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June 26, 2017

Rubella and Zika Vaccine Research—A Cautionary Tale About Caution

Author Affiliations
  • 1Center for Bioethics and Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill
  • 2School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill
JAMA Pediatr. Published online June 26, 2017. doi:10.1001/jamapediatrics.2017.1496

The public health response to the Zika crisis has evoked debate and critique, although there has been at least 1 clear success: rapid progress toward a vaccine, with phase 2 testing starting in early 2017, just a year after the Public Health Emergency of International Concern was declared.

Among the challenges of developing a vaccine to prevent Zika infection during pregnancy are ethically complex questions about the appropriate role of pregnant women in the vaccine development agenda. Though ideally women will be vaccinated before conceiving, inadvertent vaccination during pregnancy is unavoidable when women of childbearing age are targeted. Vaccination during pregnancy may also be beneficial because the risks of Zika infection persist through gestation.1 Both underscore the importance of developing an approach that meets the needs of those most at risk: pregnant women and their offspring.

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