Vaccine Expert: Once A COVID Vaccine Is Available, ‘Don’t Overthink It. Don’t Wait’

As coronavirus cases continue to surge both in the U.S. and around the world, there’s promising news on the vaccine front. Pharmaceutical companies Pfizer, Moderna and, more recently, AstraZeneca have all announced that their vaccines have shown better-than-expected results.

Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital, says that a vaccine release could begin for selected populations by the middle of December — and that a broader vaccination effort could soon follow.

“By the early part of next year, we’re going to move pretty quickly, I think, in vaccinating a significant percentage of the [U.S.] population,” Hotez says.

Hotez says that at present, all the vaccines in development work similarly, by inducing an immune response to the spike protein of the virus.

“One of the questions that I’m asked all the time is, ‘Hey, doc, which vaccine are you waiting for?’ And the answer is … I’m going to take any of those vaccines that’s made available to me that’s authorized by the U.S. Food and Drug Administration,” he says. “Don’t overthink it. Don’t wait. Get what vaccine you can.”

For two decades, Hotez and his team have worked to develop low-cost global health vaccines. Now, with COVID-19, they’re working on developing a vaccine that he hopes could be produced locally, so low- and middle-income countries aren’t reliant on the U.S. or Europe for production.

“We signed an agreement with Biological E., based in India, in Hyderabad, and they are now scaling this up to 1.2 billion doses, testing it across India,” Hotez says. “It’s very exciting for us to make a contribution. We’ve never made a billion of anything before — so that’s pretty exciting also.”

Despite this good news, Hotez urges people to continue physical distancing and wearing masks.

“Don’t be lax with it now, especially with the holidays,” he says. “It’s especially tragic if one of your loved one loses their life or has permanent, long-lasting injury during this period because it’s just a matter of staying disciplined for the next couple of months and getting them to the other side.”

Hotez’s forthcoming book is Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-Science.

Interview highlights

On his advice for the holidays: telling loved ones that visiting isn’t safe this year

Remember, this is a true gesture of love — telling people not to come — because right now … COVID-19 [is] accelerating across the United States at this screaming-high level of approaching 200,000 confirmed cases per day, which really means about probably at least half a million new cases a day. Any airport right now, any bus terminal, any train station has lots of COVID-infected people in those venues. It’s not worth it. It’s not worth that short-term event, getting family together, in order to put them at risk and put yourselves at risk. Vaccines are coming. It’s just a matter of recognizing we have to get everybody through to the other side.

On the U.S. pulling out of the World Health Organization and how vaccines have become nationalized

I think the scientists are still sharing information and communicating at an international level, so I don’t think that’s been too affected. The thing that I worry about now is people have tied national identities to vaccines. In fact, there’s a new term that’s been coined called “vaccinationalism.” We talk about the Chinese vaccine, the Russian vaccine, the British vaccine, the American vaccine. We’ve never had that before. I think it’s counterproductive. And so by the U.S. pulling out of the World Health Organization and refusing to be a part of the COVAX sharing facility, which is our new mechanism that’s been put in place to provide global equity for vaccines, I think this has been counterproductive and could hold us back.

We also now have this unfortunate situation where countries that don’t have full access to vaccines are now making one-off deals with the Russians, the Chinese, and [it] has kind of a Cold War smell to it. We have to fix that as well. I’ve been devoted my whole life to this concept of vaccine diplomacy, sharing vaccine development practices between countries. And I served that role as U.S. science envoy in the Obama administration. I think we have to get back to that.

On the vaccine development he’s working on and why he hopes it will reach low- and middle-income countries

This is a very traditional technology. The same technology used to make the recombinant hepatitis B vaccine used all over the world. And that’s important for two reasons. One, many countries have the ability to make their own hepatitis B vaccine — that includes Brazil and Cuba and Bangladesh and India and Indonesia — so that potentially our vaccine could be made locally. It doesn’t depend on it being made in Europe or the U.S. and then filtering to the low- and middle-income countries. And it could be made pretty inexpensively, we think. So the hepatitis B vaccine, in many cases, is made for under a dollar a dose, so we think our vaccine could come along in a similar cost structure. So we’re looking potentially at using this to help fill the gaps where low- and middle-income countries don’t have access to COVID-19 vaccines, and possibly even a strategy for the U.S. and Europe.

