October 11, 2023
The Washington Post reports a second anti-malaria vaccine has been approved by the World Health Organization. Based on preclinical and clinical trial data, the vaccine showed reduced symptomatic cases in those who received the Oxford University-developed vaccine by 75% following a three-dose series in a year. The data were collected in areas with high seasonal malaria transmission. It is the second vaccine to be recommended by the WHO and will offer a cheap, accessible option to combat the disease.
The vaccine, R21/Matrix-M, will cost $2-$4 per dose and is expected to be available by mid-2024. The other WHO recommended vaccine for malaria, RTS,S, was approved in 2021. Demand for that vaccine has remained high, however, the supply has been limited, which has impeded prevention efforts. WHO, UNICEF, and Gavi allotted 18 million doses of RTS,S to 12 African countries. The Serum Institute of India will produce R21 and has the capacity to produce 100 million doses annually.
Phase III clinical trial results for R21 are under peer review. No evidence suggests one vaccine outperforms the other. There have been no head-to-head trials to gauge that performance.
Public health experts were pleased with the recommendation for a second vaccine to combat malaria, though they believe there is more to be done. Deaths due to malaria rose during the pandemic and remain above pre-pandemic levels. The WHO reported an estimated 619,000 deaths from malaria for 2021, mostly in Africa. Children under five account for 80% of those deaths.
PIDS member and 2023 Caroline B. Hall lecturer (Thursday, 3:15-4:30 p.m.) Chandy John commented (portions of the lecture will include his work in malaria), “The R21 vaccine is a major advance in combating malaria in children because it makes a second malaria vaccine available to children in malaria endemic areas. This is particularly important now, because we are facing increasing insecticide and anti-malarial drug resistance, so malaria appears to be increasing again, after years of decreasing cases.”