October 02, 2023
2 min read
Source/Disclosures
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Disclosures:
Moeti, O’Brien and Tedros report no relevant financial disclosures.
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Key takeaways:
- R21 is the second malaria vaccine recommended by WHO.
- WHO said there are currently no data showing that either of the two vaccines outperforms the other.
WHO on Monday recommended the widespread use of a second vaccine for the prevention of malaria in children.
“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,” WHO Director-General Tedros Adhanom Ghebreyesus, PhD, MSc, said during a press briefing.
Data derived from WHO.
Tedros Adhanom Ghebreyesus
He added that demand for the first vaccine — called RTS,S — “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.”
According to WHO, clinical trials of R21 have shown that in areas with high seasonal malaria transmission, R21 was shown to reduce symptomatic cases of malaria by 75% during the 12 months following a three-dose series, while a fourth dose given a year after the third maintained that efficacy. Vaccine efficacy was 66% during the 12 months following the first three doses, WHO said.
WHO recommended the first malaria vaccine in 2021 after it showed promise in a 2-year pilot program in Ghana, Kenya and Malawi. During the program, more than 2.3 million doses were given to more than 800,000 children. Since then, 18 million doses have been allocated to 12 countries in Africa.
WHO experts said that although the two vaccines have not been tested in head-to-head trials, there is currently no evidence showing one vaccine performs better than the other.
“There is really no choice to be made based on the current evidence around performance of the two vaccines, but there are some differences between them,” Kate O’BrienMD, MPH, director of WHO’s Department of Immunization, Vaccines and Biologicals, said during the press briefing.
She explained one of the biggest differences is supply.
“I think we want to emphasize the supply situation,” she said. “We have only 18 million doses of RTS,S through the end of 2025, with work going on to increase that supply. With R21 coming in and commitments from the manufacturer with having over 100 million doses per year, this is a very big step toward access.”
According to WHO, next steps for R21 include completing the ongoing WHO prequalification process, which would enable broader rollout of the vaccine. So far, at least 28 countries in Africa plan to introduce a WHO-recommended malaria vaccine as part of their national immunization programs.
“This second vaccine holds real potential to close the huge demand-and-supply gap,” Matshidiso Moeti, WHO Regional Director for Africa, said in a statement. “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.”
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