How to conduct clinical trials while releasing a vaccine

There are many ways to conduct clinical trials while releasing a vaccine—indeed, we can make the clinical trials better by randomizing a phased release. Suppose we decide health care and transit workers should be vaccinated first. No problem–offer the workers the vaccine, put the SSNs of those who wants the vaccine into a hat like draft numbers, vaccine a randomly chosen sub-sample, monitor everyone.This is the well known lottery technique for measuring causal effects often used in the school choice literature. If we use this technique we can greatly increase sample sizes and as we study each wave we will gather more confidence in the data. We won’t have enough vaccine in November to vaccinate everyone or probably even all health care and transit workers so a lottery is an ethically fair as well as statistically useful way to distributed the vaccine. We can also randomize across cities and regions.

That is from a recent post by Alex Tabarrok, on the blog Marginal Revolution, and there is more at the link.  Of course I don’t have to tell you what Alex’s brother thinks of all this.

Addendum: Anup Malani notes:

BTW, those worried about ethics here should note that most product markets, even many dangerous ones (including non-FDA regulated medical care) use the population testing approach. Drugs are the exception. Elsewhere handle risk via exclusively via ex post tort liability.

So please don’t offer some kind of passive, under-argued Twitter comment on how unacceptably unethical it is — do some analysis and empirics on the trade-offs!  And read up on surgical procedures while you are at it.


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