Possible COVID-19 vaccines need a challenge trial

As the COVID-19 pandemic continues, so does uncertainty about whether we will be able to return to “normal life” in the near future. A vaccine would be the surest way to eliminate the virus, and development of a COVID-19 vaccine has already been significantly faster than the development of other vaccines, but we need an additional step: to let willing volunteers be intentionally infected with the virus.

In this situation, called a human challenge trial, volunteers are first injected with the vaccine, and then exposed to the virus in order to judge the vaccine’s efficacy. The intentional exposure is the main difference between a  challenge trial and the other existing human trials of COVID-19 vaccines. It would greatly speed up vaccine development. Developing a vaccine even one day sooner would save thousands of lives—a challenge trial has the potential to be one of the most impactful interventions that anyone can be involved in, which is why I signed up as a
challenge trial volunteer through the organization 1Day Sooner. I am young and healthy, and I wanted to share my good fortune with other people by donating my health. Participating in a challenge trial might be the most important thing I ever do.

Human challenge trials do come with ethical concerns; for example, it must be clear that volunteers made a free and informed decision to participate, and both researchers and volunteers have to be convinced that the potential benefits are worth the risk to the volunteers. But ultimately, the trial’s risks may be equal to or even less than the dangers of simply living in our virus-filled world. Volunteers, chosen to be healthy people with low health risks, would be briefed on all the potential risks of participating in the trial, receive a carefully calculated viral dose, and stay under medical observation and care for the duration of the trial. Exposing volunteers in a controlled environment and keeping them under full medical quarantine with the best possible care means that volunteers might even be safer than people who are exposed through day-to-day activities and unable to receive treatment because of overcrowded hospitals.

It is striking that, despite the trial’s risks, volunteers are among the loudest, most enthusiastic voices calling for a challenge trial. We ought to be involved in conversations that purport to be concerned for our health and our rights. It must be at least partially up to us to determine whether the risks are worth the benefits of a challenge trial. We say the benefits are worth it.

The world is reminded of those benefits with every day that passes. The death toll is only one measure of the damage this virus causes. People are dying and losing loved ones to COVID-19, but even people who recover can develop long-term or permanent disabilities, such as lung damage, due to this virus. The possibility of permanent health problems is my biggest fear involved in volunteering—but protecting other people’s lives is more important than my fear.

The economic devastation will damage lives even further, and the repercussions of a global economic crash might far outlive the virus itself. Any time that can be saved in that process of developing a vaccine directly translates to people’s lives saved and substantially improved. We should accept the help of the volunteers, who are willing to use their own health to protect others. As the sages of Judaism, my religious tradition, say: if someone saves a single life, it is as if that person has saved an entire world. I believe that we need to run a COVID-19 vaccine human challenge trial, for the sake of every single person.

Gavriel Kleinwaks  is a graduate student in the mechanical engineering department at the University of Colorado Boulder.

 

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