Publications from the PREVENT grant team

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Pregnant women & vaccines against emerging epidemic threats: Ethics guidance for preparedness, research, and response

The PREVENT Working Group. 2019. Vaccine

"Zika virus, influenza, and Ebola have called attention to the ways in which infectious disease outbreaks can severely – and at times uniquely – affect the health interests of pregnant women and their offspring. These examples also highlight the critical need to proactively consider pregnant women and their offspring in vaccine research and response efforts to combat emerging and re-emerging infectious diseases. This Guidance offers 22 concrete recommendations that provide a roadmap for the ethically responsible, socially just, and respectful inclusion of the interests of pregnant women in the development and deployment of vaccines against emerging pathogens."


An ‘indefensible’ decision: not vaccinating pregnant and lactating women in an Ebola outbreak’

Ruth Faden, Ruth Karron, Carleigh Krubiner. 2018. STAT News

"[The DRC]’s ministry of health, the World Health Organization, and partners are working to launch a rapid and effective response that includes the use of an experimental vaccine. But their decision not to vaccinate women who are pregnant or lactating unfairly deprives them of the protection they deserve against this deadly disease. The rVSV-ZEBOV vaccine will give pregnant women, and the children they are carrying, a chance to live. Without it, most of the pregnant women infected with Ebola, and almost all of their infants, will die. The DRC ministry of health and the WHO must recognize that women who are pregnant or lactating and who are contacts of Ebola patients must be given equal treatment. They are as entitled as any other contacts to the lifesaving benefits of the rVSV-ZEBOV vaccine."

Pregnant women should not be categorised as a ‘vulnerable population’ in biomedical research studies: ending a vicious cycle of ‘vulnerability’

CB Krubiner and RR Faden. 2017. Journal of Medical Ethics.

"Because the designation of ‘vulnerable’ is otherwise applied to populations whose decision-making capacity about research participation is somehow compromised—such as children and adults of limited cognitive ability—many of us have been arguing for some time that using this designation for pregnant women is inappropriate and disrespectful. There is nothing about the state of pregnancy that renders pregnant women incapable of offering valid research consents or refusals. Moreover, rather than protecting the health interests of pregnant women and their offspring, this designation has had the opposite effect. It has contributed to the widespread exclusion of pregnant women from research activities, which is itself pernicious to the health of pregnant women."

Ethics, pregnancy, and ZIKV vaccine research & development

The Ethics Working Group on ZIKV Research and Pregnancy. 2017. Vaccine.

"The rapid spread of the Zika virus (ZIKV) has galvanized the global public health community toward development of ZIKV vaccines. The most dire consequence of ZIKV infection, Congenital ZIKV Syndrome (CZS), results from infection during pregnancy. As a consequence, pregnant women figure prominently in global concerns about ZIKV. They should also figure prominently in ZIKV vaccine development, but the way forward is not well established."