‘Historic moment’: WHO recommends malaria vaccine for children
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WHO on Wednesday recommended the widespread use of a malaria vaccine among children in sub-Saharan Africa and other areas heavily impacted by the mosquito-borne disease, which kills more than 400,000 people a year.
The vaccine, RTS,S/AS01 (GlaxoSmithKline), acts against Plasmodium falciparum — the most deadly of the world’s five malaria parasite species and the most common cause of the disease in Africa.
WHO said children in sub-Saharan Africa and other areas with moderate to high transmission of P. falciparum malaria should receive the vaccine, which has shown promise over the past 2 years in a pilot program in three African countries.
“This is a historic moment. The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control,” WHO Director-General Tedros Adhanom GhebreyesusPHD, MSc, said in a news release announcing the recommendation. “Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year.”
The ongoing pilot program — called the Malaria Vaccine Implementation Program — has enrolled more than 800,000 children since 2019 in Ghana, Kenya and Malawi. Children receive four doses of the vaccine the first three between age 5 to 9 months, and the fourth dose at age 2. According to WHO, more than 2.3 million doses of the vaccine have been administered during the program.
WHO said the program has demonstrated that the vaccine has a strong safety profile, is feasible to deliver — even in the context of the COVID-19 pandemic — and has been able to “reach the unreached,” in that the program increased access equity for malaria prevention.
There has been no decrease in the use of insecticide-treated bed nets — another disease-cutting tool — or uptake of other childhood vaccinations or health-seeking behavior for febrile illness, WHO reported. It said the vaccine has reduced severe malaria by 30%, even in areas where insecticide-treated nets are widely used and people have good access to malaria care.
Additional data showed that layering the vaccine with the use of bed nets resulted in over 90% of children benefiting from at least one of the two interventions.
According to WHO, there were 229 million reported cases of malaria worldwide in 2019, including 409,000 deaths. More than 90% of cases occur in Africa.
A report published recently in The New England Journal of Medicine detailed more evidence of malaria in Africa that is resistant to the main component of first-line treatments. Another study found that seasonal vaccination with RTS,S/AS01 in combination with seasonal chemoprevention reduced malaria episodes and deaths by 70% among children in two African countries.
"For centuries, malaria has stalked sub-Saharan Africa, causing immense personal suffering,” WHO Regional Director for Africa Matshidiso Moeti, MD, MPH, said in a statement. “Today’s recommendation offers a glimmer of hope for the continent which shoulders the heaviest burden of the disease, and we expect many more African children to be protected from malaria and grow into healthy adults.”
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