Zika rewrites maternal immunization ethics

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Science  21 Jul 2017:
Vol. 357, Issue 6348, pp. 241
DOI: 10.1126/science.357.6348.241

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Pregnant women long have been excluded from vaccine studies because researchers are wary of causing unintended harm to the highly vulnerable developing fetus. But a new report from a group that represents many disciplines contends that ethics demand pregnant women be included in the trial of experimental Zika vaccines, which are designed to protect babies from brain damage and other maladies caused by that mosquito-borne virus. The report is careful to point out that risk/benefit ratios must be weighed for each vaccine and each trial on a case-by-case basis—and indeed the Zika vaccine that has moved furthest in human studies rightly excludes pregnant women, says a co-author of the report. Other experimental maternal immunizations designed to protect babies are also being tested now, and one trial, for a respiratory syncytial virus vaccine, includes pregnant women. A vaccine against group B streptococcus has also moved along the development pipeline and may soon enter trials with pregnant women, too. A second new report on maternal immunizations issued last week explores the challenges of doing safety studies in these women and their babies.