Ethical Considerations for COVID-19 Vaccine Trials in Correctional Facilities

Dr. Emily Wang, principal investigator for the Justice Community Opioid Innovation Network’s (JCOIN) Yale Research Hub, is the lead author on a recent opinion published in JAMA. Dr. Wang is an Associate Professor in the Yale School of Medicine where she directs the Health Justice Lab, focused on health improvements for individuals and communities impacted by mass incarceration. Drs. Lauren Brinkley-Rubinstein and Jonathan Zenilman coauthored the opinion. Dr. Brinkley-Rubinstein is a co-investigator for JCOIN’s Brown Hub and Assistant Professor of Social Medicine at UNC Chapel-Hill. Their JAMA piece, Ethical Considerations for COVID-19 Vaccine Trials in Correctional Facilities, published on August 17, 2020, considers the ethics of COVID-19 vaccine trials for incarcerated individuals.

Dr. Wang and coauthors explore current policies on vaccine trials for incarcerated individuals. Research guidelines and practices for incarcerated people became restrictive in the late-1970s following a lengthy period of unethical tests that lacked consent and oversight. Restrictions were well-intentioned, the authors say, but they are too tight today—with the right precautions, COVID-19 vaccine trials could include incarcerated people, improving their health while helping to fight the pandemic.

The pandemic could be a good time to revisit current policies because of its disproportionate impact on justice populations, Dr. Wang and coauthors suggest. Trials in the U.S. hope to recruit individuals at high risk of contracting the virus, case rates are over 5 times higher in prisons, and 39 of the U.S.’s 50 biggest outbreaks happened in correctional settings. These settings could also help with follow-up testing because sentences are often over a year. “Not revisiting the inclusion of these groups in COVID-19 clinical trials presents another set of ethical challenges,” the authors write. “This omission is an example of unintended consequences of well-intentioned policies.”

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Dr. Brinkley-Rubinstein discussed this issue in an interview with Science. Read the interview here.