ICF: Seasonal R21 mass vaccination for malaria elimination

Since 2000, the malaria burden in sub-Saharan Africa has substantially decreased thanks to the scale up of standard control interventions such as insecticide treated bed nets. However, progress has stalled since 2014, particularly in countries with moderate to high transmission. New interventions able to further reduce malaria transmission are needed.

Mathematical models suggest that mass vaccination with a pre-erythrocytic vaccine before the malaria transmission season could have a major impact on transmission. The development of malaria vaccines has targeted mainly infants as children under 5 are those at higher risk of severe malaria and death. The World Health Organization recently approved RTS,S/AS01, the first malaria vaccine recommended for children from 5 month of age. However, there are other malaria vaccine candidates under development, of which R21 is the most advanced as it has recently shown excellent protective efficacy against clinical malaria in children. Both RTS,S/AS01 and R21 are pre-erythrocytic vaccines as they target the stage of the malaria parasite that is injected by infected mosquitoes into humans. Therefore, if administered to the whole population, they could decrease transmission by reducing the proportion of successful infections by the vector. However, mass vaccination for malaria control has never been evaluated. The availability of R21 offers a unique opportunity for such an evaluation.

MRC funding details

Health Systems & Op. Research
Tools for Elimination
Vaccines (Immune Correlates)

Sep 2023 — Aug 2026

$3.53M

Burkina Faso
The Gambia