Medics Question A Practice That Might Speed Up Testing Of A Coronavirus Vaccine

Apr 28, 2020
Originally published on May 14, 2020 8:53 am
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MARY LOUISE KELLY, HOST:

The challenge of responding to COVID-19 is prompting some researchers to say it's time to start thinking about what seems unthinkable. They are proposing deliberately infecting people with the coronavirus to test whether a candidate vaccine will prevent them from getting sick. NPR science correspondent Joe Palca has been looking into the ethics and the value of these so-called challenge trials.

Hey, Joe.

JOE PALCA, BYLINE: Hello.

KELLY: So just to wrap our heads around this, the idea here is to deliberately infect people with a potentially deadly virus.

PALCA: Yes, and perhaps I should say expose because it's a question of whether they get infected or not. But this is just discussion at this point. There is no vaccine ready for that kind of testing. But it has been done. And if you think about it, to show a vaccine works, you have to count on some people getting exposed to whatever is causing the illness because otherwise, you'll never know if your vaccine works or not. And you may have to wait months to get enough people exposed to get meaningful results.

So Nir Eyal is director of the Rutgers University Center for Population-Level Bioethics.

NIR EYAL: With a challenge design, you know that you will get meaningful results within weeks because they are exposed.

KELLY: So OK - sounds like this could speed things up, which would be an advantage. And of course, if people are exposed and the vaccine protects them, that's great. But what about the other outcome - if this doesn't protect them and they get sick?

PALCA: Well, that's the rub, isn't it?

EYAL: The main answer here has to do with the careful selection of study participants.

PALCA: Eyal says as long as you select people who know what they're getting into and are young and healthy and presumably at low risk for getting seriously ill and they understand that they might get seriously ill, then you can do it. In fact, there's a group called 1 Day Sooner that's taking names of people willing to volunteer. Josh Morrison co-founded that group. And according to their website, they now have 7,000 people signed up from around the world. Morrison says most of them are young and healthy. And Morrison says they're altruistic, not naive.

JOSH MORRISON: I think that people feel like they are generally less risky than the general population. But I don't see anything to suggest people don't think that it's a significant risk.

KELLY: That's fascinating. So many volunteers are lining up. Is the scientific community so enthusiastic, or are they pushing back on this, Joe?

PALCA: Well, I mean, you know, there's a variety of opinions, but there's definitely some people who think this might be misguided, at least for now. Take Anna Durbin. She's a vaccine developer at the Johns Hopkins Bloomberg School of Public Health.

ANNA DURBIN: I don't see a compelling need today for a COVID-19 human challenge, and I think the risks today are really high - really high.

PALCA: I mean, she says, look; there's no cure for people who get sick with COVID-19. There's no way of predicting who might get sick. So you've got a lot of questions on that side. And then the other problem for now is that it's not clear exactly how you would challenge people with the virus, what you would measure after they challenge. Do you want to just prevent them from getting sick? Do you want them - prevent them getting infected at all? So she thinks at the moment, there's just too many questions to work out, and it's not really a good idea.

KELLY: So in a sentence, is this a real possibility or not?

PALCA: Well, it's a possibility. And a bipartisan group of congressmen wrote to the FDA and the Department of Health and Human Services and saying they should at least give it some thought, so they will.

KELLY: So they will. NPR science correspondent Joe Palca.

Thank you, Joe.

PALCA: You're welcome. Transcript provided by NPR, Copyright NPR.