Mosquirix, first malaria vaccine approved by WHO: All you need to know

Washington, Oct 07: The World Health Organization on Wednesday endorsed the RTS,S/AS01 malaria vaccine - also known as Mosquirix - the first against the mosquito-borne disease that kills more than 400,000 people a year, mostly African children.

The decision followed a review of a pilot programme deployed since 2019 in Ghana, Kenya and Malawi in which more than two million doses were given of the vaccine, first made by the pharmaceutical company GSK in 1987.

A child dies from #malaria every two minutes.
One death is one too many.

🚨 Today, WHO recommends RTS,S, a groundbreaking malaria vaccine, to reduce child illness & deaths in areas with moderate and high malaria transmission https://t.co/xSk58nTIV1#VaccinesWork pic.twitter.com/mSECLtRhQs

— World Health Organization (WHO) (@WHO) October 6, 2021

The recommendation is based on results from an ongoing pilot programme 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 Dr Tedros Adhanom Ghebreyesus. "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.

In recent years, WHO and its partners have been reporting a stagnation in progress against the deadly disease.

"For centuries, malaria has stalked sub-Saharan Africa, causing immense personal suffering," said Dr Matshidiso Moeti, WHO Regional Director for Africa. "We have long hoped for an effective malaria vaccine and now for the first time ever, we have such a vaccine recommended for widespread use. Today's recommendation offers a glimmer of hope for the continent which shoulders the heaviest burden of the disease and we expect many more African children to be protected from malaria and grow into healthy adults."

WHO recommendation for the RTS,S malaria vaccine

Based on the advice of two WHO global advisory bodies, one for immunization and the other for malaria, the Organization recommends that:

WHO recommends 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 WHO. RTS,S/AS01 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.

Summary of key findings of the malaria vaccine pilots

Key findings of the pilots informed the recommendation based on data and insights generated from two years of vaccination in child health clinics in the three pilot countries, implemented under the leadership of the Ministries of Health of Ghana, Kenya and Malawi. Findings include:

Feasible to deliver: 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.

Reaching the unreached: RTS,S 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 RTS,S vaccine.

Layering the tools results in over 90% of children benefitting from at least one preventive intervention (insecticide treated bednets or the malaria vaccine).

Strong safety profile: 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 bednets, 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.

High impact in real-life childhood vaccination settings: 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.

Highly cost-effective: Modelling estimates that the vaccine is cost effective in areas of moderate to high malaria transmission.