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Brian Lehrer: It's the Brian Lehrer show on WNYC. Good morning again, everyone. Now we turn to the health and climate section of the show, which we do on Tuesdays every week. This week, both a heavyweight from the world of vaccine science and a heavyweight from the world of climate science have teamed up for a new book. Yes, we'll talk about actual science with Peter Hotez and Michael Mann, but also the fast-breaking politics around RFK Jr. and other news that's relevant to our guest's work. The book is called Science Under Siege: How to Fight the Five Most Powerful Forces that Threaten Our World.

The authors have been on with us separately in the past, as some of you know. They join us together for this. Dr. Peter Hotez, MD, PhD, is co-director of the Texas Children's Center for Vaccine Development, also founding dean of the National School of Tropical Medicine and Professor of Pediatrics and Molecular Virology and Microbiology at the Baylor College of Medicine. Dr. Michael Mann, PhD, Director of the Center for Science, Sustainability and the Media, and Presidential Distinguished Professor at the University of Pennsylvania. Dr. Mann and Dr. Hotez, thanks for teaming up for this. Welcome back to WNYC.

Dr. Peter Hotez: Thanks so much, Brian.

Dr. Michael Mann: Thank you.

Brian Lehrer: The five anti-science forces in your subtitle refers to what you also call the five P's. I'm just going to read them as a shorthand for our listeners. Plutocrats, authoritarian petro states, the pros who use their professional or, in some cases, scholarly credentials to deceive or promote unsupported contrarian views. The propagandists who amplify them on social media and other venues, and increasingly the press, even including the mainstream press, you say. Dr. Mann, you want to start with your first group, the plutocrats. Who does that refer to more specifically, and why?

Dr. Michael Mann: Yes, thanks. What we're talking about are folks like the Koch brothers. These are billionaires who have used their massive wealth and influence to place their thumb on our public discourse, funding think tanks and front groups that focus on undermining public faith and understanding of science, be it the science of climate change, the science of vaccines, any science that is a threat to their ideological or their political views. There are others, of course, there's Rupert Murdoch and News Corp. This media empire that he uses to attack the science that we're talking about.

It is other individuals like Elon Musk, for example, who has weaponized social media for anti-science messaging to promote climate denial, to promote anti-vax rhetoric. These are the main players who help fund this apparatus, this anti-science apparatus, and all of these pieces, each of the five P's, link together in various ways, but it's really the plutocrats who are providing the gasoline for the fire, if you will.

Brian Lehrer: Do you have a response to the critique of that critique that might say, yes, there are plutocrats on both sides? They'll cite George Soros at the top of the list, throwing a lot of money at more liberal or progressive causes.

Dr. Michael Mann: Yes, that's bothsiderism as we call it, is often intended to just confuse the public, get them to throw up their hands. "Oh well, it's both sides, so we can't really do anything about it." That's hogwash. There's no comparison between the amount of money and wealth, and influence, and bad faith behind this conservative network of plutocrats and a few individuals that these people will point to as boogeymen. In the book, we actually talk about Soros because of his Jewish heritage. They use him as a boogeyman to tie this into various anti Semitic tropes of which both Peter and I have been subject to as well.

Brian Lehrer: Another one from your five P's, Dr. Hotez, I'll ask you to describe this one. The pros who, you write, "Generate tangible disinformation content deliverables legitimized by their professional reputation." Who are these pros in your field, for example? Where would you want to start on that?

Dr. Peter Hotez: Yes. The pros differ-- One of the themes of the books is if you think of the attacks on biomedicine and vaccines versus the attacks on climate science, I think of them as two circles of the Venn diagram. They're not completely overlapping, but there's significant overlap. We talk about some of the differences and some of the similarities, and that goes with the pros. I'll let Michael talk about the pros and the climate side. For vaccines, there's two classes of them. One are those from the health, wellness, and influencer industry.

