A major challenge facing malaria vaccine development programs is identifying efficacious combinations of antigens. To date, merozoite surface protein 1 (MSP1) is regarded as the leading asexual vaccine candidate. Apical membrane antigen 1 (AMA1) has been identified as another leading candidate for an asexual malaria vaccine, but without any direct in vivo evidence that a recombinant form of Plasmodium falciparum AMA1 would have efficacy. We evaluated the efficacy of a form of P. falciparum AMA1, produced in Pichia pastoris, by vaccinating Aotus vociferans monkeys and then challenging them with P. falciparum parasites. Significant protection from this otherwise lethal challenge with P. falciparum was observed. Five of six animals had delayed patency; two of these remained subpatent for the course of the infection, and two controlled parasite growth at <0.75% of red blood cells parasitized. The protection induced by AMA1 was superior to that obtained with a form of MSP1 used in the same trial. The protection induced by a combination vaccine of AMA1 and MSP1 was not superior to the protection obtained with AMA1 alone, although the immunity generated appeared to operate against both vaccine components.Many malaria vaccine strategies, including our own, depend on including multiple asexual antigens in order (i) to improve coverage of polymorphisms in field isolates, (ii) to overcome individual nonresponsiveness to some antigens, (iii) to improve vaccine efficacy by eliciting immunity to multiple targets, and (iv) to prevent or delay the evolution of escape mutants. If we include two different antigens in a vaccine combination, ideally, synergy in protection will be induced.The most extensive experience in vaccine trials with New World monkeys has been obtained with the C-terminal 42-kDa portion of merozoite surface protein 1 (MSP1 42 ) (3,10,17,18). Recombinant forms of MSP1 42 have been efficacious against homologous parasite challenges, and MSP1 42 is regarded as a leading asexual vaccine candidate.We have now produced a second antigen, Plasmodium falciparum apical membrane antigen 1 (AMA1) (see reference 13a), and in the present study we test the efficacy of this antigen, both alone and in combination with MSP1 42 , in a vaccine trial with Aotus vociferans monkeys.AMA1 is the subject of intensive vaccine research; at least six of the major malaria vaccine research centers have AMA1 programs. This is based on protection against rodent malaria (Plasmodium chabaudi [1,2,6,20] and Plasmodium yoelii [16]) and nonhuman primate malarias (Plasmodium knowlesi [7] and Plasmodium fragile [5]) by use of purified parasite and recombinant antigens and on the generation in rabbits of an in vitro growth-inhibitory antiserum to an Escherichia coli-expressed recombinant P. falciparum AMA1 (12).However, no evidence exists that vaccine-elicited immunity to a recombinant form of P. falciparum AMA1 will be effective against a P. falciparum challenge in vivo, and establishing this prior to human trials is seen by us as essential, especi...