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Ethical Rationale for the Ebola "Ring Vaccination" Trial Design
Annette Rid1, Franklin G Miller1
1Annette Rid is with the Department of Social Science, Health & Medicine, King's College London, London, UK. Franklin G. Miller is with the Division of Medical Ethics, Department of Public Health, Weill Cornell Medical College, New York, NY.
American Journal of Public Health
|January 23, 2016
Summary
The 2014 Ebola epidemic spurred innovative clinical trials. Ring vaccination trials are ethical but ethically similar to placebo-controlled trials regarding intervention withholding.
Area of Science:
- Epidemiology
- Clinical Trials
- Medical Ethics
Background:
- The 2014 Ebola epidemic was the largest recorded outbreak.
- No approved vaccines or specific treatments for Ebola existed at the epidemic's start.
- Global partnership led to rapid clinical trial launches.
Purpose of the Study:
- To scrutinize the ethical rationale behind the ring vaccination design.
- To evaluate the ethical equivalence of ring vaccination and placebo-controlled trials.
- To discuss implications for ongoing and future Ebola research.
Main Methods:
- Analysis of the ethical considerations for the ring vaccination design.
- Comparison of the ethical implications of ring vaccination versus placebo-controlled trials.
- Discussion of the operational, scientific, and ethical reasons for choosing the ring vaccination design.
Main Results:
- The ring vaccination design is deemed ethical.
- The design is fundamentally equivalent to placebo-controlled designs in withholding potentially effective interventions.
- Ethical superiority over placebo-controlled designs is questioned.
Conclusions:
- Ring vaccination trials are ethically acceptable.
- Ethical considerations necessitate careful comparison with placebo-controlled designs.
- Further research and discussion are needed regarding the ethical implications of trial designs in epidemics.
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