A COVID-19 vaccine is needed as soon as possible – how can this be accomplished in the most ethical way possible?

Maxwell J. Smith, PhD, Western University, London, Ontario, Canada (maxwell.smith@uwo.ca)
 
The world is desperate for a safe and effective COVID-19 vaccine. Indeed, there is an ethical imperative to develop a safe and effective vaccine as quickly as possible to avert the tremendous amount of morbidity and mortality associated with COVID-19. Consequently, many efforts are underway to accelerate the research, development, and regulatory approval of COVID-19 vaccine candidates. For example, Russia, China, and the United Arab Emirates have each authorized COVID-19 vaccination outside of clinicals trials and in advance of phase three trial data on their vaccine candidates’ safety and efficacy. In addition, the COVAX pillar of the World Health Organization’s Access to COVID-19 Tools (ACT) Accelerator is coordinating a global approach to the acceleration of COVID-19 vaccine R&D.
 
Pandemics do not obviate the need for rigorous scientific assessment of potential interventions and adherence to universal standards of research ethics. As such, any steps taken to accelerate COVID-19 vaccine research should be accompanied by an explicit ethical justification. In a recent PHEPREN guidance document, Ezekiel Emanuel, Beatriz Thomé, Ross Upshur, and I argue that accelerating COVID-19 vaccine research can be ethically justified, provided that social value, scientific validity, and a favourable risk-benefit ratio can be maintained or enhanced when doing so.

Reply