ArticleBMJ public health2025
Mixed-methods study assessing the acceptability and feasibility of Human Challenge Studies for Disease X in Healthy UK Adults in a SARS-CoV-2 pandemic setting.
Article in BMJ public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
12 authors.
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Abstract
Introduction: Preparation for a future pandemic or serious epidemic caused by a known or yet unknown pathogen (Disease X) is a global health priority. Controlled human infection studies (CHIS) are recognised as a valuable tool to accelerate development of vaccines and immunotherapeutics against pathogens with pandemic potential and may play a role in future pandemic settings. The acceptability of CHIS to potential participants in a pandemic setting has not been explored. Methods: A mixed-methods study of adults screened to participate in a first-in-human SARS-CoV-2 vaccine trial, using online survey and interviews, was undertaken between September and October 2020 in Oxford, UK. This work assessed individuals' views, motivations and experiences of participating in a trial during a pandemic setting, including attitudes towards a hypothetical SARS-CoV-2 CHIS. Results: 349 of 770 (45%) invited individuals completed the survey, and 102 survey respondents (29%) participated in a structured interview. Participants were highly educated, research informed and predominantly of white ethnicity. Approximately a third of survey respondents agreed they would be willing to participate in a hypothetical SARS-CoV-2 CHIS. Individuals aged <35 years old, those without children and those who were single were more likely to agree to participate in a hypothetical SARS-CoV-2 CHIS. This decision was dependent on short-term and long-term complications of infection, availability of rescue therapy, likelihood of CHIS to accelerate vaccine development and urgency of the public health need. Motivations to participate in a SARS-CoV-2 CHIS included altruism and a preference to acquire infection of a circulating pandemic pathogen in a controlled setting. The views of family and friends were important in individuals' decision-making. Conclusions: Vaccine trial participants are an informed and motivated public group who can provide situated public expertise for CHIS pandemic preparedness. Recruitment to CHIS in a pandemic may be more efficient if targeted to younger, single individuals without children. Media engagement and information specifically for potential CHIS participants' families is important to facilitate informed discussion.
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