CUGH: Vaccines and Vaccine Hesitancy

Peter Hotez, M.D., Ph.D.

Texas Children’s Hospital Endowed

Chair in Tropical Pediatrics

Dean, National School of Tropical Medicine

at Baylor College of Medicine

Former US Science Envoy

@PeterHotez

Page 2

xxx00.#####.ppt 7/26/2019 4:47:54 PM

Vaccine Scientist, Pediatrician, Autism Dad

Page 3

xxx00.#####.ppt 7/26/2019 4:47:54 PM

UNDER 5 CHILDHOOD DEATHS• Measles 478,727• Pertussis 138,048• Tetanus 105,333• H. flu 86,104• Diphtheria 10,413

UN Millennium Summit and MDGs

Page 4

xxx00.#####.ppt 7/26/2019 4:47:54 PM

IMAGE(S) REMOVED FOR COPYRIGHT PURPOSES

Page 5

xxx00.#####.ppt 7/26/2019 4:47:54 PM

Under 5 Child Deaths 2000-2017

GBD 2017

2000

‐Measles 478,727

‐Pertussis 138,048

‐Tetanus 105,333

‐H. flu 86,104

‐Diphtheria 10,413

2017

‐Measles 83,438 (-83%)

‐Pertussis 86,091 (-38%)

‐Tetanus 18,623 (-82%)

‐H.flu 36,185 (-58%)

‐Diphtheria 2,914 (-72%)

Page 6

xxx00.#####.ppt 7/26/2019 4:47:54 PM

Can we eliminate measles globally?

Page 7

xxx00.#####.ppt 7/26/2019 4:47:55 PM

Measles Transmissibility

Page 8

xxx00.#####.ppt 7/26/2019 4:47:55 PM

Europe in 2018: 60,000+ Measles

Page 9

xxx00.#####.ppt 7/26/2019 4:47:55 PM

20 Years of ‘Vaccine Hesitancy’ 1998-2018

IMAGE(S) REMOVED FOR COPYRIGHT PURPOSES

Page 10

xxx00.#####.ppt 7/26/2019 4:47:55 PM

Page 11

xxx00.#####.ppt 7/26/2019 4:47:55 PM

Page 12

xxx00.#####.ppt 7/26/2019 4:47:55 PM

Page 13

xxx00.#####.ppt 7/26/2019 4:47:56 PM

TEXAS NON-MEDICAL VACCINE

EXEMPTIONS (2003-2019)

2,314 2,722 6,9919,606 10,404

12,633

19,050

22,910

28,432

32,616

38,19740,997

44,716

52,756

56,738

64,176

2003to

2004

2004to

2005

2005to

2006

2006to

2007

2007to

2008

2008to

2009

2009to

2010

2010to

2011

2011to

2012

2012to

2013

2013to

2014

2014to

2015

2015to

2016

2016to

2017

2017to

2018

2018to

2019

13

Page 14

xxx00.#####.ppt 7/26/2019 4:47:56 PM

Texas Tribune

Schools with Highest Rates of Vaccination Exemptions

School Percent exemptedAustin Waldorf School (Travis) 40.51%Regents Academy (Nacogdoches) 37.75%Austin Discovery School (Travis) 30.06%Joshua Adv Multi-Gr Sch (Johnson) 26.67%Trinity Christian Academy Paris (Lamar) 23.86%The Khabele School (Travis) 22.08%Aesa Prep Academy (Travis) 20.65%

IMAGE(S) REMOVED FOR COPYRIGHT PURPOSES

Page 15

xxx00.#####.ppt 7/26/2019 4:47:56 PM

Page 16

xxx00.#####.ppt 7/26/2019 4:47:56 PM

Vaccine Hesitancy in USA

IMAGE(S) REMOVED FOR COPYRIGHT PURPOSES

Heat map of county-level NME rates in 2016 to 2017

Olive JK, Hotez PJ, Damania A, Nolan MS (2018) Correction: The state of the antivaccine movement in the United States: A focused

examination of nonmedical exemptions in states and counties. PLOS Medicine 15(7): e1002616.

https://doi.org/10.1371/journal.pmed.1002616

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002616

Page 18

xxx00.#####.ppt 7/26/2019 4:47:56 PM

Heat map of counties with >400 kindergarteners with NMEs in 2016 to 2017

Olive JK, Hotez PJ, Damania A, Nolan MS (2018) Correction: The state of the antivaccine movement in the United States: A focused examination of nonmedical exemptions in states and counties. PLOS Medicine 15(7): e1002616. https://doi.org/10.1371/journal.pmed.1002616http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002616

Page 19

xxx00.#####.ppt 7/26/2019 4:47:56 PM

Page 20

xxx00.#####.ppt 7/26/2019 4:47:57 PM

Page 21

xxx00.#####.ppt 7/26/2019 4:47:57 PM

Sarkar et al (2019) Lancet Infect Dis

Measles resurgence in the USA: how international travel

compounds vaccine resistance

IMAGE(S) REMOVED FOR COPYRIGHT PURPOSES

Page 22

xxx00.#####.ppt 7/26/2019 4:47:57 PM

Four Factors Driving Antivax in America

• The Media Empire

• The Political Machine

• Deliberate Predation

• Lack of Robust Vaccine Advocacy

Page 23

xxx00.#####.ppt 7/26/2019 4:47:57 PM

The Antivax Media EmpireDominating the Internet

>480 AntivaccineMisinformation Websites

IMAGE(S) REMOVED FOR COPYRIGHT PURPOSES

Page 24

xxx00.#####.ppt 7/26/2019 4:47:57 PM

The Antivax Political Machine

Page 25

xxx00.#####.ppt 7/26/2019 4:47:57 PM

Predation in NY: 40 Hospitalizations,

including 11 ICU Admissions

IMAGE(S) REMOVED FOR COPYRIGHT PURPOSES

Page 26

xxx00.#####.ppt 7/26/2019 4:47:57 PM

Page 27

xxx00.#####.ppt 7/26/2019 4:47:57 PM

Science and Public Engagement

IMAGE(S) REMOVED FOR COPYRIGHT PURPOSES

Page 28

xxx00.#####.ppt 7/26/2019 4:47:58 PM