Central Idea

In a momentous development in the fight against malaria, the World Health Organization (WHO) issued a recommendation for the R21/Matrix-M malaria vaccine on October 2.
This pioneering vaccine, developed by the University of Oxford and manufactured by India’s Serum Institute, has already gained approval for use in children under 36 months in Nigeria, Ghana, and Burkina Faso.

R21/Matrix-M Vaccine

Extensive Testing: The vaccine’s efficacy was rigorously assessed in a phase-3 trial involving 4,800 children across five sites in Mali, Burkina Faso, Kenya, and Tanzania. These sites vary in malaria transmission intensity and seasonality.
Blind Trial: Participants were randomly assigned to receive either the malaria vaccine or a control (approved rabies vaccine) in a double-blind study, ensuring impartiality.
Multi-Dose Regimen: The vaccination schedule comprised three doses administered 4 weeks apart, with a booster shot administered 12 months after the last dose.
Strategic Timing: Primary vaccinations occurred before the malaria season in seasonal transmission regions or at any time of the year in perennial transmission regions.

According to preprint data (pending peer review), the vaccine demonstrated a remarkable efficacy of 75% in children aged 5-36 months in seasonal malaria regions and 68% in perennial malaria regions after one year.
Notably, children aged 5-17 months, more vulnerable to severe malaria, exhibited even higher vaccine efficacy of 79% in seasonal regions and 75% in perennial regions.
Vaccine efficacy remained substantial for 18 months, further reinforced by a booster dose administered 12 months after the primary series.

Optimal Timing: Results suggest that the vaccine performs more effectively in regions with seasonal malaria compared to perennial transmission areas.
Seasonal Patterns: In seasonal sites, 82% of malaria episodes occurred in the first six months of follow-up, while only 26% occurred in the initial six months in perennial sites.
Vaccination Timing: Since the vaccine is administered just before the malaria season, its protection is more pronounced when malaria is seasonal.