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Commentary
Commentary
The idea of intentionally infecting people in search of a vaccine is no stranger to medical research, says Anjana Ahuja.
(Photo: AFP / NICOLAS ASFOURI)
LONDON: Josh Morrison, a former corporate lawyer in New York, wants to deliberately expose himself to the coronavirus.
He came up with the idea after reading a scientific article suggesting that infecting volunteers could speed up the development of the vaccine.
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Morrison, an advocate of living organ donation and himself a kidney donor, created an online registry for willing human guinea pigs.
“Even developing a vaccine the day before could save tens of thousands of deaths,” it begs on the One Day Sooner website, which already has 15,000 signatories.
US vaccine developer Moderna has been in contact. The prospect is now being discussed by the World Health Organization and the US National Institutes of Health. USA
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The idea of intentionally infecting people in search of a vaccine is no stranger to medical research, but is strictly regulated. It has been used to combat diseases such as malaria, cholera and influenza, for which there are effective treatments.
The pandemic is now prompting scientists to recalculate what is considered a reasonable risk. There is no life-saving treatment, and the long-term effects of COVID-19 are unknown.
As Rutgers University bioethicist Nir Eyal and others wrote in the Journal of Infectious Diseases article that caught Mr. Morrison’s attention: “Challenging volunteers with this live virus can lead to serious illness and possibly even death “but” it could reduce the overall burden of coronavirus-related mortality and morbidity. “
CHALLENGE STUDIES
Trials that expose people to deliberate infections are called challenge studies because they challenge the immune system with a pathogen.
(Photo: AFP / Alberto PIZZOLI)
They can shorten the time-consuming test stage: Phase 3 trials, which establish whether a vaccine works effectively at scale. This stage often involves thousands of people.
After a period of time, the vaccinated test group should show fewer infections than the unvaccinated control group.
However, that process depends on the volunteers becoming infected while doing their normal activities. But this can take months, perhaps more in an era of orders to stay home, social estrangement, and self-isolation.
Instead, Professor Eyal suggests, phase 3 trials should purposely give COVID-19 to about 100 healthy young volunteers. It would only be done for a test vaccine that already looks promising.
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If the volunteers are already highly exposed healthcare workers or other frontline workers, that further reduces the relative risk. Professor Eyal told the journal Nature that it might be “curiously safer” for such workers to be deliberately infected, since those who become ill could be caught more quickly in a trial than in real life.
Volunteers may be paid, but Professor Eyal fears it could damage public confidence in a vaccine and fuel accusations of preying on the poor.
Whether money is involved or not, there is a hint of Russian roulette in the proposal: Some healthy youngsters have succumbed to COVID-19.
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EXTRAORDINARY TIMES
Perhaps extraordinary times justify extraordinary measures.
Scientists are seen working at Cobra Biologics on a possible vaccine against COVID-19, following the outbreak of coronavirus disease (COVID-19), in Keele, Great Britain, on April 30, 2020. REUTERS / Carl Recine
“COVID-19 is an unprecedented global challenge that requires us to work unequaled,” summarizes Charlie Weller, chief vaccine officer for the Wellcome Trust.
“All options to accelerate vaccine development” should be on the table, he says, although a life-saving antiviral may be necessary before infecting volunteers.
There are good reasons to exercise caution. The ethical principles that govern human testing are rooted in the Nuremberg Code, a set of post-war guidelines designed to protect human rights.
These have evolved substantially, but still generally prevent deliberate infection with an incurable and untreatable disease.
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Infecting healthy people with COVID-19 reverses those finely calibrated judgments. But the coronavirus has overturned everything.
As we prepare for a new normal that will allow society to reopen, we may have to adopt a new ethical normal to conquer the disease that closed it.
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