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Ebola Vaccine Trials Forcing Tough Choices
An anonymous reader writes: Medical researchers hope an experimental vaccine for Ebola can help protect against infection and slow the spread of the disease. Efficacy trials for the vaccine begin in a few months, and it's forcing some difficult decisions for health care officials. The first test will involve front line health care workers, who, as a group, are at the gravest risk of infection. But every trial needs a control group, and scientists are bitterly divided over whether the vaccine should be withheld from a portion of those putting their lives on the line to protect the rest of us. Development of the vaccine has been vastly accelerated already, due to the virus's spread and its mortality rate.
"The leading alternative is a design known as step-wedge, which essentially uses time to create a control group. In this design, researchers take advantage of the inescapable reality that large-scale trials can't give everyone the vaccine on the exact same date; they compare the rates of infection in people already vaccinated with those who have yet to receive the shots. Barney Graham, a virologist ... says "people are more comfortable" with the step-wedge design, because everyone in such a study would get the Ebola vaccine. But statistically speaking, this design makes it more difficult to determine the vaccine's worth, and it takes longer." NY Mag has a related story summarizing the treatments currently being used to fight Ebola.
"The leading alternative is a design known as step-wedge, which essentially uses time to create a control group. In this design, researchers take advantage of the inescapable reality that large-scale trials can't give everyone the vaccine on the exact same date; they compare the rates of infection in people already vaccinated with those who have yet to receive the shots. Barney Graham, a virologist ... says "people are more comfortable" with the step-wedge design, because everyone in such a study would get the Ebola vaccine. But statistically speaking, this design makes it more difficult to determine the vaccine's worth, and it takes longer." NY Mag has a related story summarizing the treatments currently being used to fight Ebola.
No, the rush to create a vaccine coinicdes with the latest outbreak, which has 10 times (and counting) the number of infected as the next largest outbreak. More importantly, all previous outbreaks were local and contained reasonably easily. This is the first time Ebola is getting away from us; in previous cases we had the option of containing it and letting it run its course, now it looks like that may no longer be enough.
And before this outbreak happened, research into vaccines was already taking place. Of course the urgency is somewhat higher now, since we may be looking at a global epidemic. This has nothing to do with ohmygodanAMERICANgotinfected.
If construction was anything like programming, an incorrectly fitted lock would bring down the entire building...
This latest outbreak has already infected more than in the entire history of the virus prior to it. There hasn't been a great deal of effort, because there simply hasn't been a great deal of need. It takes time for labs to spool up against an outbreak, and the fact that new treatments are coming down the pipeline right around the same time the virus starts spreading to other countries is purely coincidence.
That scale is also the reason a person in the US got infected.
A clarification; No person in the US has gotten infected, as far as I know. The only US cases are those infected outside the US and then traveling to the US. There was a nurse in Spain that got infected from a patient, otherwise I don't think there are any known infections that happened outside of Africa.
Funny that ebola has been in existence in the modern world since the 70s, yet only now this is coming to light. Oddly enough, this is perfectly timed with someone in the US getting infected.
"Shit, this is on OUR turf now!??! Better do something about it!"
There is a causal relation driving this correlation, but it's not the one you cynically postulate. Both the appearance of someone in the US with the disease and the attempt to create a vaccine have been caused by the scale of the latest outbreak.
Note to ACs: I usually delete AC replies without reading them. If you want to talk to me, log in.
One problem with rushing a treatment to market (aside from the obvious side effects and toxicity risks) is that you sometimes end up with a treatment that works but you have no idea why it works. This has happened with some drugs in the past. We've started testing them and found that they worked really well. So we stopped the clinical trials early in order to rush the drug to market quickly for perfectly appropriate humanitarian reasons. After all if you have a drug that you know works then it's pretty cruel to withhold it from someone who would benefit. The problem is that sometimes we know a drug works before we know why or how it works.
Part of clinical trials is figuring out if a treatment will work. The other part which is sometimes even more important is figuring out why a treatment works so that we can build off that information in the future. If you skip or stop clinical trials early you sometimes end up losing this critical information. If we don't know why something works it's pretty hard to make further progress in developing even better treatments.