125 experts in various fields have signed a letter to the director of the National Institutes of Health (NIH), Francis Collins, calling for the U.S. government “to undertake immediate preparations for human challenge trials” for a vaccine for COVID-19.Human challenge trials would involve intentionally exposing human subjects to COVID-19 in order to help scientists learn more about it and develop and test vaccines for it.
The authors, among whom were a number of a philosophers, write:
The rationale for human challenge trials is that they can greatly accelerate the development of a COVID-19 vaccine.
Human challenge trials can provide information much faster than conventional efficacy trials, which take months longer. In such trials, volunteers still receive the vaccine candidate or a control. Instead of resuming life as usual and waiting to “catch” a virus, volunteers are deliberately exposed to the pathogen under controlled conditions. Beyond being faster than conventional trials, a challenge test is likelier to conclude with interpretable results, e.g. should the presence of virus around the study site begin to fade over time.
If challenge trials can safely and effectively speed the vaccine development process, there is a formidable presumption in favor of their use, which would require a very compelling ethical justification to overcome.
The authors also include in the letter a number of principles for conducting the trials effectively and ethically, including:
- Trial participants should be relatively young and in good health.
- Trial participants [should] be provided the highest quality medical care with frequent monitoring.
- Ethical and scientific review must be of the highest quality.
- The autonomy of the volunteers is of paramount concern.
Some elaboration of each of these is in the full letter.
The initial 18 signatories of the letter include Arthur Caplan (NYU), Nir Eyal (Rutgers), Peter Singer (Princeton), and Daniel Wikler (Harvard). There are many other philosophers listed among the remaining signatories.
The letter is hosted at the site 1 Day Sooner, which advocates for COVID-19 human challenge trials and solicits volunteers for them.