NEW YORK (BLOOMBERG) - The coronavirus pandemic has stress-tested the world.. Read more at straitstimes.com.
Beyond challenging human fortitude, national health services and international rivalries, it has forced a series of moral choices.
A failed Covid-19 vaccine could even compromise confidence in other vaccinations, threatening a return of measles, polio and other plagues.The first rule of deciding when they're justified, explains Dr Arthur Caplan, the head of bioethics at the NYU Langone hospital system in New York, is that risks can be balanced against the prospect of better data.
In"human challenge trials", which have been used to test cholera and dengue vaccines, volunteers are injected with a vaccine and then deliberately infected with the germ that researchers are hoping to neutralise.Researchers at Oxford are developing strains of the coronavirus in preparation for such a trial, as are the National Institutes of Health in the US.Moderna opted against human challenge trials, and instead started a conventional trial with 30,000 test subjects in July.
It's also impossible to monitor so many volunteers closely enough to determine if they are reporting their experiences inaccurately and skewing the results. There are fears that the virus can cause lasting damage even in twentysomethings, for example, but little clear evidence. Can volunteers really consent to expose themselves to such poorly understood risks?In 1999, this happened to Mr Jesse Gelsinger, a healthy 18-year-old with a rare metabolic genetic disorder who volunteered for a conventional safety trial of a virus-based gene therapy.
Nobody asserts that drug companies should be able to charge whatever the market can bear for a Covid-19 vaccine. "We have invested US$2 billion of our shareholder capital since we started the company. We need to get a return."According to the Financial Times, Moderna is planning to price its vaccine at US$25-US$30 per dose, significantly above the US$19.50 at which Pfizer is selling each of 100 million doses to the US.
Once governments have bought the vaccine, should they require patients to pay for their own shots? Most people with money would happily pay much more than US$30 to free themselves from the coronavirus. A group of much smaller developing nations has been left to build a collaboration - even though the virus knows no boundaries, and it is in all countries' interest to stamp it out everywhere.
Therefore, rationing is inevitable. Some people will have to wait. Who gets to make these decisions, and by what criteria? The same is true of some other ethnic minorities, largely because they tend to live in crowded communities, and because higher rates of poverty make them more likely to suffer the underlying conditions that make Covid-19 more deadly.Professor Anthony Skelton, a philosophy professor at the University of Western Ontario, makes a case for sending those in work-at-home professions to the back of the line.
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