Pandemic preprints—a duty of responsible stewardship - The BMJ

"bioRxiv and medRxiv were founded on the belief that early sharing of results as preprints can speed up biomedical research. Making articles available months to years before traditional publication allows experts to analyze, discuss, and build on findings immediately. This approach can accelerate understanding of basic biology and disease pathogenesis and, ultimately, the development of therapeutic and prevention strategies to improve human health. Never has this been more evident than amid the covid-19 pandemic, during which we have posted more than 15,000 pandemic related preprints so far, covering everything from structural studies of SARS-CoV-2 proteins to host immunological responses to covid-19 epidemiology, public health measures, and clinical trials.

We take responsibility for disseminating clinical information extremely seriously. Thus, we established medRxiv as a separate server that goes beyond other preprint servers in fostering transparency and promoting the responsible reporting of research by requiring clinical trial registration and declarations from authors about funding, competing interests, data availability, and ethical oversight. We also implemented dedicated screening processes involving health professionals, overseen by a leadership team that includes physicians and clinical research publishing professionals. There is a potentially huge benefit to early dissemination of the vast majority of medical findings, but we recognized from the outset that some articles would be better not disseminated as preprints because they describe work that might represent a biosecurity threat, endanger individuals, or threaten critical public health measures. Articles of this kind are declined, not because of the quality of the work or the likely accuracy of the findings, but because of the potential danger if the conclusions were to turn out to be wrong—for example, loss of public confidence in a life-saving immunization programme, as happened in the case of MMR vaccination. We recommend to the authors of such articles that their observations be disseminated after peer review by a journal, where the findings and implications can be thoroughly evaluated by experts prior to publication....

A recent germane example illustrates these issues: covid-19 vaccines and adverse effects. We have received manuscripts on this topic, but given the risks of increased vaccine hesitancy, particularly early on in population vaccination efforts, we have tended to recommend their distribution only after the thorough expert peer review, evaluation, and context that a clinical journal, not a preprint server, can provide. These articles have major public health implications, but if wrong could cause harm through public confusion, particularly if magnified by disinformation campaigns. Such caution can be criticized as being at odds with our mission to accelerate knowledge, but we consider it part of our duty of responsible stewardship. Are we making the right call? We welcome feedback and debate on this and other issues as our servers evolve."