Department of Surgery and Cancer, Imperial College London, London, UK
Business School, Kingston University, Kingston-Upon-Thames, London, UK.
J Med Ethics. 2022 Apr;48(4):250-255. doi: 10.1136/medethics-2020-106805. Epub 2021 Mar 9.
Lack of vaccine confidence can contribute to drops in vaccination coverage and subsequent outbreaks of diseases like measles and polio. Low trust in vaccines is attributed to a combination of factors, including lack of understanding, vaccine scares, flawed policies, social media and mistrust of vaccine manufacturers, scientists and decision-makers. The COVID-19 crisis has laid bare societies' vulnerability to new pathogens and the critical role of vaccines (and their acceptability) in containing this and future pandemics. It has also put science at the forefront of the response, with several governments relying on academics to help shape policy and communicate with the public. Against this backdrop, protecting public trust in scientists and scientific output is arguably more important than ever. Yet, conflicts of interest (CoI) in biomedical research remain ubiquitous and harmful, and measures to curb them have had limited success. There is also evidence of bias in industry-sponsored vaccine studies and academics are voicing concerns about the risks of working in a CoI prevalent research area. Here, we set out to challenge established thinking with regard to vaccine confidence, by shifting the gaze from a deficit in public understanding towards probity in research relationships and suggesting an alternative and perhaps complementary strategy for addressing vaccine mistrust. We argue that a concerted effort needs to be made to revisit the norms that undergird contemporary vaccine research, coupled with a willingness of all stakeholders to reimagine those relationships with an emphasis on demonstrating trustworthiness and probity.
疫苗信心的缺失可能导致疫苗接种率下降，进而导致麻疹和脊髓灰质炎等疾病的爆发。对疫苗的低信任源于多种因素的综合作用，包括缺乏了解、疫苗恐慌、政策缺陷、社交媒体以及对疫苗制造商、科学家和决策者的不信任。新冠疫情暴露了社会对新病原体的脆弱性，以及疫苗（及其可接受性）在遏制此次疫情和未来大流行中的关键作用。它还使科学成为应对措施的前沿，一些政府依赖学术界帮助制定政策并与公众沟通。在此背景下，保护公众对科学家和科学成果的信任或许比以往任何时候都更为重要。然而，生物医学研究中的利益冲突仍然普遍存在且具有危害性，遏制这些冲突的措施收效甚微。此外，还有证据表明，行业赞助的疫苗研究存在偏见，学者们对在利益冲突普遍存在的研究领域工作的风险表示担忧。在这里，我们试图通过将关注点从公众理解的不足转移到研究关系的廉洁性上来挑战疫苗信心方面的既定思维，并提出一种替代的、可能互补的策略来解决疫苗的不信任问题。我们认为，需要共同努力重新审视支撑当代疫苗研究的规范，同时所有利益相关者都愿意重新构想这些关系，重点是展示可信度和廉洁性。
