WHO expert panel urges pilot roll-out of first malaria vaccine

GENEVA, Switzerland – A World Health Organization expert panel on Friday recommended pilot roll-outs of the world’s most advanced malaria vaccine in young children in several areas of sub-Saharan Africa, before considering wider use.

The panel, brought in to advise the UN health agency on immunization policies, said the Mosquirix or RTS vaccine, should be given in three to five different areas with moderate-to-high malaria transmission, reaching up to a million children.

The first dose would be given to children between the ages of five and 17 months and the aim would be to assess its protective effect and whether it will be practical to administer four doses in routine vaccination programmes.

“In these areas of Africa … the number one killer now of children is malaria,” professor Jon Abramson, chair of the WHO Strategic Advisory Group of Experts (SAGE) on Immunization, told reporters.

Mosquirix is the most clinically-advanced vaccine against the mosquito-borne disease that infects some 200 million people and kills about 600,000 every year, more than 75% of them children under five.

In sub-Saharan Africa alone, the plasmodium parasite kills about 1,200 children on average per day, according to the WHO.

Developed by GlaxoSmithKline with funding from the Bill & Melinda Gates Foundation, Mosquirix is the first malaria vaccine to reach Phase III clinical testing — the final stage before market approval — and the first to be assessed by regulators.

Abramson said the pilot roll-outs could pave the way for wide-scale deployment of the vaccine within the next five years.

In April, the results of a years-long trial with 15,500 children in seven African countries were published in The Lancet medical journal — announcing mixed success.

The drug offered only partial protection that waned with time, researchers found, but even so could prevent millions of cases.

Abramson said one of the biggest concerns was whether parents would bring their children back for a final fourth dose of the vaccine, which must be given a year and a half after the first three doses.

“If you don’t give the fourth dose, essentially the efficacy of the vaccine goes back to zero,” he said.

The trial of the vaccine had also showed an increase in the number of cases of meningitis and cerebral malaria among those who received it, and Abramson said the pilot implementation would help determine the increased risk.

But he stressed that the health community had “ways of potentially mitigating” that threat, and the lifesaving benefits of the vaccine could outweigh the risk.

The malaria parasite has developed resistance to successive treatments. While there is a limited medicine chest available, insecticide-treated bed nets remain one of the most effective prevention methods.

GSK has said it would provide the drug at a “not-for-profit price”.

Abrahmson said it might cost around $5 a dose, or $20 per child for a full treatment. – Rappler.com