In December 2017, Texas Monthly published a feature about Peter Hotez, a scientist pushing back against Texas’s anti-vaccine movement as the state risked a deadly measles outbreak. At the time, Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston and the co-director of the Texas Children’s Hospital Center for Vaccine Development, was fighting attacks after authoring a pair of provocative articles: “Texas and Its Measles Epidemics” for the scientific journal PLOS Medicine and “How the Anti-Vaxxers Are Winning,” an op-ed for the New York Times. Last month, he offered a more thorough argument in his book Vaccines Did Not Cause Rachel’s Autism. In the work, Hotez draws on his experiences as both a vaccine scientist and as the father of an autistic child to debunk a link between vaccines and autism. (His daughter, Rachel, was diagnosed with autism in 1994 at nineteen months old.)

Hotez believes Texas is especially at risk for a measles outbreak, as the number of Texas children granted exemptions from school vaccine laws for “reasons of conscience” has increased steadily from around 3,000 in 2003 to just under 45,000 in 2015. “The political action committees like Texans For Vaccine Choice are very powerful,” Hotez said on the National Podcast of Texas. “They’re making a lot of headway in terms of making it harder and harder to vaccinate your child and easier and easier to exempt out.”

On the National Podcast of Texas, Hotez discusses the risk of a measles outbreak in Texas, the science of autism, and how anti-vaxxers are affecting legislative actions to prevent an outbreak.

Some highlights (edited and condensed for clarity):

On Autism and Vaccines

A key point in my book, which I haven’t seen very much in other pro-vaccine writing, is the genetics and developmental processes leading to autism and the associated intellectual disabilities that sometimes go along with it, as in Rachel’s case. That’s very important because it highlights not only the evidence showing there’s no link between vaccines and autism, but it also indicates that there’s a lack of plausibility. There’s just no conceivable way a vaccine is going to cause structural rearrangements in the anatomy of the brain, and that’s important for parents to hear, because they’re getting bombarded with anti-vaccine misinformation. It’s also helpful for the pediatricians, because oftentimes parents will download something from anti-vaccine websites and come storming into the pediatrician’s office. They’ll say, “Gee, I never heard that before,” and it makes the pediatrician look bad. The book attempts to give parents information, and in the back, there’s an epilogue that gives pediatricians and nurse practitioners and other health care providers talking points to address and refute some of the things that parents come in and say.

On the State of Measles in the State of Texas

Unfortunately, the numbers have gotten worse. Last year we were looking at around 50,000 kids that we knew about who aren’t getting vaccinated. Now we’re at around 60,000, so the numbers continue to climb. We’ve also learned about the home schooled kids: There are more than 300,000 homeschooled kids in Texas, and we have no numbers on the percentage of those kids who aren’t getting vaccinated. We’re probably looking at more than 100,000 kids in the state of Texas who are not getting their vaccines.

On Who’s Not Vaccinating in Texas

In Texas, the vaccine exemption rates are the highest in Austin, but also in some of the North Texas cities and towns—Plano, Denton, and Fort Worth are bad, too. It tends to be affluent parents, even educated parents—as I like to say, educated enough to know how to do a Google search, but maybe not educated enough to know what the hell they’re Googling.

On the Politics of Vaccination

[Anti-vaxxing stances] tend to come from the extreme elements of either the left or the right. In Texas, it definitely has a political rights flavor to it, because the major anti-vaccine political action committee, Texans for Vaccine Choice, uses a lot of Tea Party language and seems to get their funding from elements of the far-right wing of the Republican Party. The language they use includes phony terms like “medical freedom” and “choice,” when in fact children have a fundamental right to be protected from deadly infection. If you’re a parent, you know you don’t have a choice whether you put your child in a car seat or a safety belt—that’s the law. Or if you’re a parent and own a firearm, by law, you’re required to keep that firearm locked up—it’s not your choice. It should be the same for vaccinations.

On the Caravan and Its Risk of Tropical Disease

There’s been some outrageous statements made on cable news networks by commentators and pundits, claiming that the caravan is going to bring in a vast array of tropical diseases. In my last book, Blue Marble Health, using data from the World Health Organization and data from the Gates Foundation, we found an unexpected level of neglected tropical diseases among the poor living in wealthy countries, including the G20 economies. Today, most of the world’s neglected tropical diseases are in the G20, but among the poor. We started the book by taking the reader through a tour of the poor parts of Texas and pointing out why we already have widespread tropical diseases here. They are the consequences of poverty, unchecked urbanization, and climate change—it’s not because of immigration across our southern border.