Acceptance, availability and feasibility of RTS, S/AS01 malaria vaccine

Abstract

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.

Hesitancy towards R21/Matrix-M malaria vaccine among Ghanaian parents and attitudes towards immunizing non-eligible children: a cross-sectional survey

“…These results attract attention to the importance of spreading health messages about the new vaccine through healthcare workers and common channels of information like mass media and social platforms. The more the government invests in delivering the correct information, the lower the hesitancy rate for the R21/Matrix-M malaria vaccine [ 20 , 30 ].…”

Policy uptake and implementation of the RTS,S/AS01 malaria vaccine in sub-Saharan African countries: status 2 years following the WHO recommendation

“…The evaluation confirmed the vaccine's safety and demonstrated the feasibility of implementation within the existing Essential Programme on Immunization (EPI) in resource-limited settings. 15 Despite recent progress with RTS,S/AS01, its efficacy falls well below WHO's strategic goal set in 2013: 'By 2030, licensed malaria vaccines should have 75% or higher vaccine efficacy against clinical malaria with duration of protection demonstrated over at least two years'. 16 A second malaria vaccine, R21/Matrix-M, developed by the University of Oxford, UK and recommended by the WHO for widespread use in October 2023, was the first to achieve the WHO-specified targets with a vaccine efficacy of 78% (95% CI 71% to 83%) in the second year of follow-up following three primary series doses and a booster dose administered seasonally in phase II trials.…”

Revolutionizing malaria prevention: RSTS vaccine takes center stage in Afghanistan: correspondence

“…To overcome this challenge, partnerships between international organizations, governments, and vaccine manufacturers can be forged to negotiate affordable pricing and secure funding for vaccine procurement. In addition, efforts should be made to ensure equitable access to the vaccine, especially in remote and underserved areas, by establishing distribution networks and strengthening health care infrastructure [7] .…”

“…It is crucial to address these challenges through targeted public awareness campaigns. Information about the vaccine's safety, efficacy, and benefits should be communicated transparently to the public through various channels, including community engagement, media outlets, and social media platforms [7] . Building trust among communities, addressing concerns, and involving influential community leaders and religious authorities can help counter vaccine hesitancy and combat misinformation effectively.…”