Feature image by Texas Children’s Hospital
Maria Elena Bottazzi, PhD, is an internationally recognized vaccinologist, global health advocate, and 2022 Nobel Peace Prize nominee. Based in Houston, Texas, Dr. Bottazzi is a professor of Pediatrics and Molecular Virology and Microbiology at Baylor College of Medicine, where she is also associate dean of the National School of Tropical Medicine and Division Chief of Pediatric Tropical Medicine; she is a distinguished professor at Baylor University; and she is co-director of the Texas Children’s Hospital Center for Vaccine Development. In 2019, Dr. Bottazzi was selected by the National Academy of Medicine as one of 10 Emerging Leaders in Health and Medicine. Considered a global thought leader and expert in her field, Dr. Bottazzi has spent decades building sustainable, global biotechnology capacity. Her efforts have helped transition several neglected tropical- and emerging-disease vaccines from bench to bedside. Throughout her career, Dr. Bottazzi has received numerous national and international awards, has had more than 280 scientific publications, and has participated in more than 250 conferences worldwide.
Dr. Bottazzi earned a bachelor’s degree in microbiology and clinical chemistry from the Universidad Nacional Autónoma de Honduras and a doctorate in molecular immunology and experimental pathology from the University of Florida. She completed two postdoctoral fellowships in cell and molecular biology at the University of Miami and at the University of Pennsylvania. When she joined the Department of Microbiology, Immunology and Tropical Medicine at The George Washington University, Dr. Bottazzi started a 21-year partnership and collaboration with Dr. Peter J. Hotez. In 2011, they relocated to Houston and began their work at Baylor College of Medicine and Texas Children’s Hospital.
Dr. Bottazzi co-led a team of scientists to create a recombinant-protein-based COVID-19 vaccine technology. This COVID-19 vaccine technology is patent-free, inexpensive, more stable, and more scalable than the mRNA technology-based vaccines developed by Pfizer-BioNTech and Moderna. Its formula has been non-exclusively licensed to and manufactured by vaccine producers in low- and middle-income nations. In India and in partnership with Biological E Ltd., CORBEVAX, also referred to as “the world’s COVID-19 vaccine,” received emergency use authorization. In addition, the proteinbased COVID-19 vaccine technology has also been licensed to vaccine producers in Indonesia, Bangladesh, and Africa (Botswana).
It was my pleasure to speak with Dr. Bottazzi recently about her scientific career, research interest in microbiology and vaccine development, and her passion for global health care and vaccine equity.
Ruonan Zhao: You and your team have spent the past two decades advancing vaccines as global health technologies for poverty-related neglected and emerging diseases. Can you tell us what initially drew you to science? How did your background influence your path as a scientist?
Dr. Maria Elena Bottazzi: I moved from Italy to Honduras when I was around eight. My family were cattle ranchers, and therefore, I had a lot of exposure to the rural areas of Honduras. I do not think you can disregard what you see—I saw a lot of inequity and poor people. While growing up, we were always told that we had to put on our shoes, or we would get intestinal worms. These experiences always stuck with me.
I always liked the STEM areas—science, biology, and chemistry. I wanted to do something in the biomedical field and thought I would become a doctor. I graduated from an American high school but had applied to the School of Medicine in Honduras which did not start until January. To fill the gap in the fall, I registered in the clinical microbiology program and fell in love with it! Microbiologists study microbes and what they do to a variety of hosts, to water, to the environment, to animals and to humans. They also help the physicians, nurses, and public health officials by handing them tools—for the detection, prevention, and therapeutics of these microbes. This is why I ended up staying in microbiology.
RZ: You co-led the development of coronavirus vaccines for both SARS and MERS. How did you decide to research coronavirus vaccines?
MEB: My colleague, Dr. Peter Hotez, and I realized that we needed to focus on everything that nobody else wanted to focus on. So that’s how we started working on tropical diseases and creating vaccine programs and partnerships. We were always paying close attention to what was being left behind.
After the SARS and MERS outbreaks, we rapidly realized that the coronaviruses were a good program to adopt because nobody was really focusing on them anymore. So, we decided to add coronaviruses to our pool of neglected diseases. We then created a team filled with scientists, who knew a lot more about coronaviruses than we did, in order to continue learning about how these viruses work and how we could develop vaccines for them.
RZ: What inspired you to develop CORBEVAX, a vaccine that could be produced on a large scale with global access? What challenges did you have to overcome in order to develop the first and only patent-free COVID-19 vaccine?
MEB: The occurrence of tropical diseases is not only driven by weather. Tropical diseases occur in places where people don’t have good access to health and education, due to poverty. Peter and I came up with the philosophy that if we were really going to try to solve problems encountered by poor people, we would have to create things that were affordable to them or to the countries they were in, and the technology used would also have to be acceptable and understandable to them.
