THE EDITOR, Sir:

IN MY job, I frequently have to review regulatory records on various clinical trials and other laudable methods used by medical researchers in the fight against disease. Also, the Canadian news media often carry advertisements seeking volunteers for trials with experimental pharmaceuticals. I even recall from high-school zoology, very successfully taught to me in Jamaica, certain basics about vaccination, immunisation and how they work.

Still, having read your story on a volunteer in the 'HIV vaccine trials being undertaken by the Ministry of Health', I would like someone to correct me if I am wrong about the following, and to answer the questions arising.

The efficacy of any vaccine can only be proven if the subject is exposed to the pathogen. So, in volunteering and soliciting volunteers for trials of a vaccine, one selection criterion should be the assumption of present exposure, or exposure during the duration of the study. If volunteers are selected indiscriminately, then those who are never exposed will only be presenting and living with side effects of the drug (hopefully the research plan is complete enough to be tracking this too).

Are volunteers being solicited indiscriminately, and if so, are they able to make an informed decision? The desire to help mankind is very noble, and should not be discouraged, but one should have enough information to count the cost before embarking on any endeavour.

My family came to Canada with two teenagers, and before they had spent very long in public high school, we received a letter suggesting very strongly that they should receive immunisation against hepatitis B, which is transmitted here primarily through injection drug abuse and unprotected sex.

Hep B vaccination has been linked, albeit inconclusively, to a number of disorders, among them multiple sclerosis (MS) - Science News, September 25, 2004. People who know that they or their charges are not in danger of exposure, need to weigh carefully whether they should submit to vaccination/innoculation with experimental substances, or vaccines that have not been cleared of scientific dispute.

Wikipedia notes: "Abstinence is the only guaranteed way of preventing sexual transmission of hepatitis B", and I would say the same about HIV. For protection against non-sexual transmission, as well as the protection of health workers and 'innocent' parties, I agree that other safeguards must be pursued. The medical research should indeed be carefully conducted, with the proviso that all volunteers be very well informed, in as honest and unbiased a way as possible, about all the risks.

I am, etc.,

M. EVANGELINE ANDERSON

meangerson@rogers.com

1008 Buckskin Way

Ottawa, Ontario

Canada

Via Go-Jamaica