This is now a half-a-trillion-dollar industry, and unfortunately, a lot of it is built on buying up what's available in bulk and jacking up the price and selling it with telehealth visits. I mean, have you ever wondered why there are always anti-parasitic drugs like ivermectin or hydroxychloroquine, or fenbendazole? That's because you can buy a bucket of it. It's cheap. You jack up the price, you repackage, and you charge thousands of dollars with telehealth visits. They're often headed by physicians, in some cases, former or even current professors at major medical centers.

Unfortunately, it's created huge issues during the pandemic where people thought it's a good idea to take ivermectin instead of getting vaccinated, and then people paid for with their lives. The other part of the business model of the pros is the need to denigrate mainstream interventions such as vaccines and attack biomedical scientists and portray them as public enemies or cartoon villains. You see on social media how people go after people like myself and my colleagues.

The other class of pros are some of the Fox News talking heads that weaponize information about COVID vaccines or other pandemic measures. What happened there, I think, in their zeal to push back against vaccine mandates, which I didn't always agree with, but I understood it, libertarian philosophies, unfortunately, they went the next measure and falsely discredited the effectiveness and safety of vaccines. Americans across the country tuning into Fox News at night, Laura Ingraham, Sean Hannity, Tucker Carlson. We document their role in promoting vaccine disinformation.

You go down that rabbit hole, and you make an executive decision based on what you're hearing, either from the wellness influencers or from Fox News, not to vaccinate and take ivermectin instead. Tragically, our estimate is at least 200,000 Americans needlessly died because they refused COVID vaccines. That brings us to the next part is the reason that we wrote this book is because it's not just some arcane or academic discussion. Americans are dying because of anti-science and health disinformation, and climate science disinformation. It's a killing force unto itself.

Brian Lehrer: That's 200,000 estimated deaths in context. Another stat that I've heard, tell me if your facts back this up, is that because of the prominence of the anti-vaccine movement in this country during the height of COVID, the US had a higher COVID death rate than other countries in the world, at least other industrialized countries. That we had 18% of the COVID deaths over those first few years, even though we have only 5% of the world's population.

Dr. Peter Hotez: Yes, tragically. I can't confirm that particular number, but clearly, when you look at mortality rates in the US, the US clearly punches above its weight, tragically, compared to Canada or Western European countries. Let me give you an example, Brian. In my state of Texas, which has a population of 30 million people, 100,000 Texans died from COVID. By contrast, in Canada, which has a population the same size as Texas, similar-sized economy, obviously over a larger geographic area, it was 50,000 deaths, exactly half.

Why? Because after vaccines became available starting in early 2021, Canadians got vaccinated, and the deaths more or less halted, whereas in Texas, they kept on rolling on. Almost as many Texans died after vaccines became available as before because so many Texans refused COVID vaccines, especially in the rural conservative areas. This is how powerful the disinformation machine is to let people lose their lives. When you look at our terrible measles epidemic that we've had in Texas this year, with two unnecessary deaths and 100 hospitalizations, it occurred in the same rural conservative areas where people refuse COVID vaccines.

Brian Lehrer: Listeners, if you're just joining us, you may recognize these voices. In fact, we'll invite you, at least some of you, on our available time, to ask a question that you've always wanted to ask of Dr. Peter Hotez or Dr. Michael Mann, if you know their works. A heavyweight from the world of vaccine science and a heavyweight from the world of climate science who have teamed up for a new book called Science Under Siege: How to Fight the Five Most Powerful Forces that Threaten Our World. We will get to some actual news of recent days with them, too. Talking about the larger ideas in the book first. 212-433-WNYC, 212-433-9692. Call or text.

Back to you, Dr. Mann, because I see the book was born out of a collective experience that you both shared. Attacks on the science that you've both done that in some cases, has escalated to online harassment and death threats, and even physical harassment for the work that you've done in your separate fields. I see that you first experienced this way back in the late 1990s, well before President Trump or fracking company executive was energy secretary, when you published your 'Hockey Stick' graph, as it's called, on rising global temperatures. Can you tell us a little bit about that work and what happened when it was published?

