State employees describe pressure to join vaccine trials
Medical ethicists express concern over pressure tactics
MOSCOW — In late September, Moscow municipal official Sergei Martyanov sent a series of text messages to his subordinates: “Colleagues!!!... What is this sabotage???”
Martyanov was expressing dismay at his staff’s apparent reluctance to volunteer for the human trials of Russia’s Sputnik V coronavirus vaccine, named after the Sovietera satellite that triggered the space race. The official in the Moscow department of city property said many quota spots for his staff to join the trial remained unfilled.
He said he had heard some workers were signing up to receive flu vaccines, making them ineligible for the coronavirus trial.
“Who are you trying to trick???” Martyanov said in the texts. “The coronavirus vaccine is the absolute priority!!!”
Anyone who had received the flu jab, he said, must still sign up for the COVID trial, allowing a month’s delay. He urged his colleagues to recruit friends and family into the trials. “At least two people per employee!”
Martyanov, the head of his department and Moscow’s city administration did not respond to requests for comment. The Moscow health department said the vaccine has already successfully passed two stages of clinical trials and has shown its safety, and the decision to participate in the trial is made by residents only voluntarily and only after a medical examination.
But the messages, seen by Reuters, reveal how some Russian state employees are coming under heavy pressure to sign up for the trials, an effort that medical ethicists say may run afoul of ethical norms for voluntary participation in such tests.
A source close to Martyanov’s department told Reuters that all departments in Moscow’s city administration, which employs around 20,000 people, were set quotas for participation in the trials.
Russia’s vaccine testing began in early September and is in its final phase in 29 clinics across Moscow. About 20,000 people have already taken part. The government says interim results show the vaccine is 92% effective. The country aims to produce more than a billion doses of the shots at home and abroad next year.
Even before the trials have been completed, Russians are already receiving the vaccine. The medicine received formal regulatory approval from Russian authorities in August; Russia, which has the world’s fourth-highest number of recorded COVID-19 cases, says it has so far inoculated more than 100,000 people considered at high risk such as military personnel, doctors and teachers.
President Vladimir Putin has said the vaccine “passed all checks.” Putin himself has yet to be vaccinated, however: His position means he cannot take something that is still being tested, the Kremlin says.
In conducting the trials, Moscow is helped by legions of Russian public sector workers who rely on the government for their pay. Over three days in November and six days in October, Reuters reporters visited 13 of the trial clinics and spoke to 32 trial participants. Thirty of the 32 said they had been told about the trial at work.
Of the 32, 23 people said they were genuine volunteers. Most expressed enthusiasm for participating in the trial.
Nine said they were not true volunteers. All nine were public sector workers who spoke on condition of anonymity. A few said they felt they could not refuse their employers’ entreaties to seek the vaccinations, but that after they arrived, medical tests had shown them to be ineligible, or staff gave them reasons they could use to opt out.
Some said they got as far as the clinic and then simply refused to take part. None said they had been injected against
their will.
Medical ethicists said the pressure being put on state employees may nonetheless be stretching the norms of ethical testing guidelines.
Generally speaking, if people feel there’s a cost to them if they refuse to take part in a trial, that is coercion, which wouldn’t be justified in the United States, the UK or other Western countries, Oxford University ethics professor Julian Savulescu told Reuters.
Jonathan Ives, a reader in empirical bioethics at Bristol University’s Centre for Ethics in Medicine in Britain, said that what counts as coercive can depend on the relationship between those involved.
“Even if very light pressure is being put on an employee by an employer to take part in a trial, and that employee feels their job or wellbeing may be at risk if they do not accede to that pressure, I think this would be coercive, and I would be very concerned about that,” he said.