The World Health Organization (WHO) has recommended a new malaria vaccine R21/Matrix-M for the prevention of malaria in children. The Oxford University’s Jenner Institute and world’s largest vaccine manufacturer by doses Serum Institute of India, has developed the vaccine.
Malaria, a mosquito-borne disease, has a high mortality rate in the African Region, where nearly half a million children die from the disease each year. In 2021, there were 247 million cases of malaria out of which 619,000 people died. Most of them are children under the age of five. More than 95% of cases of malaria are found in Africa.
The health agency has approved this vaccine based on advice from WHO’s two expert groups- the Strategic Advisory Group of Experts on Immunization (SAGE) and the Malaria Policy Advisory Group (MPAG). The WHO Director-General Tedros Adhanom Ghebreyesus endorsed the vaccine following a biannual meeting held on 25-29 September. Almost two years ago, in 2021, the first malaria vaccine RTS,S/AS01, received a WHO recommendation.
“As a malaria researcher, I used to dream of the day we would have a safe and effective vaccine against malaria. Now we have two,” Tedros said.
“Demand for the RTS,S vaccine far exceeds supply, so this second vaccine is a vital additional tool to protect more children faster, and to bring us closer to our vision of a malaria-free future," added Tedros.
The World’s largest vaccine manufacturer Serum Institute of India is set to make more than 100 million doses a year and plans to scale up to 200 million doses a year. Ghana became the first country to approve malaria vaccines followed by Ghana and Burkina Faso.
Dr Matshidiso Moeti, WHO Regional Director for Africa, explained the importance of this vaccine recommendation for the continent. “This second vaccine holds real potential to close the huge demand-and-supply gap. Delivered to scale and rolled out widely, the two vaccines can help bolster malaria prevention and control efforts and save hundreds of thousands of young lives in Africa from this deadly disease.”
Features of the R21 Vaccine:
The Vaccine has high efficacy when given just before the high transmission season. In highly seasonal malaria transmission areas the R21 vaccine was shown to reduce symptomatic cases of malaria by 75% following a 3-dose series.
The R21 is expected to have high public health impact, including low rate of transmission. The vaccine is cheaper ( Two to four dollars) and is about half the price of RTS,S and also safe in every way.
The effects of both malaria vaccines are “very similar” according to WHO. There is no evidence that one vaccine is better than the other. The two vaccines use the same technologies and target the same stage of malaria's life cycle.
The newer vaccine is easier to manufacture as it requires a smaller dose and uses a simpler adjuvant. An adjuvant is a chemical given in the vaccine that jolts the immune system into action.
Prof. Sir Adrian Hill, director of the Jenner Institute in Oxford where R21 was developed, said: " The R21 malaria vaccine is shown to be highly effective in our published clinical studies and is now approved for use. The vaccine is easily deployable, cost effective and affordable, ready for distribution in areas where it is needed most, with the potential to save hundreds of thousands of lives.”
The RTS,S vaccine will be available in African countries in early 2024 and from mid-2024, R21 will be available in Africa and other parts of the world. 28 countries are planning to introduce vaccines as part of their national immunization programmes.
WHO has also issued recommendations for new vaccines for dengue, and meningitis, with immunization schedules and product recommendations for COVID-19.
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