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Slack / Private Message Drop, p.89 [SLACK_000303] · slack_pm:msg:00903

Date: 2020-06-25 09:29
Type: chat message · slack
recipient: Kristian G. Andersen, Edward C. Holmes, Andrew Rambaut
speaker: Robert F. Garry
Topics: Vaccines Intelligence community assessments

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https://science.sciencemag.org/content/368/6494/948The possibility of performing controlled human challenge trials,in which a small number of volunteers are vaccinated and subsequently challenged with SARS-CoV-2, has been suggested. Such experiments, if designed to define potential immune correlates or winnow out less effective vaccineapproaches, may have utility. However, this approach has shortcomings with respect to pathophysiology and safety(_*12*_). Although the risk of severe disease or death in young healthy individuals from COVID-19 is quite low, it isnot zero, and we do not yet have proven effective therapies for COVID-19 to rescue volunteers with complicationsfrom such a challenge. It is likely that a SARS-CoV-2 challenge strain will, by design, cause mild illness in mostvolunteers and thus may not recapitulate the pulmonary pathophysiology seen in some patients. Moreover, partial efficacy in young healthy adults does not predict similar effectiveness among older adults with major cofactorsassociated with COVID-19 disease, nor would it prove reduction of transmissibility to major susceptibility groups. Whether such experiments may be worthy of pursuit or would have a beneficial impact on timelines for vaccine development needs careful evaluation by an independent panel of ethicists, clinical trialists, and experts on vaccine development.

Links shared

journal https://science.sciencemag.org/content/368/6494/948The

Extracted statements

Rule-extracted, not adjudicated. The grade says what may be done with each one; read the document above before relying on any of them.

Statement	Grade	Attribution	Stance
Such experiments, if designed to define potential immune correlates or winnow out less effective vaccineapproaches, may have utility.	own voice, substantive	speaker_own	asserts
Moreover, partial efficacy in young healthy adults does not predict similar effectiveness among older adults with major cofactorsassociated with COVID-19 disease, nor would it prove reduction of transmissibility to major susceptibility groups.	own voice, substantive	speaker_own	asserts
Whether such experiments may be worthy of pursuit or would have a beneficial impact on timelines for vaccine development needs careful evaluation by an independent panel of ethicists, clinical trialists, and experts on vaccine development.	quoted / not their view	hypothetical conditional framing	asserts

Statement

Grade

Attribution

Stance

Such experiments, if designed to define potential immune correlates or winnow out less effective vaccineapproaches, may have utility.

own voice, substantive

speaker_own

asserts

Moreover, partial efficacy in young healthy adults does not predict similar effectiveness among older adults with major cofactorsassociated with COVID-19 disease, nor would it prove reduction of transmissibility to major susceptibility groups.

own voice, substantive

speaker_own

asserts

Whether such experiments may be worthy of pursuit or would have a beneficial impact on timelines for vaccine development needs careful evaluation by an independent panel of ethicists, clinical trialists, and experts on vaccine development.

quoted / not their view

hypothetical conditional framing

asserts

In context

A single line often inverts meaning once you see what it answers, so neighbouring messages are always shown.

2020-06-25 09:27 Robert F. Garry open

Peak COVID-19 case numbers in the US and worldwide today.
2020-06-25 09:27 Robert F. Garry open

https://science.sciencemag.org/content/368/6493/832?ijkey=e55a58bb80b74541eda2f9e3dabc4635a2aa188f& ;keytype2=tf_ipsecsha
2020-06-25 09:28 Robert F. Garry open

Pushback on Controlled human trials
2020-06-25 09:29 Robert F. Garry

https://science.sciencemag.org/content/368/6494/948The possibility of performing controlled human challenge trials,in which a small number of volunteers are vaccinated and subsequently challenged with SARS-CoV-2, has been suggested. Such experiments, if designed to define potential immune correlates or winnow out less effective vaccineapproaches, may have utility. However, this approach has shortcomings with respect to pathophysiology and safety(_*12*_). Although the risk of severe disease or death in young healthy individuals from COVID-19 is quite low, it isnot zero, and we do not yet have proven effective therapies for COVID-19 to rescue volunteers with complicationsfrom such a challenge. It is likely that a SARS-CoV-2 challenge strain will, by design, cause mild illness in mostvolunteers and thus may not recapitulate the pulmonary pathophysiology seen in some patients. Moreover, partial efficacy in young healthy adults does not predict similar effectiveness among older adults with major cofactorsassociated with COVID-19 disease, nor would it prove reduction of transmissibility to major susceptibility groups. Whether such experiments may be worthy of pursuit or would have a beneficial impact on timelines for vaccine development needs careful evaluation by an independent panel of ethicists, clinical trialists, and experts on vaccine development.
2020-06-25 09:31 Robert F. Garry open

I think the above paragraph from NIH leaders suggest that Fauci et al. are open to controlled human trials - "may have utility." I think the time has come.

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