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Malaria Vaccine: A Silver Bullet?

Author: Jason Lin

Date: December 5, 2021


Every 2 minutes, a child dies of Malaria: often in pain, under a coma, and completely helpless. According to the CDC, “more than 200 million new cases of the disease are reported.” and another of those 1-3 million die each year (Medscape).


Malaria itself isn’t caused by one parasite. Rather Malaria, the disease, is caused by a host of 5 parasites, Plasmodium, species P. falciparum is the most deadly. Malaria generally begins with mild fever, headache, and chills 10–15 days after infection. Left untreated, P. falciparum malaria can cause severe illness and death. According to the CDC, Malaria is endemic to Africa but most prominent in the Sub-Saharan African region: “Six countries accounted for approximately half of all malaria deaths worldwide: Nigeria (23%), the Democratic Republic of the Congo (11%), United Republic of Tanzania (5%), Burkina Faso (4%), Mozambique (4%) and Niger (4%).”


See: “Malaria” for more information.


The Malaria vaccine, RTS,S promises new hope for the eradication of Malaria and free the world from its insufferable grasp.


"For centuries, malaria has stalked sub-Saharan Africa, causing immense personal suffering,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We have long hoped for an effective malaria vaccine and now for the first time ever, we have such a vaccine recommended for widespread use. 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.”


However, intriguingly, roots of a Malaria vaccine exist as long back as 2019. On April 23 2019, a WHO program tested the use of the vaccine, mosquito nets and insecticides against Malaria on children in Mawlai, Ghana, and Kenya. According to clinical trials, the immunization required four doses per child and prevented 40% of cases of Malaria and 30% of severe cases of Malaria.


“This is a bold thing to do, but it’s not a silver bullet,” Thomas Churcher, a malaria expert at Imperial College London, in an interview with the Associated Press. “As long as using the vaccine doesn’t interfere with other efforts, like the urgent need for new insecticides, it is a good thing to do.”


Despite, 40% seeming statistically low: it is far better than the current measures against Malaria which are available: see “Historic go-ahead for malaria vaccine to protect African children” for more. As Malaria is a parasite its lifecycle passes through a sporozoite and merozoite stage --- thus becoming very difficult to target and kill. The RTS,S vaccine specifically targets the sporozoite stage of Malaria and thus cuts off Malaria’s lifecycle from the source.





Infographic of Malaria’s life cycle provided by the CDC: https://www.cdc.gov/malaria/about/biology/


In the end, the pilot study was very successful and convinced the WHO to expand the scale of vaccine administration. Through the study, researchers found that the new vaccine was feasible to deliver, reached the unreached by increasing equity in access to malaria prevention, had no negative impact on uptake of bednets, other childhood vaccinations, or health seeking behavior for febrile illness, and was highly cost-effective.


Now, the WHO Is recommending that the RTS,S/AS01 malaria vaccine be used for the prevention of P. falciparum malaria in children living in regions with moderate to high transmission. The RTS,S/AS01 malaria vaccine will be administered in 4 doses to children from 5 months of age.


"The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control," Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said. "[It] could save tens of thousands of young lives each year." (BBC)



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