The R21/Matrix-M Vaccine for Children: A Milestone in the Fight Against Malaria

2023-10-06 09:33:50

A panel of key experts from the World Health Organization (WHO) yesterday recommended approval of the R21/Matrix-M vaccine for use in children at risk of malaria caused by the parasite Plasmodium falciparum, marking a significant milestone in the global effort to combat this disease. WHO Director-General Tedros Ghebreyesus called the news “a great day for health, a great day for science and a great day for vaccines.”

This recommendation comes from the WHO Senior Advisory Group on Immunization, which is comprised of the Strategic Advisory Group of Experts on Immunization (SAGE) and the Malaria Policy Advisory Group (MPAG). It makes the R21/Matrix-M vaccine the second recommended vaccine once morest malaria, following the approval of the RTS,S/AS01e vaccine in 2021.

“The joint WHO SAGE and MPAG recommendation of the R21/Matrix-M vaccine represents another major step forward towards our goal of creating a malaria-free life for every child.”

– David Marlow, Executive Director of Gavi

Although the two vaccines have not been directly compared, Dr. Dyann Wirth, president of the MPAG Group, noted that there is “every indication that they will be very similar,” with an effectiveness of around 75%. when given to young children in areas of high and moderate seasonal transmission.

Strengthening the offer

A crucial aspect is that the R21/Matrix-M vaccine, developed at the Jenner Institute at the University of Oxford, has the potential to quickly help bridge the gap between supply and demand for an effective vaccine once morest malaria.

With demand for the vaccine already outstripping supply, with around 18 million doses of RTS,S/AS01 available through the end of 2025, R21/Matrix-M’s manufacturer, the Serum Institute of India, aims to provide more than 100 million doses per year, which might expand access and “have a significant impact on public health,” according to Wirth.

The approval of the new vaccine is welcomed by those fighting malaria globally, hoping it will strengthen efforts to expand access to safe and effective malaria vaccines, as part of a strategy comprehensive approach to control and eradicate the disease by 2030.

David Marlow, CEO of Gavi, said: “The joint recommendation of SAGE and WHO MPAG of the R21/Matrix-M vaccine represents another major step forward towards our goal of creating a malaria-free life for every child. This vaccine, combined with the existing RTS,S/AS01 vaccine, will be an effective complement to current malaria interventions. Once it receives WHO prequalification, it will play a key role in meeting the high demand we are seeing in countries endemic.”

Progress that stagnates

The announcement comes at a time when efforts to control and eradicate malaria have stagnated or regressed in parts of Africa. Climate change has allowed the mosquito Anopheleswhich spreads the malaria parasite, to expand into new territories.

At the same time, the increase in frequency and severity of extreme weather events has hampered efforts to control mosquito populations. Additionally, growing resistance to the most widely available insecticides and drugs has begun to erode the effectiveness of key disease prevention and treatment measures.

Faced with this situation, African heads of state used the UN General Assembly in September to call for urgent measures and increased funding to get back on the path to eradicating malaria on the continent. In 2021, the vast majority (95%) of the approximately 247 million cases and 619,000 deaths from malaria were recorded in sub-Saharan Africa, with the majority of deaths affecting children under 5 years old.

Before making their decision, the WHO joint SAGE-MPAG group reviewed evidence, including new findings from a phase 3 randomized controlled trialwhich showed that the vaccine was safe and provided a high level of protection once morest clinical malaria in African children.

How these vaccines work

Both the RTS.S/AS01e vaccine and the new R21/Matrix-M vaccine work by signaling the malaria parasite to the body’s immune system at an early stage in the parasite’s life cycle, before it has a chance to multiply. By packaging a protein from the malaria parasite with a protein from the hepatitis B virus, which typically triggers a strong immune response, vaccines can train the immune system to target the parasite when it is most vulnerable, immediately following entry. in its new host. The Matrix-M component of the R21 vaccine also acts as a powerful adjuvant, helping the immune system mount a stronger and more sustained response once morest the parasite.

While the decision to approve the vaccine is welcomed, Dr. Michael Charles, CEO of the Malaria Partnership, expressed a note of caution in emphasizing that there is no silver bullet to end the malaria. He noted that significant obstacles still needed to be overcome, including significant funding gaps.

But on the day the Nobel Prize in Physiology and Medicine was awarded to researchers whose work led to the development of messenger RNA vaccines once morest COVID-19, the WHO Director-General was optimistic regarding the potential of vaccines once morest malaria to be just as revolutionary. “I dreamed of the day when we would have a safe and effective vaccine once morest malaria,” he recalled. “Now we have two.”

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