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Comment by unchocked | Hacker News Reader

Yes. We need accelerated testing. In the case of a pandemic, we need to make better use of volunteers. I believe that as the history of this one is reckoned with, one of the more interesting moral failures to be acknowledged will be the failure to utilize challenge testing protocols with willing volunteers (give them the vaccine and then deliberately expose them to the virus. It is a calculated risk.)

Earlier phases could have been accelerated as well. For mRNA vaccines, deleterious effects are unlikely, inefficacy is the likeliest problem. It might be possible to be challenge testing (highly informed) volunteers within a week of a novel virus being isolated.

On a similar note, national stockpiles of RT-PCR machines and reagents would allow widespread testing within the same week.

If I’m right, these indicate moral failures deeply embedded within our political and medical systems. Better luck next time.

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> In the case of a pandemic, we need to make better use of volunteers.

You’d run the risk of have a non-representative sample and wrongly estimating the effectiveness of the vaccine as well as possibly missing side effects.

1daysooner.org lists almost 40,000 volunteers, and that's without anyone official even asking for them. And you need far fewer subjects in a challenge trial than a normal trial.

We need accelerated testing. In the case of a pandemic, we need to make better use of volunteers.

How would you attract volunteers for these less-safe clinical trials? Pay them money?

You'd ask. I recall seeing multiple human interest stories about people who were eager to volunteer for challenge trials. I believe challenge trials are how the original vaccines were tested in the earlier 20th century prior to contemporary developments in medical ethics.

And you'll get volunteers. It's a rational decision for effective altruism. Say you face a 1% chance of death but a 50% chance of substantially contributing to saving a million lives. If that's technically possible, highly informed people should have the opportunity to make that choice.

I believe some of the earliest challenge testers were the developers of the drug themselves.

1daysooner.org lists almost 40,000

Maybe a new test would look like this:

1. Vaccinate humans and animals and see if they create antibodies and test if they can neutralize the virus.

2. Infect animals on placebo and vaccine on purpose.

3. If it improves outcome, infect humans on the vaccine.

The old system could be run in parallel

Don't you need a control group for stage 3 (no vaccine)? If so, that might be highly problematic/unethical.

No, you don't, because you're infecting them on purpose. It's safe to assume that an extraordinarily high percentage of them would be infected if they were on a placebo leg of the trial.

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