Epidemiology and Health

COVID-19: Perspective

COVID-19 herd immunity in the absence of a vaccine: an irresponsible approach: Jade Khalife, Derrick VanGennep; Epidemiol Health. 2021;43:e2021012. Published online February 3, 2021; DOI: https://doi.org/10.4178/epih.e2021012

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Abstract

As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread rapidly throughout the human population, the concept of “herd immunity” has attracted the attention of both decision-makers and the general public. In the absence of a vaccine, this entails that a large proportion of the population will be infected to develop immunity that would limit the severity and/or extent of subsequent outbreaks. We argue that adopting such an approach should be avoided for several reasons. There are significant uncertainties about whether achieving herd immunity is possible. If possible, achieving herd immunity would impose a large burden on society. There are gaps in protection, making it difficult to shield the vulnerable. It would defeat the purpose of avoiding harm caused by the virus. Lastly, dozens of countries are showing that containment is possible.

Summary

Key Message
Pursuing herd immunity without a vaccine involves numerous uncertainties, is costly in terms of lives and disease, is ineﬀective, and - being unethical and uncompassionate - is not compatible with human dignity and development.

Citations

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Mathematical assessment of the roles of age heterogeneity and vaccination on the dynamics and control of SARS-CoV-2
Binod Pant, Abba B. Gumel
Infectious Disease Modelling.2024;[Epub] CrossRef
Analyzing natural herd immunity media discourse in the United Kingdom and the United States
Marco Zenone, Jeremy Snyder, Alessandro Marcon, Timothy Caulfield, Veena Sriram
PLOS Global Public Health.2022; 2(1): e0000078. CrossRef
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Nele Brusselaers, David Steadson, Kelly Bjorklund, Sofia Breland, Jens Stilhoff Sörensen, Andrew Ewing, Sigurd Bergmann, Gunnar Steineck
Humanities and Social Sciences Communications.2022;[Epub] CrossRef
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Sustainability.2022; 14(16): 10286. CrossRef
Effective strategies against COVID-19 and the importance of infection sequelae
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Global Health Research and Policy.2022;[Epub] CrossRef
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Jiyoung Oh, Sohyun Kim, Boyeong Ryu, Minjoung Shin, Bryan Inho Kim
Epidemiology and Health.2021; 43: e2021054. CrossRef
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Reviews

Rapid qualitative review of ethical issues surrounding healthcare for pregnant women or women of reproductive age in epidemic outbreaks: Patrik Hummel, Abha Saxena, Corinna Klingler; Epidemiol Health. 2018;40:e2018003. Published online January 23, 2018; DOI: https://doi.org/10.4178/epih.e2018003

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Abstract

This article describes, categorizes, and discusses the results of a rapid literature review aiming to provide an overview of the ethical issues and corresponding solutions surrounding pregnancies in epidemic outbreaks. The review was commissioned by the World Health Organization to inform responses to the Zika outbreak that began in 2015. Due to the urgency of the response efforts that needed to be informed by the literature search, a rapid qualitative review of the literature published in PubMed was conducted. The search and analysis were based on the operationalization of 3 key concepts: ethics, pregnancy, and epidemic outbreak. Ethical issues and solutions were interpreted within a principlist framework. The data were analyzed using qualitative content analysis. The search identified 259 publications, of which the full text of 23 papers was read. Of those, 20 papers contained a substantive part devoted to the topic of interest and were therefore analyzed further. We clustered the ethical issues and solutions around 4 themes: uncertainty, harms, autonomy/liberty, and effectiveness. Recognition of the identified ethical issues and corresponding solutions can inform and improve response efforts, public health planning, policies, and decision-making, as well as the activities of medical staff and counselors who practice before, during, or after an epidemic outbreak that affects pregnant women or those of reproductive age. The rapid review format proved to be useful despite its limited data basis and expedited review process.

Summary

Citations

Citations to this article as recorded by

How often is the placenta included in human pregnancy research? A rapid systematic review of the literature
Leigh A. Taylor, Kelly Gallagher, Katherine A. Ott, Alison D. Gernand
Gates Open Research.2021; 5: 38. CrossRef

Bioethics and Protection of Personal Information in Experimental Studies.: Ock Joo Kim; Korean J Epidemiol. 2007;29(1):1-12.

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Abstract PDF: Abstract
Experimental studies involve intervention and manipulation of study elements such as randomization of the participating groups. In general, experimental studies involving human are riskier than observational studies, demanding robust ethical vigilance and compliance among such stakeholders as investigators, sponsors, IRBs and health authorities. Social values of research should be counted as a primary ethical consideration in experimental research. It is unethical to put human subjects into uncertain and risky conditions if the study does not pursue valuable knowledge. Sound scientific design is prerequisite for good ethics. Risk-benefit ratio of the study must be carefully evaluated study. Not only risks from physical harms but also socio-economical and psychological harms from the study should be considered as risk of the study. Risks from the design of the study such as randomization and placebo must be carefully examined. Voluntary informed consent is essential in experimental studies involving human. Human subjects, before they decide to participate in the study, must be informed the followings: risks, benefits, experimental procedures, alternative treatment, compensation for injury, and participants' voluntariness and right to withdraw at anytime. Experimental studies are usually required written consent documentation and full institutional review board (IRB) review. Other elements of experimental research ethics includes special protection for high risk groups and various vulnerable groups, and protection of privacy and confidentiality.; Summary

Bioethics and Protection of Personal Information in Observational Studies.: Ock Joo Kim, Eun Kyung Choi; Korean J Epidemiol. 2006;28(2):129-137.

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Abstract PDF: Abstract
Observational studies constitute an important part of epidemiologic research. Researchers need to recognize that some of the observational studies may result in serious damage to the participants, and it is very important to understand that which aspect of such studies may pose a risk to the participant. The key element of an observational study that may raise an important ethical issue is specific information itself. Researchers need to make sure who has the right to make decision on the information, and by what pathways the information flows. Informed consent is an essential component involved in handling the information associated with participants' interest. Institutional review board (IRB) should oversee the study design and procedures to ensure the study procedures respect the rights of the participants and communities they belong to and protect them from any harm. Modern technologies add new dimensions to observational studies because of genetic information and large scale database systems that are linked with the study. Data security need to be assured by various procedures and legal protections. As the value of information becomes greater in the modern society, the importance of bioethics and personal information protection also becomes greater in the observational studies.; Summary

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