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MAY 14, 2020 — Medscape has asked top experts to weigh in on the most pressing scientific questions about COVID-19. Check back frequently for more COVID-19 Data Dives.
Could a small number of people at low risk for severe COVID-19 infection accelerate the process of vaccine development by volunteering to be exposed?
Obviously, this must be voluntary. The societal benefits could be large. The apparent policy of some governments seems to have been to allow low-risk age groups to become infected to build immunity (sometimes while protecting older age groups, sometimes not).
Such policies are founded on the notion that it is possible to build up a protective quantity of population immunity in these cohorts. Let’s leave aside for the moment the question of whether these infections generate neutralizing immunity. It is unquestionable that generating immunity in low-risk cohorts does not occur without the danger of exposure among high-risk cohorts.
Basically, if you allow people aged 20-50 to become infected at a high rate, how do you then avoid them infecting those over 70? Or those with comorbidities who are also at high risk?
And for those who are at high risk, for whatever reason, have they given consent to be risked in this way?
In contrast with those policies, vaccine trials of this kind would involve small numbers of volunteers and have extensive ethical oversight.—and also a level of accountability that is notably absent from the actions of certain governments.
Worth thinking carefully about once we have a decent vaccine candidate.
Bill Hanage is an associate professor at the Center for Communicable Disease Dynamics in the Department of Epidemiology at the Harvard T. H. Chan School of Public Health. He specializes in pathogen evolution. Follow him on Twitter.
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