Intended for healthcare professionals

Letters Ebola

Ebola virus vaccine trials: the ethical mandate for a therapeutic safety net

BMJ 2014; 349 doi: (Published 10 December 2014) Cite this as: BMJ 2014;349:g7518
  1. Steve E Bellan, postdoctoral fellow1,
  2. Juliet R C Pulliam, assistant professor2,
  3. Jonathan Dushoff, associate professor3,
  4. Lauren Ancel Meyers, professor4
  1. 1Center for Computational Biology and Bioinformatics, The University of Texas at Austin, Austin, TX 78712, USA
  2. 2Department of Biology and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
  3. 3Department of Biology and Institute of Infectious Disease Research, McMaster University, Hamilton, ON, Canada
  4. 4Department of Integrative Biology, The University of Texas at Austin, Austin, TX, USA
  1. steve.bellan{at}

Randomised controlled trials (RCTs) offer the fastest and most rigorous assessment of vaccine efficacy.1 But they are ethical only if there is “clinical equipoise”—genuine uncertainty in the medical community about whether the experimental intervention will do more good than harm.2 We argue that Ebola virus vaccine RCTs can achieve clinical equipoise without sacrificing scientific rigour by providing trial participants who develop Ebola virus disease (EVD) with enhanced supportive care and access to experimental therapeutics.

Most discussions have analysed Ebola vaccine and treatment …

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