Ethical Rationale for the Ebola "Ring Vaccination" Trial Design

American Journal of Public Health
Annette Rid, Franklin G Miller

Abstract

The 2014 Ebola virus epidemic is the largest and most severe ever recorded. With no approved vaccines or specific treatments for Ebola, clinical trials were launched within months of the epidemic in an unprecedented show of global partnership. One of these trials used a highly innovative "ring vaccination" design. The design was chosen for operational, scientific, and ethical reasons--in particular, it was regarded as ethically superior to individually randomized placebo-controlled trials. We scrutinize the ethical rationale for the ring vaccination design. We argue that the ring vaccination design is ethical but fundamentally equivalent to placebo-controlled designs with respect to withholding a potentially effective intervention from the control group. We discuss the implications for the ongoing ring vaccination trial and future research.

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Citations

Jul 2, 2016·The American Journal of Bioethics : AJOB·Toby Schonfeld, Daniel K Nelson
Aug 11, 2016·American Journal of Public Health·Bridget G Haire, Morenike O Folayan
Oct 28, 2016·Applied Ergonomics·Patrick WatersonHenning Boje Andersen
Oct 19, 2016·Journal of Medical Ethics·Adélaïde Doussau, Christine Grady
Mar 23, 2017·PLoS Neglected Tropical Diseases·Matt David Thomas HitchingsMarc Lipsitch
Jul 15, 2017·Science·Marc Lipsitch, Nir Eyal
Nov 28, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Susan S EllenbergKeith P W J McAdam
Aug 8, 2018·PLoS Medicine·Rebecca KahnMarc Lipsitch
Nov 7, 2019·Nature·Juliet BedfordJohn Nkengasong
Jul 26, 2019·Journal of Medical Ethics·Ariella Binik
Sep 3, 2020·World Journal of Clinical Cases·Khalid AlNaamaniAlan N Barkun
Jan 2, 2021·Frontiers in Pediatrics·Tulika SinghSallie R Permar

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