Table 1 Final coding guidelines
Theme | Description | Type |
|---|---|---|
Secret trial | Anything that indicates that the trial is/was secret. | NEG |
No approval | The trial lacks approval from a public authority. | NEG |
Inappropriate incentives | The incentives for trial participants are mentioned as a problem. | NEG |
Insufficient trial information | The trial ought to have declared itself to / done more outreach and sensitisation with participants/general public/local leaders/national leaders. Having gotten approval without informing goes into this category | NEG |
Corporate conspiracy | The Ebola/vaccine/trial being done for business. | NEG |
Introduction of Ebola before vaccine | Any claim that the trial will give people Ebola first, to be able to test the vaccine | NEG |
Risk of Ebola after vaccine | People will get Ebola from the vaccine | NEG |
Safety and side effects | Any side effects and safety concerns | NEG |
Past violations of medical ethics | The trial is similar to historical examples of unethical medical practice/experiments | NEG |
Sterilisation/population control | The trial is part of a conspiracy to sterilise people / control the population | NEG |
Other diseases more important | Addressing other health issues (e.g. cholera) more important than conducting the trial. | NEG |
Not in Ghana | Thinks it should be done, but in another place, for reasons including: NIMBY/county/town/region/ethnic group, doesn't make sense because Ghana is Ebola-free | NEG |
Guinea Pig | Any description of trial participants as Guinea Pigs. | NEG |
Animals first | The vaccine hasn’t been tested on animals yet. | NEG |
Trials are unnecessary | The trial is unnecessary/needless (e.g. because Ghana is Ebola-free) | NEG |
Religion | The trial should not be done because “we prayed and God spared us” from Ebola | NEG |
No introduction of Ebola before vaccine | We don’t have to give people Ebola to test the vaccine | POS |
No risk of Ebola after vaccine | People will not get Ebola from the vaccine | POS |
Protocols followed | Responses that say ethical, legal requirements have been met (which presumes public trust in the FDA, in the regulations and their enforcement). Excellent example of the difference between what ethics means to a researcher vs. a layperson. | POS |
Vaccine important | Helping develop the vaccine is an ethical imperative in itself | POS |
Ghana benefits from the trials | Participating the trials is in Ghana’s self interest since it will develop scientific and business capacity/reputation, and/or having the vaccine will help Ghana prepare for another outbreak | POS |
Tested elsewhere | Other countries have tested the vaccine/are also testing it, which should reassure/inspire Ghana to participate as well | POS |
Sufficient trial information given | We are doing/have done/ will do all the necessary and appropriate informing and sensitizing and outreach | POS |
Ignorant opponents | People opposing the vaccine are ignorant etc. Including general characterisation of people opposing trial | POS |
Appropriate Incentives | Money and phone are for practical purposes of transport and communication, not an undue incentive | POS |
Trials are safe overall | The trial is safe (this code applies to all safety/side effect reassurances except those focusing on the fear of getting Ebola, which were coded as Not Ebola first/after) | POS |
Ebola-free setting useful for testing vaccines | The test must be done in Ghana because it is an Ebola-free country | POS |