Why people won't trust DIY COVID vaccines
Is George Church's DIY vaccine a good idea, or will it come to nothing? Bioethicist Arthur Caplan, from New York University, joined Chris Smith to weigh in on whether George Church is on shaky ground...
Arthur - Yeah, I do. I think he's on very shaky ground. Look, when you do vaccines, you're developing a product that you're planning to give to billions of people. You would have to have a manufacturing partner, you need to make sure you follow regulatory requirements, because the risk of something going wrong at huge numbers is just too great. I also think this notion of self experimentation, while it has some role to play in the history of medicine, we learned a lot about experimentation and we know that it matters… your health, your age, your gender. Just showing that something works on one person, or two people, or even ten people, proves nothing about what's going to work in the diversity of people that take drugs and vaccines today, not as it was in the 19th Century.
Chris - Even when it's somebody with a lot of reputation to lose, like George Church? And also, when you wrote your commentary in the journal Science last year, when a lot of this began to surface, you said, "do-it-yourself (DIY) vaccine research is morally troubling. It's an obstacle to securing trust." So why wouldn't people trust it if it's got somebody with a good reputation behind it?
Arthur - Well there's no doubt that George is a brilliant scientist, but that doesn't make people trust vaccines in particular. There are plenty of brilliant scientists who keep saying, "take a vaccine, trust vaccines," and many, many people around the world do not. They worry that people are promoting their pet ideas; they worry that they're out to boost their reputation; they worry that they're out to make money; they're worried that they're short-cutting the regulatory process. So if you're going to get people to trust that a vaccine is something they ought to accept, there may be a few here and there who would say, "if a leading scientists took it, then maybe I'll do it, or maybe I'll brew it up in my basement," but that doesn't cover the vast majority of people with doubts... hesitancy... and I think saying, "yes, it's a do it yourself vaccine! Go ahead, take it, trust in it," is not the path forward to getting a lot of people to take vaccines.
Chris - What did you make of what Josiah Zayner was saying when I put it to him that perhaps by encouraging people to do not just vaccines, but this sort of experimentation, with tools that in the wrong hands can do dangerous things, is there not some degree of irresponsibility? And he said, well, he thinks it's irresponsible that the technology is only in the hands of a small group of individuals, scientists, and academic institutions; corporate hands as well. Do you think he's got a point?
Arthur - No, it's not safe to take genetic engineering and have people who aren't necessarily properly trained to handle it muddling around in their own homes with no supervision or accountability. These are powerful techniques; many people around the world already don't trust things like genetically modified foods. And again, if you want to ruin the future of genetic engineering, which I don't - either medically, or for food, for animal use, or even in humans - then I think the easiest way to do that is to have people think that there are nuts in the basement doing what they want.
Chris - So your view is that at the moment there's a fragile trust, and that's easily broken, because if things go wrong because of a lack of regulation or people just stepping outside the boundaries of what's sensible - and then accidents do happen, let's face it - that will shatter what we do have left of that thread of trust, and we might not get it back?
Arthur - Absolutely right. I think it would take one leak of a modified organism, one death from a do-it-yourself vaccine or drug, and all of a sudden you have fundamentally damaged public trust in drugs and vaccines, or genetic engineering technology. It's seen as too risky, too dangerous, just to have it in the hands, if you will, of amateurs. Look, the public can barely trust it when it's in the hands of professionals, even when there's some oversight. I don't see it as doing anything but creating more mistrust.
Chris - Where do you stand on the point that we heard earlier from... the example given was the discovery of hashish, and the person then documented their own reactions to it, and so on. Obviously this sort of self-experimentation is going on all the time, around the world, with illicit drug use and things like that. People are experimenting; occasionally they might discover interesting things that actually turn out to have enormous therapeutic potential, which if we were not doing that kind of thing, we wouldn't necessarily discover.
Arthur - People do try things, taste things, chew on things; but that's different as a form of self-experimentation from saying, "let's try and disseminate a product, let's get people to pick up on a drug or a vaccine in a big way." Finding out that something might have a beneficial impact on your headaches by chewing a unusual substance is a baby step, and you're not going to stop that, nor should you. But trying to develop products that the world takes - that's not going to happen through self-experimentation alone.
Chris - Has it not gone too far though? Because - and just very briefly - Barry Marshall, whom we heard earlier, has said he's doubtful, in the present regulatory environment, because of ethical controls and so on, that he would make the same discovery again.
Arthur - But if you will, what we're talking about is the need to produce products. And that's where the regulation is essential to cement that trust.