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The Monkeypox Vaccine Trials Left Some People Out

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Scientists try to protect children and pregnant women from harm, but exclusion from early research carries a cost.

About the authors: Jay Varma, a professor at Weill Cornell Medical School, is a physician and epidemiologist who worked for the CDC in New York, Bangkok, Beijing, and Addis Ababa. Sallie Permar is a professor at Weill Cornell Medicine and the pediatrician in chief at NewYork–Presbyterian/Weill Cornell Medical Center.

Late last month, the CDC confirmed that two young children had been diagnosed with monkeypox. Although almost all infections in the United States are associated with men who have sex with men, the virus is spreading rapidly and, through household exposure or other transmission routes, could soon turn up in other populations, such as infants, adolescents, and pregnant people (including their fetuses).

Public-health officials recommend the Jynneos vaccine for household contacts of, and others recently in close contact with, people who have monkeypox. But this shot suffers from the same problem as many vaccines developed against emerging infectious diseases: It has never been rigorously tested in people who are pregnant or under 18 years old.

In vaccine research, the usual presumption has been that people who are pregnant or under 18 are uniquely vulnerable to being harmed by medical research. But in many cases, that means that they end up being studied last—and are systematically excluded from the benefits of innovation during epidemics.

Pregnant and lactating women were excluded from early COVID-19 vaccine trials. Although they were still allowed to get shots, only about a third of them were fully vaccinated against COVID-19 by the end of 2021. Many........

© The Atlantic


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