We were fortunate that we got an NIH grant back in 2011, and it really helped drive our coronavirus vaccine development mission. We were designing our vaccine programs with the mentality that the vaccines had to be based on conventional technologies and had to be easy to make, because that would allow us to rapidly transfer them to developing countries where and when they were needed.
There was no difficulty scientifically. By 2020, we had already spent 10 years researching coronaviruses, so we knew that protein-based vaccines would work. We just needed to find good partners and funding to advance a COVID-19 vaccine. We also knew that many manufacturers were familiar with the technology required to make this type of protein-based vaccines. Thus, the development process would be scalable and affordable. Plus, protein-based vaccines can be stored for the long term. The difficulty was that very few manufacturers would put aside their interest in innovation and in turning a profit in order to produce large numbers of affordable and accessible vaccines for developing countries.
So, we broke the paradigm that to produce vaccines a multinational from a high-income country needs to be involved. Instead, we publicly shared information regarding the vaccine technology, including the prototype vaccine recipe, product development, the immunological studies, and all key information to enable its production and testing. From there, vaccine manufacturers in developing countries could take our technology and create and mature products from scratch. Therefore, they became indigenous products—they owned the technology and crafted it in ways that would fit their regulations and country needs.
In order for us to do that, we had to ensure that our partners were like-minded and stayed aligned with the mission of vaccines for global access.
RZ: Having worked on coronavirus vaccines for ten years before the current pandemic, what has it been like having your work come to the forefront of a global crisis in this way?
MEB: I think it was like, “Oh my god, our dream came true.” We’ve always thought that we were doing what we needed to do—focusing on all of these neglected diseases. We were doing the work with the paradigm that we were building capacity, but we did not expect to see success this quickly. We initially thought that this work would just allow others to get interested in this topic and continue our legacy in the future.
It was a little bit of a shock or surprise that we still created our vaccine technology in less than a year, even with a delayed start compared to the development of mRNA vaccines. We were strategic about whom we partnered with, and we applied the philosophy and guiding principles of open science and transparency. Each of us, our scientific team, our partners, were very clear about what we would be accountable for, and our partners didn’t take unfair advantage of the situation.
RZ: You’re a role model not only for your scientific excellence and leadership but also for your fierce commitment to making the world a better place. What advice or lessons learned can you share, especially with other women in science?
MEB: The most important thing for me has been to perform self-introspection—to keep an eye on my strengths and weaknesses, to discover my personal values, and to seek opportunities to step out of my comfort zone to learn more about myself. This self-reflection has been a very challenging and difficult but exhilarating process. People react in different ways to crisis and stress, so I believe that it was also important to keep an eye on our team and to make sure that they were taken care of both physically and mentally. Understanding who you are and knowing how to maintain a good mental-health state are very important components in normal times but even more during stressful times.
RZ: What do you think are the biggest remaining obstacles to vaccine equity in today’s world, and what can the scientific community do to help overcome them?
MEB: Public engagement, understanding, and trust of the COVID-19 vaccines are still lacking. Some people are entirely focused on the uncommon side effects associated with vaccines. These rare risks in many instances are dramatized, and truth is distorted, leading to all sorts of misinformation, which has led people to make the wrong decisions and to become hesitant about getting vaccinated.
We are very hopeful that our vaccine technology will restore people’s confidence in vaccines, because it is vegan—there are no human cells, animal cells, or animal protein—and the development process for this vaccine has been used before for Hepatitis B, which has been tested, shown to be safe, and has been approved for use in kids.
As of July 7, 2022, more than 37 million kids within the 12-14 age group have received one dose of CORBEVAX, and more than 24 million kids in the same age group have received the second dose.
RZ: What’s next for CORBEVAX?
MEB: We want to expand the population size that receives CORBEVAX. As of July 7, 2022, more than 37 million kids within the 12-14 age group have received one dose of CORBEVAX, and more than 24 million kids in the same age group have received the second dose. Additionally, authorization has been given by the Indian government to administer CORBEVAX to kids aged 5-11 and as a booster in individuals previously vaccinated with the AstraZeneca (Covishield) vaccine and with Covaxin.
Botswana has also approved the use of CORBEVAX, which will enhance vaccine accessibility in Africa. Lastly, the vaccine development process by Bio Farma in Indonesia is also advancing well, with authorization and distribution expected by the end of the summer (Bio Farma is Indonesia’s only vaccine manufacturer).
Meanwhile, we are also investigating pan/universal coronavirus vaccine development strategies and continuing all the other programs for neglected tropical diseases. Our goal and mission are always to serve the people in need and to reduce the burdens caused by these diseases.
Ruonan Zhao is a graduate research fellow and PhD student in the Anatomy and Cell Biology program at the University of Kansas Medical Center. She is a science writer who is passionate about research, human health, and medicine. After completing her degree, she would like to pursue a career in clinical research development, where she can apply her scientific skills to make advances in human health. She has been an AWIS member since 2022.