US-based ethicist Christine Grady argues that clinical trials of vaccines, including against HIV, require special considerations when it comes to deciding upon an ethical framework. Most clinical trials, she says, are for therapeutic drugs, with narrowly focused outcomes aimed at benefiting the individual. Vaccine trials have broader goals, including that of benefiting the community at large, rather than simply the individual.
The commentary is clearly written and aimed at general readers with a basic understanding of the concept of vaccines, but not requiring a specialised knowledge of vaccines or immunology terms. It uses examples drawn from different types of vaccine research, including against malaria, rotavirus, and hepatitis virus infections.
The article summarises specific issues involved in vaccine trials that are worth considering when deciding upon ethical guidelines, including the need to ensure that the design of a trial is appropriate not only for the scientific question being asked, but also for minimising risks and maximising benefits to the trial volunteers. These include the questions of whether or not a placebo arm should be included, and the nature of placebos, as well as the process of selection and randomisation of volunteers into different groups within the trial.