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GLIDE collaborators have contributed towards the first publication on the ethics of vaccine-enhanced disease, published last month on Wellcome Open Research.

GLIDE collaborators have contributed towards the first publication on the ethics of vaccine-enhanced disease, published last month on Wellcome Open Research, Vaccine-enhanced disease: case studies and ethical implications for research and public health.

The paper is part of a project on uncertainties in vaccine development led by Dr Susan Bull, who co-authored with Dr Euzebiusz Jamrozik (GLIDE postdoctoral fellow) and Professor Michael Parker in collaboration with Dr George Heriot, an infectious diseases physician at the University of Melbourne. 

Most vaccines are highly safe and effective, but in rare cases experimental or new vaccines result in a paradoxical increase in infection or disease among people who receive the vaccine - sometimes resulting in death. This paper explores four case studies of vaccine-enhanced disease for four different pathogens from the 1960s to the present, making it the most comprehensive review on this topic. 

Table 1. Cases of vaccine-enhanced disease and relevant outcomes.

Despite significant scientific progress and careful pre-clinical testing, vaccine-enhanced disease remains an important uncertainty and source of rare but serious potential harms for trial participants and vaccine recipients. The paper highlights how risks and uncertainties can be reduced, and how transparency and support for those affected can help to maintain public trust in vaccines.

One reason this topic is important now is that coronavirus vaccines have sometimes shown disease enhancement in animal studies, although fortunately not in humans to date. It also explores cases of public backlash after rare vaccine-related harms among children, making it relevant to current debates on COVID-19 vaccination among young people.

This paper would be of interest to GLIDE network members and others working in research ethics, public health, and on topics related to vaccination ethics.

Jamrozik E, Heriot G, Bull S et al. Vaccine-enhanced disease: case studies and ethical implications for research and public health [version 1; peer review: 3 approved]. Wellcome Open Res 2021, 6:154 (https://doi.org/10.12688/wellcomeopenres.16849.1)