Research ethics and public trust in vaccines: the case of COVID-19 challenge trials

Abstract

Despite their clearly demonstrated safety and effectiveness, approved vaccines against COVID-19 are commonly mistrusted. Nations should find and implement effective ways to boost vaccine confidence. But the implications for ethical vaccine development are less straightforward than some have assumed. Opponents of COVID-19 vaccine challenge trials, in particular, made speculative or empirically implausible warnings on this matter, some of which, if applied consistently, would have ruled out most COVID-19 vaccine trials and many non-pharmaceutical responses.

Should Children Be Included in Human Challenge Studies?

“…Divergences between members of society and their expectations of science complicate efforts to draw ethical and policy implications from the basis of public trust in science. 55 Eyal draws on ambiguities about who is meant by "the public" and what sort of confidence is at risk of being undermined (e.g., confidence in a particular type of research, in a research enterprise as a whole, in researchers) to develop and consider a series of arguments against efforts to ground research ethics in the need to protect public trust. 56 His conclusion may be overstated, given that recommendations and policies with negative impacts for members of the public may be in direct tension with ethical justifications for research.…”

The Normative Power of Consent and Limits on Research Risks

“…Eyal (2022) notes that appeals to public trust are ambiguous between an empirical reading, which is factually dubious, and a normative reading, which is question-begging against those who oppose the risk limit in question.5 See US Code 45 CFR 46.404.…”