Immunization, Vaccines and Biologicals

Pilot implementation of first malaria vaccine recommended by WHO

29 January 2016

Malawi children awaiting vaccination
UN/E. Schneider

In a new position paper published in today’s edition of the Weekly Epidemiological Record, WHO recommends the implementation of pilot projects to understand how to best use a vaccine that protects against malaria in young children.

WHO recognizes the importance of malaria due to Plasmodium falciparum as the most deadly malaria parasite globally and most prevalent in sub-Saharan Africa. Despite considerable scale-up of life-saving interventions, malaria transmission, morbidity and mortality remain high in many endemic settings. Prevention needs to be further strengthened and new life-saving tools are needed.

The RTS,S/AS01 vaccine considered in this position paper has been evaluated in a large Phase 3 trial and received a positive regulatory assessment. However, a number of uncertainties need to be resolved in order to assess the advisability of introducing the vaccine for routine use. A highly critical issue is the extent to which the protection demonstrated in children aged 5 to 17 months in the Phase 3 trial can be replicated in the context of routine health systems, particularly in view of the need for a 4-dose schedule that requires new immunization contacts.

WHO therefore recommends further evaluation of RTS,S/AS01 in a series of pilot implementations addressing several gaps in knowledge, before considering wider country level introduction. This is an important step in the process toward making the first malaria vaccine RTS,S/AS01, available alongside existing tools currently recommended for malaria prevention, diagnosis, and treatment.

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