Characterizing altruistic motivation in potential volunteers for SARS-CoV-2 challenge trials

Abstract

In human challenge trials, volunteers are deliberately infected with a pathogen to accelerate vaccine development and answer key scientific questions. In the U.S., preparations for challenge trials with the novel coronavirus are complete, and in the U.K., challenge trials have recently begun. However, ethical concerns have been raised about the potential for invalid consent or exploitation. These concerns largely reflect worries that challenge trial volunteers may be unusually risk-seeking or too economically vulnerable to refuse the payments these trials provide, rather than being motivated primarily by altruistic goals. We conducted the first large-scale survey of intended human challenge trial volunteers and found that SARS-CoV-2 challenge trial volunteers exhibit high levels of altruistic motivations without any special indication of poor risk perception or economic vulnerability. Findings indicate that challenge trials with the novel coronavirus can attract volunteers with background conditions, attitudes, and motivations that should allay key ethical concerns.

Better recognition for research participants: what society should learn from covid-19

“…Recruitment for covid-19 vaccine trials, including riskier human challenge trials, was supported by public engagement efforts that framed volunteerism as contributing to the public good, and many participants were motivated by altruism. 39 Public messaging about the societal benefits of organ donation has similarly been shown to evoke greater intention to donate. 50 As we look beyond the covid pandemic, we suggest that public engagement has potential to promote participation in research into other health concerns.…”

“…While the praise for participants in covid-19 trials suggests some recognition of the importance of their contributions, concerns about being seen as a “guinea pig”25 and hesitation about discussing participation with others40 persist. Recruitment for covid-19 vaccine trials, including riskier human challenge trials, was supported by public engagement efforts that framed volunteerism as contributing to the public good, and many participants were motivated by altruism 39. Public messaging about the societal benefits of organ donation has similarly been shown to evoke greater intention to donate 50…”

Research ethics and public trust in vaccines: the case of COVID-19 challenge trials

“…The people who declared willingness to volunteer for COVID-19 HCTs tend to be neither low-income nor racial/ethnic minorities. 61 …”

The past, present, and future of human challenge trials

“…However, other experts challenge this idea, arguing that underpayment is a greater concern [28,29]. 1 Day Sooner surveyed the motivation of volunteers for the SARS-Cov-2 challenge trials, revealing that most volunteers displayed "high levels of altruistic motivations without any special indication of poor risk perception or economic vulnerability" [30]. A majority of the volunteers identified as non-Hispanic white, held bachelor's degrees, and lived in high income countries.…”