Ebola virus vaccine trials: the ethical mandate for a therapeutic safety net

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Abstract
Randomised controlled trials (RCTs) offer the fastest and most rigorous assessment of vaccine efficacy.1 But they are ethical only if there is “clinical equipoise”—genuine uncertainty in the medical community about whether the experimental intervention will do more good than harm.2 We argue that Ebola virus vaccine RCTs can achieve clinical equipoise without sacrificing scientific rigour by providing trial participants who develop Ebola virus disease (EVD) with enhanced supportive care and access to experimental therapeutics. Most discussions have analysed Ebola vaccine and treatment …