Exploring the acceptability of controlled human infection with SARSCoV2-a public consultation
Exploring the acceptability of controlled human infection with SARSCoV2-a public consultation
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DOI：
10.1186/s12916-020-01670-2
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发表时间：
2020-07-07
期刊：
影响因子：
9.3
通讯作者：
Read, R. C.
中科院分区：
文献类型：
--
作者：
Gbesemete, D.;Barker, M.;Read, R. C.
迅速研制非典病毒2型的有效疫苗是全球优先事项。控制人感染模型（CHIM）将加速候选疫苗的疗效评估。这一策略要求志愿者故意暴露于SARSCoV2病毒，目前没有可用的治疗方法，严重疾病或死亡的风险很小但确定。考虑到对更广泛人群的潜在益处，这就提出了关于个人风险的社会和伦理可接受性的复杂问题，因此，没有公众参与就无法进行研究。我们对57名年龄在20-40岁之间的人进行了有组织的公众咨询，以了解公众对CHIM的态度以及注册的先决条件。对这一策略的总体反应是积极的，许多人愿意无私地做志愿者。谨慎控制的感染被认为比自然接触野生病毒更安全。拟议的CHIM所需的长期社会隔离被认为是一种障碍，但并非不可克服，可提供合理的补偿和支持性护理。鉴于公共利益的重要性，CHIM应该作为开放科学进行，定期、有控制地向公共领域传播信息。重要的是，有一种强烈的观点认为，是否进行CHIM的最终决定应该掌握在合格和有经验的临床科学家和当局手中。
Rapid development of an effective vaccine for SARSCoV2 is a global priority. A controlled human infection model (CHIM) would accelerate the efficacy assessment of candidate vaccines. This strategy would require deliberate exposure of volunteers to SARSCoV2 with no currently available treatment and a small but definite risk of serious illness or death. This raises complex questions about the social and ethical acceptability of risk to individuals, given the potential benefit to the wider population, and as such, a study cannot be done without public involvement. We conducted a structured public consultation with 57 individuals aged 20-40 years to understand public attitudes to a CHIM, and pre-requisites for enrolment. The overall response to this strategy was positive, and many would volunteer altruistically. Carefully controlled infection is viewed as safer than natural exposure to wild virus. The prolonged social isolation required for the proposed CHIM is considered an obstacle but not insurmountable, with reasonable compensation and supportive care. Given the significant level of public interest, a CHIM should be done as open science with regular, controlled dissemination of information into the public domain. Importantly, there was a strong view that the final decision whether to conduct a CHIM should be in the hands of qualified and experienced clinician-scientists and the authorities.