WHO recommends R21/Matrix-M malaria vaccine developed by Serum Institute of India and University of Oxford.


WHO recommends R21/Metrix-M vaccine for malaria (Image courtesy: Tom Wilkinson, University of Oxford)
WHO recommends R21/Metrix-M vaccine for malaria (Image courtesy: Tom Wilkinson, University of Oxford)

The World Health Organization (WHO) has approved its use. R21/Matrix-M Malaria vaccine, jointly developed by Oxford University and Serum Institute of India. This approval is obtained after the vaccine has successfully met all necessary safety criteria, and efficacy criteria.

WHO has also issued recommendations for new vaccines targeting dengue and meningitis, as well as guidance on immunization schedules and product recommendations for Covid-19. Additionally, WHO has issued important programmatic recommendations regarding polio, IA2030, and the maintenance of immunization programs.

The World Health Organization (WHO) has recommended the R21 vaccine as a second malaria vaccine with the RTS,S/AS01 vaccine approved in 2021. Both vaccines have been shown to be safe and effective in preventing malaria in children, with the potential to significantly improve public health. Especially in Africa where many children die from this disease. There is a high demand for malaria vaccines, but the limited supply of RTS,S is a concern. The addition of R21 to the WHO-recommended vaccine is expected to address this shortage and benefit children in malaria-endemic areas.

What is Matrix-M or R21?

gave R21/Matrix-M The vaccine is designed to target the initial stage of malaria parasite entry into the human body, focusing on the Plasmodium ‘sporozoite’. Infected mosquitoes ingest a relatively small number (10-100) of sporozoites before the parasite begins to replicate, making these sporozoites excellent candidates for vaccination.

This is what the WHO official says.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus expressed his excitement, saying, “As a malaria researcher, I dreamed of the day when we would have a safe and effective vaccine against malaria. Now we have There are two. The RTS,S vaccine is in excess supply, so this second vaccine is an important additional tool to protect more children sooner and bring us closer to our goal of a malaria-free future.”

Dr. Matshidiso Moeti, WHO Regional Director for Africa, emphasized the importance of this recommendation for the continent, saying, “This second vaccine has the potential to close a significant gap between demand and supply. The two vaccines prevent malaria and can strengthen control efforts, ultimately saving the lives of millions of young people in Africa from this deadly disease.”

Key Features of R21 Malaria Vaccine

The latest World Health Organization (WHO) malaria vaccine recommendation is based on evidence from ongoing clinical trials of the R21 vaccine and other research. Results include:

  1. Highest effectiveness when given just before peak malaria transmission season: In regions with highly seasonal malaria transmission, where the disease is prevalent for only 4 or 5 months of the year, the R21 vaccine reduced symptomatic malaria cases by 75% at 12 months after a three-dose series. Adding a fourth dose a year later maintained this high effectiveness, similar to the seasonal effectiveness of RTS,S.

  1. Effectiveness in an age-based schedule: The vaccine showed good efficacy (66%) in the year after the first three doses. A fourth dose given one year later maintained this effectiveness.

  2. Important public health effects: Mathematical models suggest that the R21 vaccine is expected to have substantial positive public health effects in a variety of malaria transmission settings, including areas with low transmission rates.

  3. Price Effectiveness: At prices ranging from US$2 to US$4 per dose, the cost-effectiveness of the R21 vaccine is comparable to other recommended malaria interventions and childhood vaccines.

  4. Similarities Between R21 and RTS,S Vaccines: The two WHO-recommended vaccines, R21 and RTS,S, have not been directly compared, and there is no evidence that one vaccine is superior to the other. The choice of which vaccine to use in a country should be based on program availability, vaccine availability, and affordability.

  5. Security: The R21 vaccine has demonstrated safety in clinical trials, and safety monitoring will continue, as is standard practice for new vaccines.

Next steps for the second proposed malaria vaccine, R21/Matrix-M, include completing the ongoing WHO prequalification process, which will enable international procurement of the vaccine for wider distribution.

A total of at least 28 African countries plan to introduce the WHO-recommended malaria vaccine as part of their national immunization programs. The Gavi Vaccine Alliance has agreed to provide technical and financial support for malaria vaccine rollout in 18 countries. The RTS, S vaccine is expected to be introduced in some African countries in early 2024, while the R21 malaria vaccine is expected to be available to countries in mid-2024.

First Published: 03 Oct 2023, 10:34 IST


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