Peter Hotez is no stranger to scientific backlash. The esteemed pediatrician and vaccinologist has been working to develop vaccines for neglected tropical diseases for decades and has encountered fierce opposition to his work. But in recent years the backlash has gained momentum and spread beyond vaccines to science and scientists in general.

Hotez, who is dean of the National School of Tropical Medicine at Baylor College of Medicine, chronicles this movement in his new book The Deadly Rise of Anti-Science. The book traces Hotez’s experiences battling the false belief that vaccines cause autism (a condition that his daughter has), the highly partisan backlash to the COVID vaccines (a low-cost version of which Hotez and his colleagues helped develop) and the authoritarian roots of the antiscience movement.

Scientific American spoke with Hotez about the book, the experiences he’s had as a target of antiscience attacks and the things that should be done to combat such threats.

[An edited transcript of the interview follows.]

Why did you decide to write this book?

I think one of the things the book does is: it helps connect a few dots. People call [the antiscience movement] “misinformation” or “the infodemic” as though it’s just random junk out there on the Internet or social media, and it’s not—it’s organized, it’s well-financed, and it’s politically motivated. It’s really its own ecosystem that’s doing a lot of damage to the country and to American science and scientists. And now it’s reached a new level. It’s become a lethal force. It’s the fact that [at least] 200,000 Americans needlessly perished [between June 2021 and March 2022] because they refused the COVID vaccine during the [Delta and Omicron COVID waves], and they were victims of this organized campaign.

Your book discusses how the modern antiscience movement grew out of false claims in the late 1990s that vaccines cause autism, right?

In some ways, it’s a sequel to one of my previous books, Vaccines Did Not Cause Rachel’s Autism. So, you know, I have a daughter who has autism. As you point out, the original assertion was that vaccines cause autism. And in the previous book, I detailed the evidence showing that there’s no link. So I’ve been in this for a while, confronting antivaccine groups. But what I saw starting about a decade ago was a shift—maybe because we were taking some of the wind out of their sails around autism, [the people in these groups] needed a new thing. And the new thing was to become part of the American political landscape and link themselves up initially to the Republican Tea Party, even before the pandemic, around this concept of health freedom, medical freedom. And that’s what came off the rails during COVID.

Why do you feel compelled to speak out now?

I’ve been the number one or two target of that movement for years or decades. And now I have an insight into how this is unfolding. It troubles me that it’s not only targeting science but scientists. I think it’s undermining the country because we’re a nation built on science and technology and on the greatness of our research universities and institutions, and they are under threat. I felt compelled to be kind of the tip of the spear, to sound that warning, because we’re seeing mostly silence from our university presidents and from our scientific societies. Even the National Academies [of Sciences, Engineering, and Medicine] weren’t really out there. I think there was a kind of hope that it would just go away on its own. But we’ve seen from past experience that this kind of stuff doesn’t go away on its own. It’s got to be confronted.

Are you concerned that confronting anti-vaxxers and antiscience people will only give them more attention?

That was the response from the [Centers for Disease Control and Prevention] back in 2017 when I wrote about how the anti-vaxxers are winning. We’re not supposed to talk about it, or we’ll give it oxygen. But it’s got all the oxygen it needs. You might say, “Well, why write it now?” For two reasons: one, it’s become a killer movement. Think about the 200,000 Americans who died because of this—that’s a major societal lethal force right up there with anything else we might be concerned about as a society. And the second is the attacks on the individual scientists and the portrayal of scientists as enemies of the state. This is unacceptable. I mean, this is undermining our national security.

It's absurd that the people who are trying to protect us all from this deadly disease are the ones who are being attacked for it.

Yeah. I mean, what’s my crime? I helped develop a low-cost COVID vaccine technology that reached 100 million people and provided a proof of concept that was an alternative to the big pharma companies. It’s really unfortunate. And I think it’s going to get worse as we head into the 2024 election.

Do you think Donald Trump’s presidency influenced the rise of antiscience attitudes?

