Introduction:In malaria-stricken regions, malaria continues to be one of the primary causes of mortality for children. The number of malaria-related fatalities has drastically decreased because of artemisinin-based pharmacological regimens. Methods: Two independent researchers did a comprehensive literature search using PubMed/MEDLINE and Google Scholar from its inception to September 2022.Results: After evaluating RTS, S/AS01 for its safety, effectiveness, and feasibility, the European Medicines Agency (EMA) issued a favorable conclusion. It was suggested that the RTS, S malaria vaccine be used extensively by the World Health Organization on October 6, 2021. The successful pilot program testing the malaria vaccine in Ghana, Kenya, and Malawi served as the basis for this proposal. Conclusion: Several challenges need to be addressed to ensure the success of vaccination programs. From the acceptability perspective, issues such as inadequate community engagement, concerns about side effects, and issues with the delivery and quality of healthcare services can affect the acceptance of the vaccine. From the feasibility standpoint, factors such as lack of transportation or long distances to healthcare facilities and the perception of completion of the vaccination calendar can affect the feasibility of the vaccine. Lastly, the availability of the vaccine is also a major concern as it may not be readily available to meet the demands.

Malaria remains the most serious infectious disease and is one of the leading causes of death among children in malaria endemic areas. The development of malaria vaccines has been underway since 1960s. Significant progress in the development of vaccine has been made in the last decade. On 6 October 2021, World Health Organization recommended widespread use of the RTS, S/AS01 malaria vaccine. The level of acceptance of RTS, S/AS01 malaria vaccine is relatively low in middle-income countries. This might be because of lack of information regarding vaccine implementation in such countries. The proper and efficient execution of the malaria vaccination program necessitates careful consideration of each community's socio-cultural setting. The most prominent RTS, S/AS01 vaccine trial was conducted from 2009 to 2011 in which eleven sites in seven African countries participated. Results of the trial, published in 2015, provided a promising advance in the development of a malaria vaccine for African children. As of 2019, large-scale pilot studies of the vaccine have been conducted in Ghana, Kenya, and Malawi, involving several hundreds of thousands of infants. The RTS, S/AS01 vaccine shows modest efficacy against malaria and has a feasible mode of administration. Although there is increased risk of meningitis, cerebral malaria, pneumonia, anemia, febrile convulsions and gastroenteritis, the vaccine still has a feasible mode of administration and high cost effectiveness and can be easily implemented in resource-limited settings.

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