Dr. Michael Mann: Yes, sure thing. That's back in the late 1990s. I was a young postdoctoral researcher, and we published this now iconic curve called the 'Hockey Stick'. It estimates temperatures back 1,000 years in time. We only have about 100 years of widespread thermometer measurements. We can go further back using indirect measures like tree rings and corals, and ice cores. What the curve showed, it looked like a hockey stick. The blade was the warming of the past century and a half, the warming that coincides with the Industrial Revolution.

What the 'Hockey Stick' showed us was that the warming of the past century is unprecedented. We know it's tied to the increase in carbon dioxide concentrations, primarily from the burning of fossil fuels. That made this graph very inconvenient to powerful vested interest in the fossil fuel industry. They came at me with everything they had. I was attacked, I was vilified on the pages of conservative newspapers by politicians, Republicans, subjecting me to vexatious demands and investigations.

Ultimately, that passed because the science stood up, the scientific community backed us up. It was PTSD for me, I have to say, when about four or five years ago, I saw the same thing happening, not to climate scientists like me, which had happened a couple decades ago, but happening to my fellow scientists and Peter in particular in the public health arena. I forget who reached out to whom, but we bonded because we had both experienced these attacks. I felt like I had some experience, based on what I had withstood, that that might be relevant to folks like-- to Peter and Tony Fauci and others.

Brian Lehrer: That experience that you had was 25, 30 years ago. I don't even think they try anymore, correct me if I'm wrong, to say climate change, including man-made climate change, is a hoax or isn't real. There's just so much data now. The 10 warmest years on record since they started keeping records in global terms, the 10 warmest years on record have been the last 10 years. I want to get your take on something, maybe from a cost-benefit analysis standpoint, because I think the Trump administration position, which maybe many voters accept, is basically that man-made climate change is real. At least they say that.

The cost of living implications outweigh the amount of pain the climate itself will cause. I think we hear this a lot from Energy Secretary Chris Wright because with mandatory green energy and greenhouse gas emissions limits, utility prices and everything that gets shipped by truck, and lots of other things get more expensive, construction gets more expensive. So many things. What's your response to that way of thinking?

Dr. Michael Mann: Yes, it's a very disingenuous, albeit seemingly compelling argument. That was actually the thesis from my last book, The New Climate War, which is just as you say, the assault has moved on, because the scientific evidence, the basic evidence of human-caused warming of the planet, is irrefutable. The other side recognizes that. They recognize they've lost that particular argument. That doesn't mean they gave up. It just means they turn to other tactics. In the end, they don't care if you deny that it's happening or that you think that the solution is worse than the cure, that doing something about the climate crisis will somehow hurt the economy, et cetera.

These are the sorts of very disingenuous arguments you hear from them when, if you talk to real economists, actual leading economists who do the cost benefit analysis properly, a full cost accounting, which is to say, sure, there's a cost of the energy transition, although I always find it ironic that somehow these same people refer to increased money for fossil fuels as investment, but they frame increased funding for renewable energy as a cost. Why is one investment and another is a cost?

It's part of their framing, but the cost, if you even want to call it that, of a clean energy transition. By the way, clean energy is actually cheaper on a levelized basis than renewable energy. The only reason that we're still using so much-- than fossil fuel energy, and the only reason we're still using so much fossil fuel energy is that it's heavily subsidized in the fossil fuel industry. The politicians who support them have made sure of that. If you do a full cost accounting, then the cost of inaction in the form of these devastating floods and heat waves and wild fires and superstorms that are-- they're literally leading to billions of dollars damages many times over.

Several times a year, we see these $20, $30 billion, $40, $50, $60 billion extreme weather events that have been amplified by human-caused warming. If you do a proper cost-benefit analysis, the cost of inaction, of all the damage climate change is doing to us, way outweighs any reasonable estimate of the so-called cost of actually taking action of moving towards renewable energy.

Brian Lehrer: Let's see. I think-- [crosstalk]

Dr. Peter Hotez: Unfortunately, on the biomedical side and the vaccine side, we're still at a more primitive stage where you have the pros or some of the elected officials putting out easily refutable statements. We had, for instance, our friend, the Florida Surgeon General, Dr. Ladapo, saying mRNA vaccines are causing turbo cancers because they're [unintelligible 00:17:26]. There's DNA inside the mRNA vaccine, lipid nanoparticle, that's integrating into our genome, next to oncogenes. It sounds very sciency, except it's all bs. It's all made up.

