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Maea Lenei Buhre
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As the world anxiously awaits development of a vaccine for COVID-19, new and controversial research measures are being considered for the first time. These include the possibility of deliberately exposing volunteers to the disease to see if they are infected. Amna Nawaz reports on a growing group of people eager to be subjects in tests that might help to heal the world -- but harm themselves.
As the world anxiously awaits the development of a COVID-19 vaccine, new and controversial measures are being considered for the first time.
Amna Nawaz reports on a growing group of young volunteers eager to be subjects in tests that might help the world move forward, despite the personal risks.
Sean Doyle is a 31 year-old medical student at Emory University. He's also one of the first Americans to test a potential vaccine for COVID-19.
If my participation in this vaccine trial can help in any way and eventually ensure that it's not infecting people in the U.S. anymore and other places, then it would be a great thing to participate in.
He knows the risks are still unknown, but he's had to weigh them before. A few years ago, he took part in another vaccine trial, that one for Ebola.
It made me a lot more confident that this was a good choice and the potential benefits were probably going to far outweigh the risks.
Doyle is taking part in a traditional clinical trial, a process that usually unfolds in three phases. First, small groups receive the test vaccine to test for its basic safety. The study is then expanded to include target groups for the vaccine, before it's then given to thousands more, who then go back to their daily lives, to see how well it protects them from the disease.
That process relies on people getting accidentally exposed to the virus and can often take months or years, leading health experts to warn that the best-case scenario for a COVID-19 vaccine could be a long way off.
Although this is the fastest we have gone from a sequence of a virus to a trial, it still would not be applicable to the epidemic unless we really wait about a year to a year-and-a-half.
The urgency to find a vaccine has led to concerns that those traditional clinical trials that are already under way aren't moving quickly enough.
And there's now growing calls to begin another more controversial kind of trial. They are called human challenge trials. And, if they move forward, it would mean a smaller group of volunteers would be given a vaccine, and then deliberately infected with COVID-19 to quickly test if the vaccine works.
Challenge studies fill a really critical gap there.
Seema Shah, a bioethicist at Northwestern University, says the real value of human challenge trials is their speed.
So, you can take two groups of people, randomize one to receive a vaccine, the other to receive placebo, and then expose them to the virus. And if you see a difference between those two groups, you know very quickly what — whether that vaccine worked.
Now, up until this point, human challenge trials have only ever been used with diseases like malaria or typhoid fever, curable if the vaccine fails.
With COVID-19, there is no cure.
Challenge trials have a lot of promise and potential. But we have to be sure that they're going to realize that potential and that we can manage the risks appropriately.
A recent study published in "The Journal of Infectious Diseases" also says that human challenge trials could have the potential to accelerate a coronavirus vaccine.
And a group of over 30 members of Congress has urged the federal government to consider using human challenge trials, likening the fight against the pandemic to war, in which — quote — "There is a long tradition of volunteers risking their health and lives to help save the lives of others."
That chance to help save lives is what led 34-year-old New Yorker Josh Morrison to look into the trials.
You know, firstly, I thought it seemed like a good idea to explore. It's something that could make a significant difference.
After becoming a kidney donor in 2011, Morrison left his corporate law job and launched a nonprofit to make donation easier.
Last month, he launched a new nonprofit, called 1 Day Sooner, signing up volunteers for a possible human challenge trial for COVID-19.
There is a real benefit to feeling like — to being able to take one step that's, you know, useful or potentially useful. And I think that helps with kind of coping with this really terrible disease and terrible situation we're in right now.
Over the last few months, his list has steadily grown. Today, more than 28,000 volunteers, mostly in their 20s and 30s, have signed up from more than 100 countries.
To be deliberately infected with a deadly virus?
Did that surprise you?
I always felt like, if challenge trials do go forward, I always did feel like there would be more than enough people who would be eligible to do it who would want to do it.
Thirty-one-year-old Lehua Gray of Austin, Texas, is one of those volunteers who thinks the risks are worth it. She signed up with her parents in mind.
My mom works for the VA and my dad works for the TSA, so they're basically, like, on the front lines every single day. And they're both essential.
So, for me, if I could take some of the risk off of them and put it onto myself, since I'm young and healthy, and, you know, they're much more high-risk, like, that's a no-brainer.
Twenty-Three-year-old Lena Jewler also signed up. She's a master's student at Johns Hopkins University School of Public Health.
Finding a vaccine faster, and a safe vaccine faster, an effective vaccine faster, has so many benefits attributed to it, not just lives saved, but being able to socially interact in ways that we haven't been able to in the past month-and-a-half, and perhaps won't be able to again until there's a vaccine.
But Dr. Mike Levine, who has worked on vaccine development since the late 1960s, including more than 100 challenge trials for diseases like cholera and dysentery, is skeptical.
If someone in your family came to you right now and said, I think I want to volunteer for this trial, what would you say?
I would say, right now, I would recommend not.
Levine argues, the time it would take to safely set up the first human challenge trials for coronavirus might not actually be faster than the clinical trials already under way.
And if the human challenge trials only include young, healthy people, there's no guarantee a vaccine would help the most vulnerable.
This would be very complicated. This is not a walk in the park.
If we had a vaccine that worked only in young adults, that would be helpful. If it didn't work — and it's possible — if it didn't work in protecting the elderly, they may have to spend the rest of their lives until COVID transmission diminishes in a degree of seclusion.
Still, Seema Shah has been working with the World Health Organization to develop the ethical criteria that need to be met if experts decide to move forward on a COVID-19 human challenge trial.
Researchers have to know this is worth doing and they have to make a solid case about that. And given everything that's happening, right now, that's a difficult case to make, but it's not out of the question.
I just think that if we're going to do something like this and expose people to risk in a way that we haven't really done in challenge studies in the past, it's really important to do it in a way that we know will move the needle.
And maybe move one step closer to ending the COVID-19 pandemic.
For the "PBS NewsHour," I'm Amna Nawaz.
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Amna Nawaz joined PBS NewsHour in April 2018 and serves as the program's chief correspondent and primary substitute anchor.
Mike Fritz is a video journalist and producer for the PBS NewsHour.
Maea Lenei Buhre is a general assignment producer for the PBS NewsHour.
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