Book Review

Peter Hotez: The Deadly Rise of Anti-science

By Alec Pruchnicki, MD

As much as I enjoyed this book, it’s sad to realize that a work can be excellent and topical and yet immediately outdated simultaneously. Dr. Hotez’ background is in a combination of pediatrics, infectious disease, and tropical medicine. But he is probably best known for his support of vaccinations, especially for children. He has been fighting anti-vaxxers for years, especially in one of his previous books, Vaccines Did Not Cause Rachel’s Autism, published in 2018 and describing the etiology of autism in his own daughter.

This book expands the conflict with anti-vaxxers but also those who are hostile to scientific theories in general. There are many areas of anti-science beliefs that he does not directly address, such as those related to evolution, global warming, the Big Bang theory, and others, but he concentrates on the area he knows best—vaccines. The ground for the growth of the anti-vax movement was set long before it exploded in the public consciousness. Some of these beliefs were religious, some traditional American anti-elitism with scientists being the elite, and some derived from the long history of paranoid thought in this country.

So, this was the ground that existed when Covid hit in 2020. Measures to combat it started with non-pharmacological interventions (NPIs) like social distancing, masks in public places, and shut downs of congregate settings like job sites, places of worship, recreational facilities, and schools. These measures produced a backlash that conservative politicians realized could benefit themselves. But the backlash increased dramatically when vaccines became available. Some opposition was conspiracy thinking about the speed at which these vaccines were developed, some about vaccines in general, and some about the mandatory guidelines requiring individuals to get vaccinated.

Although most Americans, and others around the world, enthusiastically accepted vaccinations, mandating them seemed to be excessive. Actually, mandates didn’t put unvaccinated people in jail, but limited access to public places where crowds assembled. There were also new requirements for military personnel. Declining a vaccine might affect an individual, apparently infringing on a person’s right for self-determination, but it also minimized the chances that an individual would catch Covid, and spread it to others with possibly deadly effects. Not “deadly” as a figure of speech, but literally a deadly result.

Conservative politicians saw an opportunity and Hotez traces how the anti-vaccine backlash spread throughout the right-wing population and media, spurred on by some politicians who may have not actually believed their own rhetoric. Whether the growth of opposition was due to true beliefs or opportunism, it spread quickly and widely. It even reached a point when President Trump, at one of his rallies, suggested people get vaccinated and he was booed by his own followers. Opposition became so deeply ingrained in right-wing thought that vaccine supporters were labeled as murderers and traitors for even supporting voluntary vaccinations. This led to death threats, including some directed toward Hotez himself, along with Anthony Fauci and many other scientists who are not known to the public. The threat of violence has become common place. He describes how it is now respectable on the political right to oppose almost any new scientific theory or method that seems too new or too complicated.

Hotez also describes how this attack on science is not limited to the United States. Going back to the Lysenko theories in the Soviet Union under Stalin, to the attacks on science by the Orbán administration in Hungary, the behavior of authoritarian regimes to suppress independent thought is easily spread. It doesn’t matter if it comes from opportunism or true belief, the result is damage to human knowledge and danger to human health.

Hotez’ analysis was not limited to what already occurred, but included some predictions about where trends were going. He briefly mentioned that measles had reappeared in an unvaccinated population in Brooklyn and he predicted, correctly, that it would reappear in other unvaccinated populations in the future. This is exactly what happened in the poorly vaccinated population in West Texas earlier this year.

He tried to propose some way to fight this wave of anti-science thinking. For one thing, he suggested that the normally severely apolitical scientific community learn how to communicate with the public and to do so frequently. Successful scientists must also master the art of grant writing. The anti-scientific right-wing has been successful in getting across its message to the general population and this can’t be fought with only apolitical wishful thinking. He also proposed that an advocacy center be established to defend science when controversies arise in the same way that the Southern Poverty Law Center defends civil rights when they are threatened.

This book was published in 2023 and there was no way for Hotez to predict what was coming with the new Trump administration. In addition to the general anti-scientific politics he describes in detail, there is now a budget argument that is made. Almost every government’s support for scientific research has been undermined or underfinanced and the very role of the United States as leader of the world in science is threatened. This book will get you up to date on what has occurred and why—but to describe our present situation we will have to wait for his next one.