You have to explain, first of all, there's no such thing as a turbo cancer. That term was also made up second to lipid nanoparticle, which delivers nucleic acid past our cell membrane, doesn't get past the nuclear membrane. For that, we need electroporation, other complicated devices that we use for gene therapy. Third, even if some of the DNA or RNA were to get into our nucleus, we have proteins of our innate immune system that block integration into our genome. Otherwise, every time we ate a hamburger, we'd have cow DNA into our genome.

We see that approach a lot, people using sciency language. RFK Jr. is very guilty of that. The way he talks about autism and vaccines. It's easily refutable if you have the bandwidth and if you can reach the people that you need to.

Brian Lehrer: You have stumbled into the exact news story I wanted to ask you about before we run out of time. I pulled a clip. Again, listeners, this is about the Florida Surgeon General, Dr. Joseph Ladapo, and his push to end all school vaccine mandates in his state. Florida would be the first state to do that. We're going to play a clip because on CNN State of the Union on Sunday morning, the surgeon general of Florida told the host, Jake Tapper, that officials did not undertake any data analysis to determine how many new cases of hepatitis A, whooping cough, or chickenpox would arise after the ending of vaccine mandates for kids to go to school. Let's take a listen to a bit of that exchange. It starts with Jake Tapper's question.

Jake Tapper: Before you made this decision to try to lift vaccine mandates for Florida, which include, obviously, public schools, did your department do any data analysis, did you do any data projection of how many new cases of these diseases there will be in Florida once you remove vaccine mandates?

Joseph Ladapo: Absolutely not. It's not a-- You mentioned whooping cough there. There's this conflation of the science and what is the right and wrong thing to do. Scientifically, you mentioned whooping cough. That's an example. This is part of the issue with informed consent. That's an example of a vaccine that is ineffective. The data show that it's ineffective at preventing transmission. Mandates with that really don't have anything to do with the notion of transmission, and then in terms of analysis. Ultimately, this is an issue, very clearly, of parents' rights.

Brian Lehrer: Dr. Hotez, there's so much to respond to there. Let me ask you this particular question. If the vaccines protect the children whose parents do opt them in, what's the risk other than to those children whose parents choose to take that risk of not getting their kids vaccinated? Then you could say, as a matter of public policy, "Okay, we think this is dangerous, but that risk is on you."

Dr. Peter Hotez: Yes. I think we saw that exact argument play out this year with a measles epidemic that began in West Texas and then ultimately reached four states, went up into the panhandle, across the border to Mexico, and actually five states, Colorado, and then Kansas and Oklahoma. The consequence was a hundred kids and adults required hospitalization, and two innocent school-age children needlessly perished. They died because parents decided not to vaccinate them. Now there's a good likelihood measles will become a regular occurrence, and no vaccine is 100% safe.

Brian Lehrer: My question is, what's the risk-- Oh, maybe you just started to answer that.

Dr. Peter Hotez: No vaccine is 100%. Then you have also kids who are immunocompromised. There is this problem that we don't talk about enough that I call the force of infection. That is, if you get enough cases mounting in the community, it could even have the ability to override, especially if the vaccines are partially protective. All the numbers are going in the wrong direction, Brian. We've now had this terrible measles epidemic. It won't be our last. We've had a sixfold rise in pertussis, whooping cough, cases in the United States. We've had polio in the wastewater in New York a couple of years ago.

The concern now is other states will take a similar position that Florida has, and all of these diseases will become our new normal to a point where we have to wonder whether the schools are going to be safe for kids.

Brian Lehrer: The Florida Surgeon General mentioned in the clip, or argued in the clip, that the whooping cough vaccine, in particular, is ineffective, ineffective at preventing transmission. Mandates with that really don't have anything to do with the notion of transmission, quoting from that clip. Do you disagree on the science?

