WHO Approves World’s First Malaria Vaccine: All You Need To Know

The World Health Organisation (WHO) on Wednesday, 6 October, endorsed the world's first malaria vaccine, RTS,S/ASO1 (RTS.S), also known as Mosquirix, that has shown to have the capability of significantly reducing life-threatening disease.

The recommendation is based on results from an ongoing pilot programme in Ghana, Kenya and Malawi that has reached more than 8,00,000 children since 2019, according to the WHO.

Malaria remains a primary cause of childhood illness and death in sub-Saharan Africa. More than 2,60, 000 African children under the age of five die from malaria annually, the WHO said.

“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 Dr Tedros Adhanom Ghebreyesus said.

“Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year,” he added.

What is Mosquirix?

Mosquirix is a vaccine that is given to children aged 6 weeks to 17 months to help protect against malaria caused by the parasite Plasmodium falciparum, according to the European Medicines Agency.

Mosquirix also helps protect against infection of the liver with the hepatitis B virus but should not be used only for this purpose.

The vaccine was developed by GlaxoSmithKline in 1987.

How is the vaccine used?

WHO has recommended that in the context of comprehensive malaria control, 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 as defined by it.

The malaria vaccine should be provided in a schedule of 4 doses in children from 5 months of age for the reduction of malaria disease and burden.

Mosquirix is given as a 0.5 ml injection into a muscle of the thigh or in the muscle around the shoulder. The child is given three injections with one month between each injection.

A fourth injection is recommended 18 months after the third. Mosquirix can only be obtained with a prescription.

How does Mosquirix work?

The European Medicines Agency says that the active substance in Mosquirix is made up of proteins found on the surface of the Plasmodium falciparum parasites and the hepatitis B virus.

When the vaccine is administered to a child, the immune system recognises the 'foreign' proteins from the parasite and makes antibodies against them.

The immune system will then be able to produce antibodies more quickly when the child is naturally exposed to the malaria parasites in the future.

What is its efficacy?

An analysis of the vaccine revealed that it had 30 percent effectiveness in preventing severe cases of malaria in children.

To date, more than 2.3 million doses of the vaccine have been administered in 3 African countries – the vaccine has a favorable safety profile, according to the WHO.

Azra Ghani, chair of infectious diseases at Imperial College London, said she and colleagues estimate that giving the malaria vaccine to children in Africa might result in a 30 percent reduction overall, with up to eight million fewer cases and as many as 40,000 fewer deaths per year.

What are the side effects?

The WHO said that side effects were rare, but a fever that could result in temporary convulsions was one of them.

What are the other benefits of Mosquirix?

The WHO said the vaccine is feasible and increases equity in access to malaria prevention.

Data from the pilot programme showed that more than two-thirds of children in the 3 countries who are not sleeping under a bednet are benefitting from the vaccine, the WHO said.

It is also highly cost-effective.

Modelling estimates that the vaccine is cost effective in areas of moderate to high malaria transmission, the WHO said.

It reached more than two-thirds of children who don't have a bed-net to sleep under and there was no negative impact on other routine vaccines or other measures to prevent malaria.