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The Ebola epidemic that broke out in West Africa towards the end of 2013 had been brought under reasonable control by 2015. The epidemic had severely affected three countries. This case study is about a phase I/II clinical trial (testing for safety and immunogenicity) of a candidate Ebola virus vaccine in 2015 in a sub-Saharan African country which had not registered any cases of the Ebola virus disease. The study was designed as a randomized double-blinded trial. It was sponsored and funded by one of the biggest Northern multinational pharmaceutical companies. The protocol received ethics clearance from the relevant national ethics committee. The study was coordinated and managed at the local branch of a big Northern diagnostic laboratory and a laboratory of a local regional hospital. The overall study was a multi-country, multi-site trial aimed at recruiting a total of 3,000 research participants across four or five sub-Saharan African countries. For this country, the recruitment sites were two big cities, each aiming to recruit 200 participants: adults at the first site and children at the second. The target sample size was almost achieved at the first site but, before the study commenced at the second site, some members of (the public) raised the alarm that the government was carelessly risking the health, safety and lives of citizens in the cause of an unproven vaccine that could precipitate a public health disaster. The trial was immediately suspended. A commentary on this case, and on the importance of trust, is provided by Katharine Browne and Doris Schroeder at the end of this chapter. It highlights differences between this case and a phase I Ebola vaccine trial in Canada in 2014.

This article takes up a game-theoretic perspective on California's recently passed bill (SB 277) that closes all nonmedical exemptions for school-mandated vaccination. Such a perspective characterizes parental decisions to vaccinate their children as a collective action problem and reveals the presence of an incentive to free ride-to enjoy the benefits of others' efforts to vaccinate their children without vaccinating one's own. This article defends California's legislation as a reasonable means of overcoming the free rider problem and of ensuring that the burdens of vaccination are shared equally.

Abstract:Team reasoning is thought to be descriptively and normatively superior to the classical individualistic theory of rational choice primarily because it can recommend coordination on Hi in the Hi-Lo game and cooperation in Prisoner's Dilemma-type situations. However, left unanswered is whether it is rational for individuals to become team members, leaving a gap between reasons for individuals and reasons for team members. In what follows, I take up Susan Hurley's attempt to show that it is rational for an individual to become a team member. I argue that her account fails to show that becoming a team member is necessary to gain the advantages of coordination in Hi-Lo games or cooperation in Prisoner's Dilemma-type situations, and that individuals will often fare better reasoning as individual agents than as members of a team. I argue further that there is a more general problem for team reasoning, specifically that the conditions needed to make it rational for a team member to employ team reasoning make becoming a team member unnecessary.