Two months have passed since the director of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, announced the approval of a second malaria vaccine, “R21/Matrix-M”, which is just as effective as the first and this because of its At this price, it can be manufactured in sufficient doses, which will improve vaccination rates.
This is the second malaria vaccine recommended by WHO, after “RTS,S/AS01”, which received a WHO recommendation in 2021. Both vaccines have been shown to be safe and effective in preventing malaria in children and, when widely applied, are expected to have a significant impact on public health. In fact, 95% of the world’s estimated 240 million cases are in Africa.
Malaria, a mosquito-borne disease, poses a particularly pressing burden in the African region, where nearly half a million children die from the disease each year. As the WHO reminds us, the available supply of “RTS,S” is limited. Today, with the arrival of “R21” on the list of recommended malaria vaccines, an “adequate” supply should benefit all children living in areas where malaria poses a public health risk.
“As a malaria researcher, I dreamed of the day when we would have a safe and effective vaccine against the disease. Today we have two,” Tedros said. “Since 2000, deaths from malaria have been reduced by more than half, and we have succeeded in eliminating malaria in many regions of the world. But globally, progress has stalled,” recalled in early October the director of the WHO.
The vaccine, as highlighted in the podcast Today in El País, has been shown to be very effective when administered just before the high transmission season, in areas where contagion is largely limited to 4 or 5 months of the year. “R21” has been shown to reduce symptomatic cases by 75% over the 12 months following a 3-dose series. A fourth dose administered a year after the third maintained its effectiveness.
This high efficacy is similar to that demonstrated when “RTS,S” is administered seasonally. It has also shown positive results when administered on an age-based schedule. Indeed, it shows good effectiveness (66%) during the 12 months following the first 3 doses. A fourth dose a year after the third maintained its effectiveness. Estimates from mathematical models indicate that the impact on public health is expected to be high.
At a price between 2 and 4 dollars per dose (respectively 1.9 and 3.8 euros), the cost-effectiveness of the “R21” vaccine would be comparable to that of other recommended interventions against malaria and other childhood vaccines.
At least 28 African countries plan to introduce a WHO-recommended malaria vaccine as part of their national immunization programs. Gavi, the Vaccine Alliance, has approved the provision of technical and financial support to expand malaria vaccines to 18 countries. The “RTS,S” vaccine will be rolled out in some African countries in early 2024, and the R21 malaria vaccine is expected to be available in countries by the middle of next year.