A second vaccine against malaria has been recommended by the World Health Organization (WHO), which says it is highly effective, low cost and safe.
Called R21/Matrix-M, the vaccine is given as three doses to children up to the age of 3, followed by a booster one year later.
A trial in Burkina Faso showed that this immunisation course reduced cases of malaria by around 75 per cent if given just before the rainy season. This is when malaria peaks as rain leads to stagnant pools of water that mosquitoes, which spread the parasite, breed in.
The other vaccine against malaria, called RTS,S, was introduced in some countries in 2019. Some of its trials suggested a lower efficacy, at 30 to 40 per cent, although one study that gave the vaccine before the rainy season suggested efficacy similar to R21/Matrix-M. It isn’t possible to directly compare the two vaccines without a head-to-head trial, which hasn’t yet been done.
Another key advantage of R21/Matrix-M is its low price, as it will probably cost between $8 and $16 for its four-dose course. RTS,S costs about $41 for four doses.
R21/Matrix-M is set to be mass-produced by the Serum Institute of India, which developed the vaccine alongside the University of Oxford. It was also recently approved in Ghana, Nigeria and Burkina Faso, but the WHO recommendation means it can be funded and distributed by global health bodies such as UNICEF and Gavi, the Vaccine Alliance.
Malaria is one of the “big three” infectious conditions that are considered to have the largest impact worldwide, with the other two being tuberculosis and infection with HIV. Malaria causes more than half a million deaths a year, mostly in young children in sub-Saharan Africa.
The addition of R21/Matrix-M to the WHO immunisation programmes should result in enough vaccine doses for all children living in areas where malaria is a public health risk, the organisation said on 2 October. “This second vaccine holds real potential to close the huge demand-and-supply gap,” said Matshidiso Moeti at the WHO.
R21/Matrix-M is expected to be rolled out next year, along with wider availability of RTS,S.