Health workers in Ivory Coast have initiated the administration of a new malaria vaccine to children, marking the beginning of a regional effort aimed at reducing the impact of one of Africa’s deadliest diseases.

The West African nation is the first to distribute the latest malaria vaccine, R21/Matrix-M, which was developed by Britain’s Oxford University and approved by the World Health Organization (WHO) last October.

This vaccine rollout targets approximately 250,000 children under the age of two, offering a three-dose regimen designed to combat severe malaria.

Research indicates that the R21/Matrix-M vaccine is more than 75% effective at preventing severe disease and death within the first year.

A booster dose can extend this protection for at least another year. Alice Kanga, one of the many parents who brought their children for vaccination, emphasized its importance: “It’s really important for the children, for their health,” she said.

In 2021, the WHO endorsed the first malaria vaccine, Mosquirix, produced by GSK. However, this vaccine requires four doses, and its protection diminishes within months.

Additionally, GSK previously stated it could only produce about 15 million doses. In contrast, India’s Serum Institute has already produced 25 million doses of the Oxford vaccine and plans to manufacture at least 100 million annually, at a cost of approximately $4 per dose.

Malaria remains a significant health challenge in Africa, accounting for over 94% of the world’s approximately 249 million malaria cases and 608,000 deaths each year.

The disease, caused by parasites transmitted through mosquito bites, predominantly affects children under five and pregnant women.

Ivory Coast’s Health Minister, Pierre Demba, highlighted the government’s dedication to the health of its young population: “They are the future of our country,” he stated, underscoring the importance of the vaccination initiative.

A New Era In Malaria Control

Adrian Hill of Oxford University remarked that the vaccine rollout in Ivory Coast “marks the start of a new era in malaria control,” expressing hope that the vaccine would soon be accessible to all African nations wishing to utilize it.

Despite the promise of malaria vaccines, experts caution that they do not halt the transmission of the disease.

Therefore, additional measures such as insecticide spraying, improved treatments, and the use of bed nets remain crucial.

The Gavi vaccine alliance, which aids low-income countries in acquiring vaccines, announced that other nations, including the Central African Republic, Chad, and South Sudan, have also received supplies of the Oxford-developed vaccine.

The anopheles mosquito, responsible for transmitting the malaria parasite, injects the parasite into a person’s bloodstream, where it undergoes several stages of its life cycle.

The complexity of this life cycle has long impeded vaccine development. The R21/Matrix-M vaccine targets the plasmodium ‘sporozoite,’ the initial form of the malaria parasite entering the human body.

Only a few (10–100) sporozoites are injected by infected mosquitoes before the parasite multiplies, making them an ideal target for vaccination.

R21 is a subunit vaccine that delivers parts of a protein secreted by the sporozoite, combined with a part of the hepatitis B virus known to elicit a strong immune response.

The vaccine also includes Novavax’s Matrix-M, an “adjuvant” that enhances the immune system’s response, making it more potent and durable.

Vaccines function by presenting an antigen — part of the virus or bacteria recognized by the immune system — to immune cells.

This technology, also used in Novavax’s COVID-19 vaccine, stimulates an influx of antigen-presenting cells at the injection site and enhances antigen presentation in local lymph nodes, ensuring a robust immune response.

As such, as Ivory Coast embarks on this crucial vaccination campaign, there is renewed hope that the R21/Matrix-M vaccine will significantly reduce the burden of malaria, saving countless lives and paving the way for a healthier future for Africa’s children.