Five things concerning the new R21 malaria vaccine that you should be aware of

Five things concerning the new R21 malaria vaccine that you should be aware of

The first nation to approve a novel malaria vaccine that has the potential to save millions of lives in some of the world's most malaria-prone areas is Ghana. The new vaccination has five important aspects that you should be aware of.

mosquito biting

The eagerly awaited R21 malaria vaccine, which might protect millions from the mosquito-borne illness, has been approved by Ghana, becoming the first nation in the world to do so. A kid dies from the disease every minute around the world, and in Ghana alone there were 5.3 million cases and 12,500 fatalities in 2021.

Only the second vaccine designed for a disease that has caused unimaginable agony for millennia, the R21/Matrix-M malaria vaccine was created by the University of Oxford and being produced and scaling through the India Serum Institute (IIS).

The plasmodium "sporozoite," the initial form of the malaria parasite to enter the human body, is the target of the R21/Matrix-M vaccine.

Despite the lack of a vaccine, significant progress was made between 2000 and 2015 in reducing infections and fatalities through vector control and antimalarials, which led to discussions of going beyond the goal of elimination towards malaria eradication. However, since 2015, there has been a significant decline in progress, which the COVID-19 epidemic further exacerbated. Now, it is hoped that deploying vaccines in conjunction with other infection-reduction strategies will be a game-changer.

1. Initial reports indicate that the vaccine may have a major effect.

While the phase 3 data for the R21 vaccination has not yet been released, the phase 2 data, which showed great efficiency after a fourth booster dosage, was released in September. Lead researcher Adrian Hill at the Jenner Institute, Oxford University, claims that the phase 3 data—which has not yet been published—indicates that the vaccine performed similarly to how it did in the phase 2 experiment.

The vaccine has been licenced for use in children between the ages of 5 and 36 months, who are most at risk for dying from malaria, after the Food and Drugs Authority (FDA Ghana) of Ghana evaluated the trial data.

This new vaccine follows the RTS,S vaccine, which the World Health Organisation (WHO) authorised in October 2021, closely. RTS,S vaccination reduces clinical malaria cases by 39% and severe malaria cases by 30% after four doses. This is noteworthy given the severe toll malaria takes on families, communities, and economies around the world, and the vaccine has already been administered to one million kids in pilot roll-outs since 2019. The global response to malaria could change if a second potential vaccine proves to be effective.

2. The vaccination specifically targets the parasite's early stages of life

The malaria parasite, which changes shape throughout its life cycle, enters a person's circulation when the anopheles insect that transmits it bites them. The development of vaccines has been stymied for years due to the malaria parasite's intricate life cycle. The plasmodium "sporozoite," the initial form of the malaria parasite to enter the human body, is the target of the R21/Matrix-M vaccine.

The optimal target for a vaccination is infected mosquitoes because they only inject a few number (10–100 sporozoites) before the parasite grows. A portion of a protein released by the sporozoite is packaged with a portion of the hepatitis B virus known to elicit a potent immunological response in the subunit vaccine R21.

Additionally, the vaccine contains Matrix-M from Novavax, a "adjuvant" that strengthens and prolongs the immunological response. The mechanism by which vaccines function is to expose our immune cells to the antigen, which is the component of the virus or bacteria that our body recognises and reacts to. By inducing the influx of antigen-presenting cells at the injection site and enhancing antigen presentation in nearby lymph nodes, the technology utilised in Novavax's COVID-19 vaccination ensures that the immune system is triggered as forcefully as possible.

3. The WHO could approve the roll-out of vaccines at any time.

By the end of the year, formal findings from the ongoing phase 3 trial including 4,800 kids in Burkina Faso, Kenya, Mali, and Tanzania are anticipated. The WHO is currently deciding whether to approve the vaccine for more widespread usage. If the WHO does recommend it, Gavi and UNICEF could start paying and acquiring doses right away to safeguard children in Africa.

Although Gavi has already approved money for a malaria vaccination programme and is prepared to assist the spread of R21 alongside RTS,S, the objective is not to replace RTS,S but to be complimentary to it.

4. Supply and demand ought to be balanced.

The Oxford team has an agreement with Serum Institute of India to produce up to 200 million doses annually, so the vaccine won't experience the same production constraints that many vaccines, including the COVID-19 vaccines, have faced.

This is crucial because immunising those who are at high risk of malaria at the same time will help stop the disease's spread and protect those who have already received the vaccine.

5. Local production in Ghana could result from tech transfer

An agreement for the transfer of technology to make the vaccine in Ghana was announced by the Serum Institute of India. As soon as an Accra production plant is finished, this can begin.

The COVID-19 pandemic made it abundantly evident that depending on vaccine manufacture in a small number of nations and then shipping doses to the locations where they are required is risky and frequently more expensive. Although nations like Brazil and India already have strong manufacturing capacities, it is crucial to develop local vaccine production capability throughout Africa.