malaria vaccine (Mosquirix; RTS,S)
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Indications
- prevention of Plasmodium falciparum malaria for children age 5-17 months
Dosage
- antigen-based vaccine
- 3-4 doses; 4 doses recommended (WHO)[8]
- booster 18 months after 3 doses improves vaccine efficacy (36% vs 28%)* during 48 month follow-up
* efficacy at least in part assessed by identification of malaria infections[3]
* vaccine is only 36% effective; protection fades after several months
* vaccine efficacy 4.4% at 7 years[5]
* all cases of severe malaria were seen > 2.7 years of follow-up after vaccination[5]
Adverse effects
Mechanism of action
- antigen-based vaccine
- antibodies to Plasmodium falciparum schizont egress antigen-1 (PfSEA-1), a 244 KD parasite antigen expressed in schizont-infected erythrocytes diminish parasite replication by arresting schizont rupture[2]
- sporozoite vaccine does not protect against blood-stage parasites; thus, vaccine may slow acquisition of immunity to blood-stage parasites & a rebound phenomenon may occur with high-level exposure to malaria[5]
- live attenuated Plasmodium falciparum[9]
Comparative biology
Notes
* approved by European Union, July 2015[4]
* approved by WHO October 2021[8]
* Smith-Kline Galaxo
More general terms
References
- ↑ 1.0 1.1 1.2 The RTS,S Clinical Trials Partnership First Results of Phase 3 Trial of RTS,S/AS01 Malaria Vaccine in African Children N Engl J Med, October 18, 2011 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22007715 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1102287
White NJ A Vaccine for Malaria N Engl J Med, October 18, 2011 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22007716 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1111777 - ↑ 2.0 2.1 Raj DK et al. Antibodies to PfSEA-1 block parasite egress from RBCs and protect against malaria infection. Science 2014 May 23; 344:871 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24855263
- ↑ 3.0 3.1 3.2 RTS,S Clinical Trials Partnership Efficacy and safety of RTS,S/AS01 malaria vaccine with or without a booster dose in infants and children in Africa: final results of a phase 3, individually randomised, controlled trial. Lancet. April 23, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25913272 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2960721-8/abstract
- ↑ 4.0 4.1 Reuters, July 24, 2015 http://www.msn.com/en-us/news/world/worlds-first-malaria-vaccine-gets-go-ahead-from-eu-regulators/ar-AAdqAQR
- ↑ 5.0 5.1 5.2 5.3 Olotu A et al. Seven-year efficacy of RTS,S/AS01 malaria vaccine among young African children. N Engl J Med 2016 Jun 30; 374:2519. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27355532 <Internet> http://www.nejm.org/doi/10.1056/NEJMoa1515257
Clemens J, Moorthy V. Implementation of RTS,S/AS01 malaria vaccine - the need for further evidence. N Engl J Med 2016 Jun 30; 374:2596 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27355540 <Internet> http://www.nejm.org/doi/10.1056/NEJMe1606007 - ↑ World Health Organization (WHO). April 24, 2017 Ghana, Kenya and Malawi to take part in WHO malaria vaccine pilot programme. http://www.afro.who.int/en/media-centre/pressreleases/item/9533-ghana-kenya-and-malawi-to-take-part-in-who-malaria-vaccine-pilot-programme.html
- ↑ 7.0 7.1 Walter Reed Army Institute of Research mRNA vaccine yields full protection against malaria in mice. MedicalXpress 2021 June 18. https://medicalxpress.com/news/2021-06-mrna-vaccine-yields-full-malaria.html
- ↑ 8.0 8.1 8.2 American Medical Association AMA Morning Rounds. Oct 7, 2021
Firozi P, Iati M, Cunningham E WHO endorses use of first malaria vaccine. Washington Post. October 6, 2021 https://www.washingtonpost.com/health/2021/10/06/who-malaria-vaccine-recommendation/
Mandavilli A A 'Historic event': First Malaria Vaccine Approved by W.H.O. New York Times. October 6, 2021 https://www.nytimes.com/2021/10/06/health/malaria-vaccine-who.html
Cheng M UN endorses world's 1st malaria vaccine as 'historic moment'. Associated Press (AP) October 6, 2021 https://apnews.com/article/malaria-vaccine-dcb917ea3fbd090484bfe6750d4ea58c
World Health Organization (WHO). WHO recommends groundbreaking malaria vaccine for children at risk. Historic RTS,S/AS01 recommendation can reinvigorate the fight against malaria. News Release. October 6, 2021. https://www.who.int/news/item/06-10-2021-who-recommends-groundbreaking-malaria-vaccine-for-children-at-risk - ↑ 9.0 9.1 9.2 9.3 Vaida B Malaria Vaccine Delivered by Mosquito Bite Shows Safety, Efficacy. Immunization led to protection against controlled infection in proof-of-concept study. MedPage Today, November 21, 2024 https://www.medpagetoday.com/infectiousdisease/generalinfectiousdisease/113051
Lamers OAC, Franke-Fayard BMD, Koopman JPR et al Safety and Efficacy of Immunization with a Late-Liver-Stage Attenuated Malaria Parasite. N Engl J Med. 2024 Nov 21;391(20):1913-1923. doi:http://dx.doi.org/ 10.1056/NEJMoa2313892. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39565990 Clinical Trial. https://www.nejm.org/doi/full/10.1056/NEJMoa2313892