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SARS-CoV-2 Monoclonal Antibodies in Children: Ethical Considerations

Ian D Wolfe1, Sameer J Patel2

  • 1Department of Clinical Ethics, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota.

Clinical Therapeutics
|May 29, 2021
PubMed

Insights

Monoclonal antibodies (mAbs) for high-risk children with COVID-19 are approved but lack efficacy data. Healthcare providers must ethically balance using these unproven treatments against withholding potentially life-saving care.

Area of Science:

  • Pediatric Infectious Diseases
  • Medical Ethics
  • Health Equity

Background:

  • US FDA approved monoclonal antibodies (mAbs) for high-risk children with COVID-19 under Emergency Use Authorization.
  • Limited data exist on the tolerability and efficacy of mAbs in pediatric populations (<18 years).
  • Disproportionate numbers of eligible children are from Black, Native American, and other minority communities.

Purpose of the Study:

  • To analyze the ethical challenges faced by health systems, hospitals, and clinicians regarding mAb use in children.
  • To provide recommendations for ethically balancing the use of an untested therapy versus withholding potentially life-saving treatment.

Main Methods:

  • Ethical analysis of the tensions between experimental treatment and withholding care.
  • Identification of strategies for health systems, hospitals, and clinicians.

Main Results:

  • Healthcare providers face a dilemma when administering unproven mAbs to high-risk pediatric patients.
  • Ethical frameworks are needed to navigate the risks and potential benefits of these therapies.

Conclusions:

  • Health systems must develop clear guidelines for the ethical use of mAbs in children.
  • Balancing innovation with patient safety and equity is crucial when using novel treatments.

Keywords:
COVID-19MAbsSARS-CoV-2children and adolescentsethicsmonoclonal antibodiespediatrics

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