The World Health Organization (WHO) recommends widespread use of the RTS,S/AS01 (RTS,S) malaria vaccine among children in sub-Saharan Africa and in other regions with moderate to high P. falciparum malaria transmission.
The recommendation is based on results from an ongoing pilot program in Ghana, Kenya, and Malawi that has reached more than 800 000 children since 2019.
“This is a historic moment. The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control,” said WHO Director-General Tedros Adhanom Ghebreyesus, PhD. “Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year.”
Malaria remains a primary cause of childhood illness and death in sub-Saharan Africa. More than 260,000 African children under the age of five die from malaria annually.
The WHO recommends that the malaria vaccine is provided in a schedule of 4 doses in children from 5 months of age for the reduction of malaria disease and burden.
Key findings from the pilots informed the recommendation based on data and insights generated from two years of vaccination in child health clinics. Findings include:
· Vaccine introduction is feasible, improves health and saves lives, with good and equitable coverage of RTS,S seen through routine immunization systems. This occurred even in the context of the COVID-19 pandemic.
· RTS,S increases equity in access to malaria prevention.
· Data from the pilot program showed that more than two-thirds of children in the 3 countries who are not sleeping under a bed net are benefitting from the RTS,S vaccine.
· Layering the tools results in over 90% of children benefitting from at least one preventive intervention (insecticide treated bed nets or the malaria vaccine).
· 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.
· No negative impact on uptake of bed nets, other childhood vaccinations, or health seeking behavior for febrile illness. In areas where the vaccine has been introduced, there has been no decrease in the use of insecticide-treated nets, uptake of other childhood vaccinations or health seeking behavior for febrile illness.
· Significant reduction (30%) in deadly severe malaria, even when introduced in areas where insecticide-treated nets are widely used and there is good access to diagnosis and treatment.
· Modelling estimates that the vaccine is cost effective in areas of moderate to high malaria transmission.