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Bruce J, Johnson SB. Exploring the ethics of genetic prioritisation for COVID-19 vaccines. Eur J Hum Genet 2022; 30:875-879. [PMID: 35250030 PMCID: PMC8898655 DOI: 10.1038/s41431-022-01058-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/13/2021] [Accepted: 01/25/2022] [Indexed: 01/20/2023] Open
Abstract
There is evidence to suggest that host genomic factors may account for disease response variability in COVID-19 infection. In this paper, we consider if and how host genomics should influence decisions about vaccine allocation. Three potential host genetic factors are explored: vulnerability to infection, resistance to infection, and increased infectivity. We argue for the prioritisation of the genetically vulnerable in vaccination schemes, and evaluate the potential for ethical de-prioritisation of individuals with genetic markers for resistance. Lastly, we discuss ethical prioritisation of individuals with genetic markers for increased infectivity (those more likely to spread COVID-19).
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Affiliation(s)
- Jago Bruce
- Wellcome Centre for Ethics and Humanities and Ethox Centre, Nuffield Department of Population Health, University of Oxford, Big Data Institute, Oxford, OX3 7LF, USA
| | - Stephanie B Johnson
- Wellcome Centre for Ethics and Humanities and Ethox Centre, Nuffield Department of Population Health, University of Oxford, Big Data Institute, Oxford, OX3 7LF, USA.
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Walker A, Bonham VL, Boyce A, Clayton EW, Garcia D, Johnson S, Laeyendecker O, Lewis M, Margolick JB, Mathews D, Parker MJ, Spicer P, Thio CL, Geller G, Kahn J. Ethical Issues in Genetics and Infectious Diseases Research: An Interdisciplinary Expert Review. ETHICS, MEDICINE, AND PUBLIC HEALTH 2021; 18:100684. [PMID: 34263019 PMCID: PMC8274576 DOI: 10.1016/j.jemep.2021.100684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE Research in genetics and infectious diseases (ID) presents novel configurations of ethical, legal, and social issues (ELSIs) related to the intersection of genetics with public health regulations and the control of transmissible diseases. Such research includes work both in pathogen genetics and on the ways that human genetics affect responses to ID. This paper identifies and systematizes the unique issues at this intersection, based on an interdisciplinary expert review. BASIC PROCEDURES This paper presents results of a formal issue-spotting exercise among twenty experts in public health, law and genomics, biobanking, genetic epidemiology, ID medicine and public health, philosophy, ethics and ID, ethics and genomics, and law and ID. The focus of the exercise was on the collection, storage, and sharing of genetic information relating to ID. MAIN FINDINGS The issue-spotting exercise highlighted the following ELSIs: risks in reporting to government authorities, return of individual research results, and resource allocation - each taking on specific configurations based on the balance between public health and individual privacy/protection. PRINCIPAL CONCLUSIONS The public health implications of interactions between genomics and ID frame considerations for equity and justice. In the context of the COVID-19 pandemic, these issues are especially pressing.
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Affiliation(s)
- Alexis Walker
- Berman Institute of Bioethics, Johns Hopkins University, 1809 Ashland Avenue, Baltimore MD 21205 USA
| | - Vence L. Bonham
- Social and Behavioral Research Branch, National Human Genome Research Institute, 31 Center Drive, Bethesda MD 20894 USA
| | - Angie Boyce
- Berman Institute of Bioethics, Johns Hopkins University, 1809 Ashland Avenue, Baltimore MD 21205 USA
| | - Ellen Wright Clayton
- Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville TN 37232 USA
| | - Debra Garcia
- International Society for Biological and Environmental Repositories, 750 W Pender St #301, Vancouver BC V6C 1G8 Canada
| | - Stephanie Johnson
- Wellcome Centre for Ethics and the Humanities and Ethox Centre, University of Oxford, Oxford OX1 2JD UK
| | - Oliver Laeyendecker
- Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore MD 21205 USA,National Institute of Allergy and Infectious Diseases, National Institutes of Health, 5601 Fishers Ln, Bethesda, MD 20892 USA
| | - Michelle Lewis
- Berman Institute of Bioethics, Johns Hopkins University, 1809 Ashland Avenue, Baltimore MD 21205 USA
| | - Joseph B. Margolick
- Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore MD 21205 USA
| | - Debra Mathews
- Berman Institute of Bioethics, Johns Hopkins University, 1809 Ashland Avenue, Baltimore MD 21205 USA,Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore MD 21205 USA
| | - Michael J. Parker
- Wellcome Centre for Ethics and the Humanities and Ethox Centre, University of Oxford, Oxford OX1 2JD UK
| | - Paul Spicer
- Department of Anthropology and the Center for Applied Social Research, University of Oklahoma, 455 W Lindsey St, Norman OK 73069 USA
| | - Chloe L. Thio
- Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore MD 21205 USA
| | - Gail Geller
- Berman Institute of Bioethics, Johns Hopkins University, 1809 Ashland Avenue, Baltimore MD 21205 USA,Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore MD 21205 USA
| | - Jeffrey Kahn
- Berman Institute of Bioethics, Johns Hopkins University, 1809 Ashland Avenue, Baltimore MD 21205 USA,Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore MD 21205 USA
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