Integration of the RTS,S/AS01 malaria vaccine into the Essential Programme on Immunisation in western Kenya: a qualitative longitudinal study from the health system perspective

Increasingly extreme weather events in high malaria burden areas threaten progress to disease control targets. Yet, data on the impact of these events on control programs remain rare. Using unique data from Madagascar, we estimate high rates of infection in the wake of two major tropical cyclones. Evidence that infection rebounds rapidly during gaps in interventions indicates maintaining continuity of coverage is crucial to limiting burden. Relative to other interventions, recently available malaria vaccines have a longer duration of protection, with the potential to address interruptions in prevention deployment. Evaluating this use case, we quantify the reduction in symptomatic infections expected for a range of vaccination scenarios. We find long-lasting interventions such as vaccination are a key mitigation measure against climatic disruptions to disease control.

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

Osoro,

Ochodo,

Kwambai

et al. 2024

BMJ Glob Health

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In October 2021, the WHO recommended the world’s first malaria vaccine—RTS,S/AS01—to prevent malaria in children living in areas with moderate-to-high transmission in sub-Saharan Africa (SSA). A second malaria vaccine, R21/Matrix-M, was recommended for use in October 2023 and added to the WHO list of prequalified vaccines in December 2023. This study analysis assessed the country status of implementation and delivery strategies for RTS,S/AS01 by searching websites for national malaria policies, guidelines and related documents. Direct contact with individuals working in malaria programmes was made to obtain documents not publicly available. 10 countries had documents with information relating to malaria vaccine implementation, 7 referencing RTS,S/AS01 and 3 (Burkina Faso, Kenya and Nigeria) referencing RTS,S/AS01 and R21/Matrix-M. Five other countries reported plans for malaria vaccine roll-out without specifying which vaccine. Ghana, Kenya and Malawi, which piloted RTS,S/AS01, have now integrated the vaccine into routine immunisation services. Cameroon and Burkina Faso are the first countries outside the pilot countries to incorporate the vaccine into national immunisation services. Uganda plans a phased RTS,S/AS01 introduction, while Guinea plans to first pilot RTS,S/AS01 in five districts. The RTS,S/AS01 schedule varied by country, with the first dose administered at 5 or 6 months in all countries but the fourth dose at either 18, 22 or 24 months. SSA countries have shown widespread interest in rolling out the malaria vaccine, the Global Alliance for Vaccines and Immunization having approved financial support for 20 of 30 countries which applied as of March 2024. Limited availability of RTS,S/AS01 means that some approved countries will not receive the required doses. Vaccine availability and equity must be addressed even as R21/Matrix-M becomes available.

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Integration of the RTS,S/AS01 malaria vaccine into the Essential Programme on Immunisation in western Kenya: a qualitative longitudinal study from the health system perspective

Cited by 5 publications

References 17 publications

The value of longitudinal qualitative approaches in vaccination pilot studies

The value of longitudinal qualitative approaches in vaccination pilot studies

Evidence from Madagascar shows that vaccination could mitigate climate-driven disruptions to malaria control

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

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