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
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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
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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%)
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20 Years of ‘Vaccine Hesitancy’ 1998-2018
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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
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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%
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Vaccine Hesitancy in USA
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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
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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
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Sarkar et al (2019) Lancet Infect Dis
Measles resurgence in the USA: how international travel
compounds vaccine resistance
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Four Factors Driving Antivax in America
• The Media Empire
• The Political Machine
• Deliberate Predation
• Lack of Robust Vaccine Advocacy
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The Antivax Media EmpireDominating the Internet
>480 AntivaccineMisinformation Websites
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Predation in NY: 40 Hospitalizations,
including 11 ICU Admissions
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Science and Public Engagement
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