Page 36 - Ethical Guidelines for Conducting Research Studies Involving Human Subjects
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10.2.2 Special Concern

                                 i.      The participant should be informed about that some vaccines
                                         that  contain  active  or  live  attenuated  micro-organisms  can
                                         possibly  possess  a  small  risk  of  producing  that  particular
                                         infection.
                                 ii.     In  case  of  the  participants  in  control  groups  or  when
                                         subjected to ineffective vaccines run a risk of contracting the
                                         disease, free treatment for the disease should be given and
                                         where    lifelong    treatment  is  required  then  this  should  be
                                         insisted upon by NREC.

                                 iii.    For  all  the  recombinant  vaccines/  products  the  Guidelines
                                         issued by the National Institute of Health (NIH), Food and
                                         Drug  Administration  (FDA)  and  Guidelines  issued  by  the
                                         authorities of Bangladesh should be strictly followed as the
                                         risks associated with these vaccines are not known.


                                 iv.     Post-trial access  to the vaccine should be given first to the
                                         community from which the participants were drawn as well
                                         as  to  the  control  group.  This  should  be  done  only  if  the
                                         vaccine is found to be safe and effective.  But if the vaccine is
                                         for pediatric age group and by the time the study gets over
                                         the children in the control arm may cross the age when the
                                         vaccine  is  supposed  to  be  protective.  In  such  instances  the
                                         control arm could be some other alternative vaccine for that
                                         pediatric  age  group  although  this  does  not  restore  clinical
                                         equipoise.  EC  may  examine  the  feasibility  and  ethical
                                         aspects on a case-to-case basis.

                                 v.      For choosing vulnerable group like children, care should be
                                         taken  to  choose  the  particular  age  with  regard  to  gender,
                                         ethnic background and health profile for testing vaccines for
                                         this  age  especially  if  they  are  from  over-researched
                                         community.


                                 vi.     In  RCTs  if  no  effective  vaccine  exists  as  comparator  then
                                         placebo can be used. The community should be involved to
                                         decide on the choice of comparator.









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