Interview with María Elena Bottazzi: “We Gave Away our Vaccine to Save as Many Lives as Possible”

Microbiologist María Elena Bottazzi explains how her team, co-led with Peter Hotez, developed and shared the technology to create the Corbevax and Indovac vaccines on a non-profit basis.

To define herself, microbiologist María Elena Bottazzi starts with her multicultural background: she was born in Italy and grew up in Honduras, her father’s country. She fondly remembers the rivers she used to swim in and the horses on her grandmother’s ranch. She had to be careful of intestinal worms and neglected tropical diseases that burdened the lives of many around her. This is how she began to develop her sensitivity to poverty and inequalities.

She loved studying. She earned a degree in Microbiology and Clinical Chemistry at the National Autonomous University of Honduras, from which she graduated, she says, “as prepared as anyone who had studied at a top-tier university.” She then furthered her education in Florida and Pennsylvania: a PhD in Molecular Immunology, two postdoctoral fellowships in Cellular and Molecular Biology, and even started a Master’s in Management.

Meeting Peter Hotez marked a turning point in her career. They began collaborating in 2001 and, ten years later, moved to Houston, the fourth-largest city in the United States, to establish the Vaccine Development Center at Texas Children’s Hospital. Since then, they have led a small team of scientists focused on what other research groups often overlook: neglected, emerging, or re-emerging diseases. Their goal is to design accessible, affordable vaccines for those who need them most on a non-profit basis.

When the COVID-19 pandemic broke out, their lab had already spent a decade studying coronaviruses, focusing on SARS and MERS, which had become neglected diseases. In three months, they developed a recombinant protein-based technology that led to Corbevax, a COVID-19 vaccine free of patents and low-cost, developed in collaboration with Biological E in India. “A vaccine for the world,” Bottazzi sums up. Later, they also collaborated with BioFarma in Indonesia to co-develop Indovac.

As Associate Dean of the National School of Tropical Medicine at Baylor College of Medicine and a Professor of Pediatrics, Bottazzi recently visited Barcelona, invited by the Malaria and Neglected Parasitic Diseases Program of ISGlobal.

The Division of Pediatric Tropical Medicine at Texas Children’s Hospital drives research and vaccine development for neglected diseases. Photo: Baylor College of Medicine.

-In 2020 you were nominated for the Nobel Peace Prize together with Peter Hotez, and that same year Forbes named you one of the most powerful women in Central America. How did that change you?

-The nomination was a recognition of our work seeking solutions for neglected or emerging tropical diseases (at the time, COVID-19). But the visibility also brought responsibility, because suddenly we had our “fifteen minutes of fame” and society was watching what we do. We had to become better communicators, which is not easy.

-What do you feel you have done well?

-Staying anchored in the concept of “non-profit,” remaining true to the goal that our work be accessible and affordable, beneficial to anyone regardless of economic means. Sometimes you can get distracted by opportunities that pull you away from your center, but you quickly return to your purpose.

-I imagine there are discouraging moments. What do you do then?

-In science, discouragement is constant: an experiment fails, a hypothesis doesn’t hold, funding is insufficient, unexpected events occur… But sometimes these difficult moments open doors to opportunities. During the COVID-19 pandemic, for example, when everything stopped abruptly and we couldn’t go to the lab without risk, our team became more empathetic toward one another.

Patent-free technology for a COVID-19 vaccine

-For you it was an opportunity, because it slightly changed your career path.

-We worked very hard, almost 24/7, but Corbevax and Indovac gave us visibility: we were a relatively small lab in Texas, working to benefit the world. The technology we developed has been called “the vaccine for the world.” We gave it away. We focused on how to save the lives of as many people as possible. The opportunity to do this, together with collaborators and groups who shared the same mindset, with vaccine producers in India and Indonesia, was… I don’t even know how to express what we felt. One hundred million doses of our vaccine were distributed to children aged 12 to 14, that is, to our future. That is something I think we will never forget.

-Were you able to see on site how the vaccine was administered?

-At first we kept in touch with our collaborators via Zoom, but later we were able to visit them, yes. It was very beautiful. When we visited Biological E in India, the first lab to adopt our technology, they had us plant a small tree. I have a tree in India with my name on it, which will grow and they will continue caring for it as recognition of all the children we helped save. It was a very special experience.

-Competing with big pharmaceutical companies, did you feel like David versus Goliath?

-Developing any biological medicine, especially vaccines, is a tough process. We see it now as we return to working on vaccines for neglected diseases: after 25 years of work, we are still at the beginning, we haven’t reached the level we did with the COVID-19 vaccine. But we already have a precedent: we know it can be done! Of course, it is possible when groups unite with the same goal, have government and leadership support, the necessary funding… and population acceptance. That is where we need to work a bit more: on how to explain to the public the benefit of vaccination. It is quickly forgotten when terrible infectious diseases disappear against which highly effective vaccines have worked.

-Does a scientist have to do all that? Besides research, do you have to seek funding, explain to the public the benefits of vaccines, etc.?

-For science to truly reach populations, many factors must be considered: social, economic, legal, ethical… It is very important to know how to communicate science and explain its value. Universities should emphasize that science must engage in dialogue with other disciplines.

In search of new vaccines

-Are you working on new vaccines?

-We are working on a group of vaccines against intestinal parasites, which cause many diseases, especially in children. We have made considerable progress on a vaccine against hookworm. We are also working on another for schistosomiasis, for which we are awaiting results from a study in Uganda. We are advancing a vaccine for Chagas disease, for infected patients who do not yet show clinical symptoms. We are waiting for approvals to see if we can start a study in Mexico. Additionally, we are working with other parasites and bacteria. For example, we have a vaccine project against Lyme disease, a bacterial infection transmitted by ticks.

The human factor

-Have you incorporated behavioral psychologists into your teams?

-Yes, with the aim of improving team interactions, addressing daily life stress, and making work enjoyable and productive without neglecting personal life.

-Do you maintain a balance between work and personal life?

-Yes. It is a lot of work. How do you add time to reflect and even understand yourself? I am a woman, Latina, living in the United States, and English is not my first language, so I have to interact with very important people and sometimes I feel a bit of imposter syndrome. I focus on my strengths and not so much on my weaknesses, which my team can complement. I really enjoy rowing at the gym. It’s an interesting sport because you put in your own effort, but it improves collective effort. There is a lot of science behind how exercise helps build those team connections. That is on the physical side. And we should not forget our roots, family, and maintaining that human connection.

-You have been working in tandem with Peter Hotez for 25 years. How is your relationship?

-We share the same passion and vision, but if we did a personality study, we would probably be at opposite ends of the spectrum: I focus on troubleshooting and problem-solving, while he is more of a visionary and excels at social and communication aspects. I implement, organize, and pay attention to details. Our conversations are constructive, even when we disagree. We learn from each other. We support each other; in difficult times, we remind ourselves that the work we are doing is worthwhile, and we transmit that to our teams. Peter has always seen me as an equal, even though I am a woman and younger. He has always put me at the forefront, and I have also taken the opportunity to stand out. So we move forward together. I don’t think we could have achieved what we have separately; I consider myself very fortunate, and I believe he does too.