its key lines is that vaccines impinge on “health freedom”. The argument goes that if parents want to send their children to school without vaccinating them, putting other children at risk of diseases like measles and polio, that is their right. This stance has found a natural home on the libertarian right. Vaccine hesitancy is mostly a right-wing phenomenon in the US, even a recruiting platform.
The grim irony is these “freedom” campaigners have aligned themselves with authoritarians. As Hotez writes, authoritarian regimes have always clamped down on experts: Joseph Stalin had Soviet geneticists murdered; Hungary’s Viktor Orbán forced a ; US Republicans have long targeted climate scientists. Persecuting vaccinologists, says Hotez, is part of the pattern. His analysis of the modern US anti-vaccine movement and its entanglement with the authoritarian right is astute.
He is weaker on the history of vaccine hesitancy. His account starts in the 1990s with the false claims that the MMR vaccine causes autism. This keeps things personal: Hotez has an adult daughter with autism and understands better than most why the claims were untrue. But he neglects the fact that vaccine hesitancy has existed as long as vaccines, and that it takes different forms in different cultures.
There is a lot to learn from other instances of vaccine hesitancy – including, crucially, how to persuade people that vaccines are safe and beneficial. As with so much in public health, it is down to and institutions. Still, it is churlish to complain that Hotez doesn’t know how to persuade – one of his big asks in the book is for more support (some for training programmes) for scientists who want to communicate with the public.
Hotez admits he isn’t sure his media appearances swayed many Republicans. But he was right to reach out to the vaccine-hesitant. Many more will need to do so.
Michael Marshall is a writer based in Devon, UK
