Peter Hotez, M.D., Ph.D., makes his point with a chart of COVID-19 deaths. The chart illustrates spikes of deaths at various points. Hotez points out the spikes that occur after May 1, 2021, when vaccinations became widely available.

“Just in this delta wave alone, 200,000 unvaccinated Americans needlessly lost their lives because they refused to get a COVID vaccine,” says Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital and dean of the National School of Tropical Medicine at Baylor College of Medicine. “The anti-science kills.”

Hotez was keynote speaker at the 11th annual Johns Hopkins All Children’s Research Symposium Oct. 27-28 in St. Petersburg, Florida, a celebration of science that included several presentations related to COVID-19 along with other topics ranging from biomarkers and biospecimen science to pediatric health equity research. For the first time, the hybrid symposium expanded to an audience beyond the Johns Hopkins and local communities to invite viewers from around the world.

Hotez reviewed the rise of the anti-vaccine movement, which began more than two decades ago, and traced it to today’s partisan atmosphere. He emphasized that the movement is not a group of random events on the Internet, and it’s having an impact.

“This is well-organized and politically empowered,” he says. “This is no longer kind of a theoretical or academic discussion. Lives are being lost on a massive scale here.”

Hotez challenges the notion that children don’t need the COVID-19 vaccine because they generally don’t suffer severe illness or death. He points to hospitalizations and deaths in the United States and globally and a 2021 study in London that indicates as many as one in seven children who get COVID-19 develop long-COVID symptoms.

“We still have a lot of work to do to convince people of the importance of getting their COVID vaccinations,” he says.

Aside from his advocacy, Hotez and his team have helped fill gaps by developing vaccines for parts of the world that are underserved by pharmaceutical companies. In India, more than 75 million doses of their vaccine have gone into pediatric arms and another 10 million have been used as boosters in adults. Hotez and a colleague were nominated for the Nobel Peace Prize for their work.

“That was a very moving time for us to watch the livestream of kids actually getting the vaccine that we'd first developed at Texas Children's and Baylor,” Hotez says. “That was a very, very satisfying thing to see. And now we've done a second version of the vaccine for Indonesia.” 

Other COVID-19-related information at the symposium included invited lectures and abstract presentations.

Vera Ignjatovic, Ph.D., the new assistant director for translational research in the Johns Hopkins All Children’s Institute for Clinical & Translational Research, gave a different international perspective, having spent most of the pandemic in Melbourne, Australia, which had strict COVID-19 restrictions. She spoke of how research projects quickly evolved to focus on COVID-19 and its influence on coagulation in children.

“In terms of overall findings across the three studies, SARS-CoV-2 infection causes profound changes to all aspects of coagulation,” says Ignjatovic, also a professor of Pediatrics (pending academic review) at the Johns Hopkins University School of Medicine. “The impact of SARS-CoV-2 persists beyond recovery and this is consistent with the concept of long-COVID.”

Arturo Casadevall, M.D., Ph.D., a Bloomberg Distinguished Professor and Chair of Molecular Microbiology & Immunology at the Johns Hopkins University School of Medicine based in Baltimore, spoke on antibody-based therapies for COVID-19.

He covered the monoclonal antibodies that had initial success as a treatment but generally have lost effectiveness against the more recent variants. Casadevall also outlined the missed opportunity of making more effective use of convalescent plasma earlier in the pandemic and how that therapy is returning to favor.

Convalescent plasma is most effective when used early in the course of infection, Casadevall says. Many American physicians were having success using it this way early in the pandemic, but then a clinical trial came out of Europe that cast doubt on convalescent plasma because it was used too late, Casadevall says. The therapy fell out of favor, but it now is making what Casadevall calls a “renaissance.” 

“I think the most important lesson of this time is that for the future we have now learned how to use this effectively,” Casadevall says. “When bird flu arrives, coronaviruses arrive, hopefully, we'll know what to do. Hopefully, the future generations won't forget this history.”

Invited Speakers

• Vera Ignjatovic, Ph.D., Assistant Director for translational research, Johns Hopkins All Children’s Institute for Clinical & Translational Research; Professor of Pediatrics (PAR), Johns Hopkins University School of Medicine: “Pediatric Models and Markers of Endotheliopathy in COVID-19”
• Cassandra Josephson, M.D., Director, Johns Hopkins All Children’s Cancer & Blood Disorders Institute; Professor of Oncology (PAR), Johns Hopkins University School of Medicine: “Prognostic Markers of Outcome of Blood Transfusion in Premature Infants”
• Rosie Kaplan, M.D., Senior Investigator, National Cancer Institute: “Tumor Microenvironment and the Pre-metastatic Niche”
• Erica Sibinga, M.D., Associate Professor of Pediatrics, Johns Hopkins University School of Medicine: “Mindfulness Trials in Diverse Pediatric Populations”
• Nicola Disma, M.D., Director, Unit for Research & Innovation, IRCCS Children’s Hospital and Institute
• Giannina Gaslini: “Effects of Anesthesia on the Growing Brain”
• Peter Hotez, M.D., Ph.D., Professor of Pediatrics, Molecular Virology & Microbiology, and Dean, National School of Tropical Medicine, Baylor College of Medicine; Co-Director, Texas Children’s Hospital Center for Vaccine Development: “From Bench to Community: Investigator-Initiated Vaccine Strategies for COVID-19”
• Arturo Casadevall, M.D., Ph.D., Bloomberg Distinguished Professor and Chair of Molecular Microbiology & Immunology, Johns Hopkins University School of Medicine: “Antibody-Based Therapies for COVID-19”