WHO recommends R21/Matrix-M vaccine for malaria prevention in updated advice on immunization

Oct. 3, 2023
WHO recommendations.

The World Health Organization (WHO) has recommended a new vaccine, R21/Matrix-M, for the prevention of malaria in children. The recommendation follows advice from the WHO: Strategic Advisory Group of Experts on Immunization (SAGE) and the Malaria Policy Advisory Group (MPAG) and was endorsed by the WHO Director-General following its regular biannual meeting held on September 25-29.

WHO also issued recommendations on the advice of SAGE for new vaccines for dengue and meningitis, along with immunization schedule and product recommendations for COVID-19. 

Key features of the R21 malaria vaccine:  

The updated WHO malaria vaccine recommendation is informed by evidence from an ongoing R21 vaccine clinical trial and other studies, which showed:

  • High efficacy when given just before the high transmission season
  • Good efficacy when given in an age-based schedule
  • High impact
  • Cost effectiveness
  • Similarity of R21 and RTS,S vaccines
  • Safety

Recommendations on dengue

  • The live-attenuated quadrivalent dengue vaccine developed by Takeda (TAK-003) has demonstrated efficacy against all four serotypes of the virus in baseline seropositive children (4-16 years) in endemic countries and against serotypes 1 and 2 in baseline seronegative children.
  • SAGE recommended that the vaccine be considered for introduction in settings with high dengue disease burden and high transmission intensity to maximize the public health impact and minimize any potential risk in seronegative persons. 
  • SAGE recommended that the vaccine be introduced to children aged 6 to 16 years of age. Within this age range, the vaccine should be introduced about 1-2 years prior to the age-specific peak incidence of dengue-related hospitalizations. The vaccine should be administered in a 2-dose schedule with a 3-month interval between doses.

Recommendations on meningitis

  • SAGE recommended that all countries in the African meningitis belt introduce the novel pentavalent meningococcal conjugate vaccine targeting serogroups A, C, Y, W and X (Men5CV) into their routine immunization programs in a single-dose schedule at 9 to 18 months of age.  
  • In high-risk countries, and countries with high-risk districts, a catch-up campaign should also be conducted at the time of the introduction of Men5CV, targeting all individuals aged 1 to 19 years.  

  Recommendations on COVID-19

  • SAGE recommended a simplified single-dose regime for primary immunization for most COVID-19 vaccines which would improve acceptance and uptake and provide adequate protection at a time when most people have had at least one prior infection.

WHO release