Ethical and Policy Issues in Using Vaccines to Treat and Prevent Cocaine and Nicotine Dependence

Wayne Hall; Coral Gartner


Curr Opin Psychiatry. 2011;24(3):191-196. 

In This Article

Preventive Use of Drug Vaccines

The term 'vaccine' may raise parental expectations that vaccines can be used to prevent nicotine or cocaine dependence in their children.[45,50,51] The preventive use of drug vaccines will be ethically contentious. Children would be vaccinated at the request of their parents because, as minors, they are not legally able to consent. As parents already make choices on behalf of their children that affect their lives as adults (e.g. regarding their diet and education), some have argued that immunization against nicotine or cocaine is a decision that parents have the right to make.[51,52] This is likely to be contested.

The preventive use of a vaccine in healthy young people will require stronger evidence of safety and efficacy than shorter-term use to reduce relapse in adults who are nicotine or cocaine-dependent. Obtaining evidence to meet regulatory requirements for such use is likely to be very expensive[45,50] and pharmaceutical companies may be reluctant to seek such approval. Community concerns about the safety of vaccinations against infectious diseases may also deter investment in preventive studies of drug vaccines.[50]

There are also practical impediments to the preventive use of drug vaccines. The limited period of protection provided by the current vaccines will require frequent booster injections throughout adolescence. Alternatively, a longer-acting vaccine will need to be developed. The costs of universal vaccination in adolescence, and the likely modest ability to prevent drug dependence, make it unlikely that there would be public funding for the universal preventive vaccination against drugs of dependence. Also, because the vaccine can be circumvented by using larger doses of drugs, vaccination could potentially have counterproductive effects if adolescents tested its efficacy by smoking cigarettes or using cocaine.[50]


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