Malaria is a deadly parasitic disease that is transmitted to humans by mosquitoes. It is common in tropical areas. This illness can cause mild symptoms like fever, chills, and headaches and escalate to severe symptoms. If treatment is delayed, malaria can lead to extreme conditions like kidney failure and seizures. Fortunately, there’s a recent malaria vaccine approved and recommended for use by the World Health Organization (WHO) to tackle the viral disease. One expert said malaria could be eliminated by 2040 through the vaccine.
What Is The R21 Vaccine?
The R21/Matrix-M™ vaccine involves Novavax AB proprietary saponin-based Matrix-M adjuvant and is authorized to and produced by the Serum Institute of India Private Ltd (SII). It is the second malaria vaccine recommended by WHO, after the RTS,S/AS01 vaccine, which was recommended by WHO in 2021. The vaccine was developed by the University of Oxford Jenner Institute, located in England.
Approval And Impact Of New Malaria Vaccine
Although the phase 3 data for the R21 vaccine is still pending publication, phase 2 data was published in September, revealing significant effectiveness after a fourth booster dose. Lead scientist Adrian Hill at the Jenner Institute, Oxford University, noted that the unpublished phase 3 data demonstrates an identical vaccine performance as in the phase 2 trial.
Ghana’s Food and Drugs Authority (FDA Ghana) has evaluated this trial data and authorized the vaccine for use in children aged 5 to 36 months, highly prone to death from malaria.
This new vaccine follows closely after the approval of the RTS,S in October 2021 by the World Health Organization (WHO). Four doses of the RTS,S vaccine led to a 39% reduction in clinical malaria cases and a 30% decrease in severe malaria. Due to the enormous burden malaria places on families, communities, and economies globally, this is important, and one million children have accessed the vaccine in pilot roll-outs since 2019. A second effective new vaccine could change the world’s malaria response.
How R21/Matrix-M Vaccine Targets The Malaria Parasite?
After biting a person, the anopheles mosquito, which carries the malaria parasite, injects it into the bloodstream, transforming it through several stages of its life cycle. The complex nature of the malaria parasite’s life cycle has led to vaccine development. The R21/Matrix-M vaccine targets the plasmodium ‘sporozoite,’ representing the initial stage of the malaria parasite entry into the human body.
Infected mosquitoes inject only a small number (10–100) of sporozoites before the parasite multiplies, making them the primary target for a vaccine. R21 is a subunit vaccine that provides components of a protein secreted by the sporozoite, together with an element of the hepatitis B virus responsible for stimulating a robust immune response.
Moreover, the vaccine includes Novavax’s Matrix-M, an “adjuvant” that enhances the immune system response to make it highly effective and durable. Vaccines present the antigen, a part of the virus or bacteria, to our immune cells, enabling them to identify and respond to it. This technology, recently used in Novavax’s COVID-19 vaccine, triggers the arrival of antigen-presenting cells at the injection site and improves antigen presentation in local lymph nodes, resulting in full activation of the immune system.
Prospects For Wider Use And Complementary Role
Formal results from the ongoing phase 3 trial involving 4,800 children across Burkina Faso, Kenya, Mali, and Tanzania will be released by year-end. WHO is now evaluating whether to prequalify the vaccine for broader use. If it is recommended by WHO, Gavi and UNICEF can initiate funding and procuring doses quickly to protect children across Africa. Nevertheless, it will not substitute RTS,S but complement it – Gavi has authorized funding for a malaria vaccine program and will encourage the rollout of R21 and RTS,S.
Partnership To Make More Malaria Vaccines
The Oxford team has agreed with the Serum Institute of India to manufacture 200 million doses yearly so that it won’t face manufacturing challenges of several vaccines like COVID-19 vaccines. This is essential because simultaneously vaccinating individuals at high risk of malaria will reduce the spread of disease and protect the vaccinated.
Ghana To Produce Vaccines Locally With Indian Support
Serum Institute of India has declared a technology transfer agreement to manufacture the vaccine in Ghana, which can commence once a manufacturing facility is established in Accra. The COVID-19 pandemic revealed that depending on vaccine production in a few countries that distribute doses to various locations faces potential challenges and is usually more expensive. Countries such as Brazil and India already have remarkable manufacturing capacity, but it’s crucial to build local vaccine production capacity across Africa.
The R21/Matrix-M malaria vaccine gives hope, pending phase 3 data, toward eradicating malaria. Oxford made and manufactured it in India to complement the existing RTS,S vaccine. Partnerships promote production stability, and technology transfer to Ghana encourages local production, a step that can help to end malaria by 2040, as experts suggest.