On the lack of communication among Operation Warp Speed, the pharmaceutical companies and the American public

I would have liked to see more of … a communication strategy coming out of Operation Warp Speed. The communication has been very much left to the pharma CEOs, and I think overall they’ve not done a good job communicating to the American people. First of all, too much reliance on press releases that over this past year have been sometimes hard to decipher or understand. Too many leaked phone calls, too much weirdness about the stock trading and options. And I think that has undermined some confidence.

I would have liked to have seen government scientists out there communicating on a frequent, regular basis about Operation Warp Speed, very much like the way [New York Gov.] Andrew Cuomo did in March and April. It doesn’t have to be every day, but on a regular basis. I’ve done what I can to fill in those gaps, being on the various cable news networks and podcasts, but at the end of the day, I’m not a government scientist.

On how 95% mask-wearing could prevent hundreds of thousands of deaths

We have new estimates now from the Institute for Health Metrics and Evaluation at the University of Washington, really looking at the number of deaths that are going to be projected to result from COVID-19. And they’re pretty chilling numbers. And that says that unless we can get to 95% mask-wearing, we’re looking at another 150,000 Americans who will lose their lives between now and a week or two after the inauguration. So we have the stunning number in a terrible way of 400,000 Americans losing their lives … by a week or so after the inauguration. That’s basically the number of American GIs who died in World War II. We’re looking at those kinds of numbers.

For me, the tragedy is none of those people have to die if we adhere to 95% mask-wearing — No.1. No. 2: social distancing, especially in times when there’s a threat of a big surge on intensive care units, because, remember, that’s when the mortality figures go way up. We saw this in New York in March and April. We saw it in southern Europe and Italy and Spain in March and April. The death rates really accelerate as ICU staff starts to get overwhelmed. And that’s already starting to happen now in the northern Midwest and in Lubbock and El Paso here in Texas. So just by those straightforward measures, social distancing, being responsible, wearing masks, we can save tens of thousands of American lives between now and the time of the inauguration. And that has to be our big emphasis.

On the importance of a coordinated federal government response to the pandemic

What we saw all this year in the Trump administration was putting the states in the lead and the U.S. government would be responsible for backup supply-chain management and FEMA support and manufacturing ventilators and that sort of thing. And it didn’t work. And this is why the U.S. has led the world in terms of COVID-19 deaths. And the reason it didn’t work is the states never had the epidemiologic horsepower to even know how to conduct COVID control measures. And they also needed the political cover of the federal government to deflect from the attacks that they were getting from their own internal political opposition. I think having the federally coordinated response, which the Biden administration seems committed to, will make a big difference.

On the difficulty of achieving herd immunity when so many people believe anti-vaccine conspiracies

If we’re going to really achieve that 70% herd immunity, which is what our estimates that we came up with, together with our colleagues at City University of New York … we need to figure out ways to better communicate about vaccines and the importance of vaccines and really start doing something about this very aggressive anti-vaccine movement that’s now morphed into a wide-scale anti-science machine or empire or confederacy that really dominates the Internet and dominates American life right now. We’ve got to figure out a way to begin dismantling that.

On going back to “normal” life

It’s not going to be a light switch. It’s going to be an evolving process. We will be in a much better place by the spring, and then by the summer we’ll even be in a better place, and by a year from now, life, I don’t know that will entirely return to normal, but it’s going to be much better than it is now. And the reason I say [life] may not entirely return to normal is we don’t exactly know the performance of these vaccines in terms of reducing the amount of virus shed from our nose and mouth. … So there still could be a fair bit of virus circulating. And that means there could be still some need for masks and social distancing and contact tracing. But, no question, life will be so much better in the next few months than it is right now.

Lauren Krenzel and Seth Kelley produced and edited this interview for broadcast. Bridget Bentz, Molly Seavy-Nesper and Marc Silver adapted it for the Web.

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