“The vision is that a small number of individuals in the target population could be vaccinated, and the vaccine strain would then circulate in the population much like a pathogenic virus.” p.45

“One important component of the current vaccination approach for humans is the informed consent process. In order to receive a vaccine, individuals (or their legal guardians) must be informed about the risks of vaccination by a healthcare provider and provide their consent before being vaccinated. Those who decline are not forced to receive a vaccine.

In the case of self-spreading vaccines, the individuals directly vaccinated would have this option, but those to whom the vaccine subsequently spreads would not. Additionally, self-spreading vaccines would potentially infect individuals with contraindications, such as allergies, that could be life-threatening. The ethical and regulatory challenges surrounding informed consent and prevention and monitoring of adverse events would be critical challenges to implementing this approach even in an extreme event.”  p. 46-47