Dr. Peter Hotez: A few things. One, they don't always prevent bacterial colonization, but they certainly reduce disease severity, and they can reduce transmission to some extent. They're not the older vaccine, probably reduce transmission more so. Remember, we're not talking just about the pertussis vaccine, we're talking about the measles vaccine, which is the best vaccine we have that does prevent transmission, or rubella. Now we're going to bring back congenital rubella cases. [crosstalk]

Brian Lehrer: If they go through with this in Florida, do you think polio is going to make a comeback?

Dr. Peter Hotez: That's the worry. We've already seen now polio in the wastewater in New York State in 2022 and 2023. Their vaccine ecosystem is extremely fragile, and it doesn't take much for these diseases to become roaring back. If other states start adopting a similar position, or it's not even just the passage of state policy and law, but listening to the rhetoric coming out of Washington, D.C., and from HHS and this administration, there's a worry that parents will seek non-medical exemptions in the states that allow them. There is a big risk that this is going to start to erode and ultimately collapse.

Brian Lehrer: Let me ask you one COVID vaccine question. Last Friday, New York Governor Kathy Hochul signed an executive order that would allow pharmacists in the state to administer COVID vaccines for any New Yorker who wishes to be vaccinated. In fact, I think orders them to do so. Is availability now up to the states? Seems like it for most people under 65. After RFK set 65 as the new minimum age at which the government recommends it. I'm curious if you have a take on insurance coverage under something like Governor Hochul's order. Anyone who wants it can get the vaccine, presumably at least in New York and whatever other state has that policy. Do you know if private insurance will cover it in the way they did in the past?

Dr. Peter Hotez: We're in a brave new world now without a lot of precedent. We've never had a situation really where the states start to go rogue and go up against FDA and Centers for Disease Control recommendations. That's a long way of my answering. I don't know the answer to your question. I don't think we're going to know till we know. Then the pharmacy chains also have to determine are they going to follow state recommendations or are they going to follow federal recommendations. Places like CVS and Rite Aid, et cetera, are all national pharmacy chains, Walgreens, et cetera.

Then what do the insurance companies do? I'm sure they're wringing their hands and trying to work out what the best is, but it's tragic that we have anti-vaxxer-in-chief as our Health and Human Services Secretary. Now, what you're doing is you can no longer rely on the Centers for Disease Control and FDA to provide sound public policy around health, and this is now leaving it to the states. Even the states don't really have that intellectual heft and bandwidth to always make the best decisions either. It's a scary situation.

Brian Lehrer: We're just about out of time. Dr. Mann, I want to give you-

Dr. Michael Mann: I'm just going to add one quick point.

Brian Lehrer: -one last word. Let me ask you the specific closing question because in the book, you make an analogy between this moment and the novel and movie series Lord of the Rings. You write, "The battle for Middle-earth wasn't won by appeasing the Dark Lord and his forces, it was won by defeating them." In our last 45 seconds or so, what does that look like in your opinion?

Dr. Michael Mann: Yes. The Tolkien-esque framing was something that I brought to this story. I think Peter very much feels the same way that what we need is a grassroots-- frankly, a rebellion against this anti-science. We need scientists to be far more visible and active, and we're seeing some of that right now. We need people. People have to get out and vote for politicians who will represent us and our interests, or we get politicians who are just rubber stamps for the Koch brothers, for the fossil fuel industry, for these bad actors.

Right now, what we're seeing is all three branches of government weaponized against climate action in the US and weaponized against basic public health measures like vaccination. What we need are people to get out, people to vote for politicians who will help turn this around. Expand the court. We probably need to expand the court because the Supreme Court right now is also a rubber stamp for these policies. If people turn out in droves in the midterm elections, a lot of this can change pretty quickly.

Brian Lehrer: That's our health and climate section of the show for this week, as we do every Tuesday. We thank Dr. Michael Mann, Dr. Peter Hotez, now co-authors of Science Under Siege: How to Fight the Five Most Powerful Forces that Threaten Our World. Thank you for sharing it with us.

Dr. Michael Mann: Thank you, Brian.

Dr. Peter Hotez: Thanks.

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