The World Health Organization (WHO) has given its recommendation for the use of a second malaria vaccine as part of efforts to combat the spread of the life-threatening disease transmitted by certain mosquitoes.
At a briefing in Geneva, WHO chief Tedros Adhanom Ghebreyesus stated, “Almost exactly two years ago, W.H.O. recommended the broad use of the world’s first malaria vaccine called RTS,S.” He continued, “Today, it gives me great pleasure to announce that WHO is recommending a second vaccine called R21/Matrix-M to prevent malaria in children at risk of the disease.”
The R21/Matrix-M vaccine, developed by Britain’s University of Oxford, is expected to be available to countries by mid-2024, with doses priced between $2 and $4. It is currently undergoing WHO prequalification, a necessary step for GAVI and UNICEF to procure it from manufacturers.
This vaccine, mass-produced by the Serum Institute of India using Novavax’s Matrix M adjuvant, has already generated over 20 million doses in anticipation of WHO’s endorsement. Adar Poonawalla, CEO of the Serum Institute of India, stated, “We will ramp it up as per what the demand requirements are,” with hopes of achieving a balance between supply and demand by the end of 2024.
R21/Matrix-M will compete with GSK plc’s RTS,S shot, which was recommended by the UN agency in 2021 and sold under the brand Mosquirix. Both vaccines have demonstrated similar efficacy in separate trials, though there has been no direct comparison to determine superiority.
Countries will make their choice based on factors such as affordability and availability. GSK commented, “GSK has always recognised the need for a second malaria vaccine, but it is increasingly evident that RTS,S, the first-ever malaria vaccine and the first-ever vaccine against a human parasite, set a strong benchmark.”
In addition to the malaria vaccine, the WHO also recommended Takeda Pharmaceuticals’ dengue vaccine, Qdenga, for children aged six to 16 years residing in regions where the infection poses a significant public health concern. This viral infection, transmitted by mosquitoes, is common in tropical and subtropical climates. Takeda’s vaccine demonstrated effectiveness against all four serotypes of the virus in individuals with previous dengue exposure, though uncertainties remain about its performance against serotypes 3 and 4 in those without prior infection.
The WHO’s strategic advisory group also proposed a simplified single-dose regimen for primary immunization with most COVID-19 vaccines to enhance acceptance, especially as a significant portion of the population has already had at least one prior infection. They noted that any monovalent or bivalent vaccine targeting the dominant XBB.1.5 variant could be used, as availability may vary across countries.