
On Sunday Dr. Peter Hotez posted a thread of tweets regarding our pandemic present and our possible future. Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Center for Vaccine Development at Texas Children’s Hospital, acknowledged that things feel pretty calm with COVID-19. He pointed out that in Texas, “we’re at about 6 new cases per 100,000, which is among the lowest we’ve been during the entire pandemic.”
But Hotez’s work requires looking beyond the present. He expressed concern about the BQ.1.1 variant, which seems to be on the increase in Europe. As has been the case in past winters, problems in Europe often point to future problems here. His solution, however, remains much the same: Hotez continues to encourage everyone to maximize their boosters and get their children vaccinated.
Q: How did it go with you?
A very good one. Life is full and interesting. It’s crazy, but complete and interesting. But it’s nothing I didn’t sign up for. I find the thing that worries me, with all the stressors – COVID-19, the stock market, inflation, the potential for nuclear disaster in Eastern Europe – that must have a huge impact on the mental health of the American people. What I tell people is that if you’re feeling sad or depressed or upset or having panic attacks, that’s a normal reaction to living in extraordinary times. People need to hear this more.
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Mental health issues are still stigmatized in this country. People should know, it’s not just you. Having mental health issues through it all means you’re a normal, good person. It is a normal physiological reaction to the state of the world.
Q: You recently received good news regarding the approval of your halal vaccine, Indovac, in Indonesia. Where do things go from here?
A: The original idea was that when it all started, we were getting pretty frantic calls from ministers of health and ministers of science around the world, because they realized the mRNA vaccine wasn’t getting to them. So the question was whether they could partner with us at Texas Children’s and Baylor College of Medicine to transfer the vaccine we were developing if they had the local capacity to develop vaccines.
It was a combination of their interest and also knowing that they had abilities and knew what they were doing. The last thing you want is to work with someone who doesn’t pay close attention to quality control or quality assurance. Because it doesn’t take much to derail even a good vaccine because of misperception. I always say it doesn’t take much to vote a good vaccine off the island if there is a perception problem. It was therefore important that we did our due diligence not for financial purposes, but for quality purposes.
We narrowed it down to four countries: India, Indonesia, Bangladesh and Botswana. Now in India, our Corbevax has entered 75 million guns. With Indovac, it’s 20 million doses, which is exciting because it’s vegan technology. It was important to have it certified halal.
Q: It’s like when people wanted to measure this pandemic in weeks, you knew it was going to take years.
A: Well, we played the long game for several reasons. The rapid evolution of variants. Despite what President Biden said in “60 Minutes,” it’s not over. It’s just a new Little Shop of Horrors. And it will continue.
So remember this: COVID-19 is the third major coronavirus epidemic/pandemic of the 21st century. We had SARS in 2002 and MERS in 2012, then COVID-19. Mother nature tells us what she has in mind, generating new coronavirus pandemics every seven years or so. Based on that, we should expect COVID-25 or 26 and then COVID-32 or 33. We have to do better than trying to make a new vaccine every time. The big brass ring is to develop a universal coronavirus vaccine so we don’t have to worry so much. And I think it’s doable based on what we’re seeing so far.
Q: That’s why you work with nations on building infrastructure.
A: Yes, and recognizing vaccine ecosystems as currently defined is too narrow in scope. We focus on the multinational pharmaceutical companies, the Modernas, Pfizers and GSKs of the world, who have the best chops to make it happen. But it’s the best way to make sure vaccine equity is not achieved. It is not just a humanitarian concept. But because we know that the delta variant originated from an unvaccinated population in India last year. And omicron was born from an unvaccinated population in southern Africa. There is also an interest in doing so.
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What we’re doing at Texas Children’s and Baylor is trying to find a way to better balance or expand the ecosystem to encompass low-income vaccine producers. This is what is missing in the geopolitical landscape at the moment. Not that multinational corporations are demons or villains. They distributed a lot of vaccines around the world. But we need a broader or decolonized ecosystem to ensure greater vaccine equity.
Q: I’m afraid I look like a skipping record. But I feel like we should be more humble about the interconnectedness of the world.
A: What’s really interesting is seeing these new variants of COVID emerge. It’s like watching a train roll down the tracks from miles away. Except in this case, the train started on the African continent and in Asia. First he travels to Western Europe, then to the UK. Once that happens, we know what happens next: Boston and New York. And we know it’s going to happen in Texas.
We repeated a pattern. Now with these new omicron sub-variants – I call them the Scrabble variants, because they’re those high-value Scrabble letters like Q and X and V. We’re seeing cases increase again. At the moment we are in a good position, in Texas in particular. Cases are almost at their lowest. That’s great, but guess what? Scrabble variants with rising numbers worry me in the UK and France. What happens as we head into winter will be interesting. I think in January we could have another wave like we had last year winter and the winter before. That’s how we should plan it.
Q: You also expressed concern about people skipping flu shots.
A: Yes. The thing is, we’re still underperforming in our boosters. The new bivalent booster has only reached 11 million Americans so far. It’s something like 4 percent of the population that could get it. So people don’t run to get it. They walk. There’s a new Kaiser Family Foundation survey that found 30% of Americans “plan” to get it, whatever that means. And it’s still not very good.
There is still a lot of work to do. With the flu shot, kids don’t get that or the COVID booster. We have a very vulnerable population. And I’m worried about these new escape variants of Scrabble. If you’re not boosted against BA.5, which is more like Scrabble variants than the original line, it’s like starting over. So it’s like smashing the football on the 20-yard line. I was on PBS NewsHour and called on the president to hold a press conference and really talk about the importance of these boosters. There is a bad moon rising.
Q: What are the next steps for what you’re all working on?
A: This will be done in two stages. Right now we are looking at a bivalent version of our Corbevax and potentially Indovac that targets the new omicron subvariants, including Scrabble variants. It’s a. From there, we are looking to see how we could develop a truly universal version of the vaccine. Our vaccine scientists are busier than ever. So it’s an exciting time, and the science is very interesting. Lab meetings are interesting and rewarding.
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There is a famous book on molecular biology, written at the beginning of the molecular genetics revolution, when physicists were still thinking about how to do quantitative biology. It was by a guy named Hershey and it was called “We Can Sleep Later”. Even though sleep is very important and you are supposed to take care of yourself, this title sometimes comes to mind.
Q: What is the lab like? Does it hum 24/7?
A: It’s more cohesive, just people working in the trenches day after day, day after day. Often they are there on weekends and outside working hours. But they all hang in there. Even though everyone is exhausted and stressed and has this potential for burnout, they hang on. They are all heroes.
Q: I see your Baylor School of Medicine logo, which is interesting. It reminds me of a lot of contemporary art I’ve seen in Honduras that took on Mayan themes.
A: It was very deliberate. College tells me I can’t call it a logo. It is therefore an emblem. Apparently there is a registered trademark. The genesis of this one is rather interesting. With the National School of Tropical Medicine, the Baylor College of Medicine, I wanted it to be built on the model of the great schools of tropical medicine in London and Liverpool. The Liverpool School of Tropical Medicine and the London School of Hygiene and Tropical Medicine. They both had old world themes, Egyptian themes, in their logos. I thought we were in the new world now, so maybe the Mayan jaguar would be more appropriate. And although we work globally, including in Africa and the Middle East, I would say that our greatest activity is in Central America, Mexico, Mesoamerica and the tropical regions of South America.
andrew.dansby@chron.com