Dr Tom Kerns
North Seattle Community College


Jenner On Trial

Tom Kerns






The first HIV vaccine efficacy trials will probably be proposed sometime before the end of the millennium, and will probably take place somewhere in the developing world rather than in any of the Western industrialized nations. These trials will doubtless be surrounded by controversy, and well they should be.

Two hundred years ago, when Edward Jenner proposed his first smallpox vaccine efficacy experiment, it too was rightly surrounded by much controversy. Doubts about the scientific as well as ethical propriety of Jenner's experiment arose from within the medical community, from within the popular media, and from the populace of his time, and the same will doubtless be the case for our century's HIV vaccine efficacy experiments.

Some of the similarities between the two cases - Jenner's smallpox vaccine experiment in 1796, and today's proposed HIV vaccine efficacy experiments - are quite striking. Some of the differences also are ethically quite significant. Both the similarities and differences will be detailed in the following pages.

This study is an examination of some of the key ethical dilemmas entailed by Jenner's proposed experiment, the first (I believe) scientifically designed biomedical experiment in the history of modern scientific medicine.

The ethical quandaries entailed by HIV vaccine efficacy trials are far more complex than those entailed by Jenner's experiment. Yet I believe that much can learned about the problems associated with today's vaccine efficacy trials - whether they be trials for HIV vaccines, for malaria vaccines, for tuberculosis vaccines, or for any number of other potential experimental vaccines - by a close examination of Jenner's much earlier experiment based on much simpler data and covering a much shorter period of time. Sometimes highly complex problems can be most effectively approached by an examination of problems that are simpler and more fundamental, then extrapolating some of what is learned in the simpler case to what is still unclear in the more complex case.

I believe that an examination of some of the ethical issues in Jenner's work will be illuminating for analogous issues raised by today's proposed vaccine efficacy trials.



Jenner homepage and Table of Contents
preface | Introduction | chp 1 | chp 2 | chp 3 | chp 4
cchp 5 | chp 6 | chp 7 | chp 8 | App I | App II
Ethical Issues in HIV Vaccine Trials