March 2021

It’s been more than a year since the advent of COVID-19. We now have several different vaccines to choose from, all of them effective, produced by a variety of different countries and firms. In all likelihood, and assuming that vaccination continues apace, the pandemic is mostly behind us. But could we have done better?

Rather than asking such a wide-open question, this month we’re focusing on just one way that the process of vaccine development and testing might have been sped up: the use of human challenge trials, in which healthy volunteers, giving informed consent beforehand, are infected with the SARS-CoV-2 virus under controlled conditions so as to test vaccine candidates for efficacy, and for other purposes that could shorten the pandemic and save lives. Here to discuss with us this month are a trio of prominent bioethicists: Jessica Flanigan of the University of Richmond, writing the lead essay; Ben Bramble of the Australian National University; and Charles Weijer of Western University. After all have written, a free-form discussion will follow. The comments are open, and we invite readers to join us as well.

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Lead Essay

  • Jessica Flanigan says much of the suffering of the past year might have been avoided had vaccines been available earlier, and this could have been the case in a culture and regulatory environment that supported and welcomed human challenge trials. Flanigan argues that bureaucratic foot-dragging and excessive caution on these matters have been some of the most serious contributors to the severity of the pandemic, and that ethicists and researchers should bear this in mind for the future.

Response Essays

  • Ben Bramble argues that challenge trials would be less of a help against COVID-19 than we may suspect. He adds that the real lost opportunity for the United States in the last year was that the United States never acquired sufficient personal protective equipment and failed to implement contact tracing and a strict, nationwide lockdown. If such measures were in place, the pandemic might have been kept at bay, but the fact that they were not implemented does not warrant turning humans into guinea pigs.

  • Charles Weijer says that it’s impractical, unethical, and simply dangerous to expose healthy volunteers to the virus that causes COVID-19. Promises of faster vaccines and greater knowledge about the virus are illusory because the necessary safety measures and experimental protocols can’t even be considered, much less designed, in the absence of good data. This makes human challenge trials fundamentally unworkable.