What’s happening now, I say in the book at the beginning, is actually not about Trump. Most of this got worse after Trump in 2021 to 2022. Now there’s this effort to rewrite history—maybe in part because I’ve called [antiscience politicians and influencers] out by saying 200,000 Americans died because of their disinformation campaign. They’re doubling down and trying to say, “No, it was the COVID vaccine that killed Americans, and the scientists made the COVID virus.” This revisionist history is playing out now with the [U.S. House of Representatives] hearings that we’re seeing in the [Select Subcommittee on the Coronavirus Pandemic], which are trying to parade prominent scientists in front of C-SPAN cameras to try to humiliate them. It’s very Stalin-like, very [similar to the] U.S.S.R. in the 1930s.

That’s an interesting analogy because the far right and the anti-vax movement have compared COVID vaccination efforts to the Nazis’ treatment of Jewish people during the Holocaust.

It’s totally offensive, right? I mean, trying to draw parallels between vaccinations and the Holocaust, and the heavy use of Nazi imagery—that, too, is a form of antisemitism. So there are a lot of antisemitic undercurrents. And [those making the comparisons] know I’m Jewish, so that’s also a component.

Do you think that anti-vax and antisemitic groups overlap and strengthen each other?

In the Venn diagram, there’s not a complete overlap between the circles, but there’s definitely overlap. There’s a history to that too. People called what Einstein and Freud did “Jewish science,” so there’s that modern history of linking antiscience to antisemitism.

The big issue then is: Where do we go from here, now that we’ve got this sort of entire well-oiled, well-financed antiscience ecosystem? How do we begin addressing it and chipping away at it? That was one of the hardest things for me to get my arms around. What do you do? Because it’s a political movement. The scientific societies and national academies don’t want to talk about it because it takes them into an unpleasant place. I don’t like talking about it either. But you have to report it and describe it so you know what you’re dealing with because maybe it'll autocorrect eventually. But right now, it’s not going away.

In the book you also talk about how the U.S. is exporting anti-vax and antiscience sentiment around the world.

This is coming out of the authoritarian playbook, with devastating consequences. We’re seeing it not only in the U.S. but also in Brazil with [former president Jair Bolsonaro’s] regime or with [Prime Minister] Viktor Orbán in Hungary. This is part of how authoritarian regimes operate: you denigrate science and scientists.

I think we’re seeing more of the globalization of what’s happening in the U.S. A lot of it’s not in the biomedical literature. It’s in local newspapers and that sort of thing. But there are enough pieces there that make me believe that this is certainly contaminating Canada and also Germany and Austria and France to some extent—and low- and middle-income countries as well. I think this is going to start affecting all immunizations, including childhood immunizations globally. I’m worried about measles and polio coming back.

What’s happening now with the antiscience movement here in the U.S.?

I worry about what’s going to happen as we head into the 2024 election. I worry about these House hearings—I think they’re going to ratchet up, and they’re going to continue to target scientists. I worry about what’s going on with some members of the Senate and the rhetoric coming out of the [presidential] campaign. I mean, you already have two prominent antivaccine activists running for president—Robert F. Kennedy, Jr., and Ron DeSantis. What’s so chilling is that these are state-sanctioned attacks on science and scientists.

You’ve personally experienced some very threatening attacks and even physical confrontations. How do you deal with that?

These are multimodality attacks: it’s the threatening e-mails; it’s the stuff on social media. And Twitter’s gotten so awful in the past year that it’s just almost untenable. And then, you know, [people are] stalking me when I speak at scientific conferences or outside my home recently, so it is getting very, very troubling.

What can be done to combat antiscience attitudes and support science and scientists?

I don’t think the community of scientists by itself can solve this. We’re going to need help, both from the White House and the United Nations because this is now a politically motivated assault. So we need the White House, for instance, to treat this like any politically motivated attack on the country, whether it’s a cyberattack or global terrorism or nuclear proliferation.

The first step is bringing in people from the Department of Homeland Security, the Department of Commerce, the Department of Justice and the Department of State because of the role of Russia in amplifying the discord. I think we need an interagency task force [in the U.S.] and the same at the U.N. I don’t think the World Health Organization can solve this problem. I think this needs to go to the attention of the U.N. General Assembly and maybe the Security Council and NATO, perhaps, because it is a security threat, and it undermines democracies and the security of countries.