SPOTLIGHT
estimates that 200,000 Americans needlessly died in 2021–2022 because they refused Covid vaccines. The deaths disproportionately occurred in Republican Party–majority states, including approximately 40,000 deaths in Texas. As the pandemic wound down, antivaccine sentiments again spilled over to childhood immunisations, causing a large 2025 measles epidemic that has extended from Texas to three additional states. It has resulted in 100 hospitalisations and two deaths of unvaccinated schoolchildren. The financial aspect stems from the wellness and influencer movement seeking to peddle generic medicines and supplements, which they could buy in bulk and repackage together with expensive telehealth visits. Their drugs of choice: low-cost antiparasitics such as ivermectin, hydroxychloroquine and fenbendazole. This has become a lucrative business empire. AN ANTI-SCIENCE ECOSYSTEM Now with Robert Kennedy as secretary of the US Department of Health and Human Services, the antivaccine rhetoric has acquired an unprecedented platform, as he attempts to resurrect vaccine-autism links and discredit the measles- mumps-rubella vaccine or mRNA vaccines for Covid and future pandemic threats. In his first few months, Mr Kennedy has consistently downplayed the MMR vaccine in favour of vitamins or (in a nod to the wellness industry) a cocktail of medicines – vitamin A, budesonide and clarithromycin. Many activists further claim pandemics are hoaxes or planned for personal gain by scientists or public health officials. The term ‘plandemic’ has entered the lexicon. Academic health centres and research universities are also under threat. The Trump administration has proposed a nearly 40% cut to the US National Institutes of Health budget, with some universities such as Harvard, Columbia and the University of California system threatened with additional sanctions. In my latest book, with Michael Mann, Science Under Siege , we compare the coordinated attacks against both biomedicine and climate science. Will this unique brand of American
PETER HOTEZ Peter Hotez is professor of paediatrics and molecular virology and microbiology at Baylor College of Medicine, where he is also co-director of the Texas Children’s Hos- pital Center for Vaccine Development and dean of the National School of Tropical Medicine. He is also a senior fellow in disease and humanity at the Baker Institute of Public Policy of Rice University. He has led or co-led the development of vaccines for parasitic infections (hookworm, schistosomiasis, Chagas disease) and two low-cost Covid vaccines for global health, administered to 100 million children and adults in India and Indonesia.
X-TWITTER @PeterHotez peterhotez.org
anti-science, linked to extremist politics and wellness influencer products, globalise? American anti-science has already gone beyond US borders into Canada where measles outbreaks are also underway. In addition, the US government has indicated its intention to pull critical financial support for science-driven global health organisations, including the World Health Organizationand Gavi, the Vaccine Alliance. But documenting the spread of US
antivaccine–anti-science activism to LMICs in Africa, Asia and Latin America is not straightforward or easy to document, given that it mainly occurs through local media, WhatsApp and other personal device messaging. Reports on American antivaccine leaders pop up often on local news sites in LMICs, as do antivaccine films made in the US. It is not unusual to learn of LMIC government leaders repeating antivaccine and anti-science rhetoric from the US. In 2023, the WHO sounded an alarm regarding the decline in MMR vaccination rates and the return of measles and other childhood illnesses. The concern is that this reflects the globalisation of what accelerated out of Texas a decade ago. For years, I would visit Latin American countries to address their medical societies. I would begin by congratulating their physician members on holding the line and preventing the contamination of US antivaccine activism south of the border. This is no longer the case. I am concerned that increasingly vaccination rates will decline in LMICs across the world. Our global vaccine ecosystem is fragile. ▪
200 k Americans who needlessly died in 2021–2022 because they refused Covid vaccines 100 k The number of Texas school children who do not receive their full complement of vaccines
77 Health: A Political Choice – The Future of Health in a Fractured World
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