Malaria Vaccine Efficacy, Safety, and Community Perception in Africa: a Scoping Review of Recent Empirical Studies

Overview

Journal Infection

Date 2024 Mar 5

PMID 38441731

Authors

Muhammad Chutiyami

Priya Saravanakumar

Umar Muhammad Bello

Dauda Salihu

Khadijat Adeleye

Mustapha Adam Kolo

Kabiru Kasamu Dawa

Dathini Hamina

Pratibha Bhandari

Surajo Kamilu Sulaiman

Jenny Sim

Affiliations

Soon will be listed here.

Abstract

Aim: The review summarizes the recent empirical evidence on the efficacy, safety, and community perception of malaria vaccines in Africa.

Methods: Academic Search Complete, African Journals Online, CINAHL, Medline, PsychInfo, and two gray literature sources were searched in January 2023, and updated in June 2023. Relevant studies published from 2012 were included. Studies were screened, appraised, and synthesized in line with the review aim. Statistical results are presented as 95% Confidence Intervals and proportions/percentages.

Results: Sixty-six (N = 66) studies met the inclusion criteria. Of the vaccines identified, overall efficacy at 12 months was highest for the R21 vaccine (N = 3) at 77.0%, compared to the RTS,S vaccine (N = 15) at 55%. The efficacy of other vaccines was BK-SE36 (11.0-50.0%, N = 1), ChAd63/MVA ME-TRAP (- 4.7-19.4%, N = 2), FMP2.1/AS02A (7.6-9.9%, N = 1), GMZ2 (0.6-60.0%, N = 5), PfPZ (20.0-100.0%, N = 5), and PfSPZ-CVac (24.8-33.6%, N = 1). Injection site pain and fever were the most common adverse events (N = 26), while febrile convulsion (N = 8) was the most reported, vaccine-related Serious Adverse Event. Mixed perceptions of malaria vaccines were found in African communities (N = 17); awareness was generally low, ranging from 11% in Tanzania to 60% in Nigeria (N = 9), compared to willingness to accept the vaccines, which varied from 32.3% in Ethiopia to 96% in Sierra Leone (N = 15). Other issues include availability, logistics, and misconceptions.

Conclusion: Malaria vaccines protect against malaria infection in varying degrees, with severe side effects rarely occurring. Further research is required to improve vaccine efficacy and community involvement is needed to ensure successful widespread use in African communities.

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References

Dobano C, Ubillos I, Jairoce C, Gyan B, Vidal M, Jimenez A . RTS,S/AS01E immunization increases antibody responses to vaccine-unrelated Plasmodium falciparum antigens associated with protection against clinical malaria in African children: a case-control study. BMC Med. 2019; 17(1):157. PMC: 6693200. DOI: 10.1186/s12916-019-1378-6. View

Jongo S, Shekalaghe S, Church L, Ruben A, Schindler T, Zenklusen I . Safety, Immunogenicity, and Protective Efficacy against Controlled Human Malaria Infection of Sporozoite Vaccine in Tanzanian Adults. Am J Trop Med Hyg. 2018; 99(2):338-349. PMC: 6090339. DOI: 10.4269/ajtmh.17-1014. View

Oneko M, Steinhardt L, Yego R, Wiegand R, Swanson P, Kc N . Safety, immunogenicity and efficacy of PfSPZ Vaccine against malaria in infants in western Kenya: a double-blind, randomized, placebo-controlled phase 2 trial. Nat Med. 2021; 27(9):1636-1645. DOI: 10.1038/s41591-021-01470-y. View

Nouatin O, Ibanez J, Fendel R, Ngoa U, Lorenz F, Dejon-Agobe J . Cellular and antibody response in GMZ2-vaccinated Gabonese volunteers in a controlled human malaria infection trial. Malar J. 2022; 21(1):191. PMC: 9204906. DOI: 10.1186/s12936-022-04169-8. View

Nouatin O, Ngoa U, Ibanez J, Dejon-Agobe J, Mordmuller B, Edoa J . Effect of immune regulatory pathways after immunization with GMZ2 malaria vaccine candidate in healthy lifelong malaria-exposed adults. Vaccine. 2020; 38(27):4263-4272. PMC: 7297038. DOI: 10.1016/j.vaccine.2020.04.046. View

Mensah V, Gueye A, Ndiaye M, Edwards N, Wright D, Anagnostou N . Safety, Immunogenicity and Efficacy of Prime-Boost Vaccination with ChAd63 and MVA Encoding ME-TRAP against Plasmodium falciparum Infection in Adults in Senegal. PLoS One. 2016; 11(12):e0167951. PMC: 5158312. DOI: 10.1371/journal.pone.0167951. View

Datoo M, Natama H, Some A, Bellamy D, Traore O, Rouamba T . Efficacy and immunogenicity of R21/Matrix-M vaccine against clinical malaria after 2 years' follow-up in children in Burkina Faso: a phase 1/2b randomised controlled trial. Lancet Infect Dis. 2022; 22(12):1728-1736. DOI: 10.1016/S1473-3099(22)00442-X. View

Witte D, Cunliffe N, Turner A, Ngulube E, Ofori-Anyinam O, Vekemans J . Safety and Immunogenicity of Seven Dosing Regimens of the Candidate RTS,S/AS01E Malaria Vaccine Integrated Within an Expanded Program on Immunization Regimen: A Phase II, Single-Center, Open, Controlled Trial in Infants in Malawi. Pediatr Infect Dis J. 2018; 37(5):483-491. DOI: 10.1097/INF.0000000000001937. View

Asante K, Ansong D, Kaali S, Adjei S, Lievens M, Nana Badu L . Immunogenicity and safety of the RTS,S/AS01 malaria vaccine co-administered with measles, rubella and yellow fever vaccines in Ghanaian children: A phase IIIb, multi-center, non-inferiority, randomized, open, controlled trial. Vaccine. 2020; 38(18):3411-3421. PMC: 7611265. DOI: 10.1016/j.vaccine.2020.03.014. View

10.

Dimala C, Kika B, Momo Kadia B, Blencowe H . Current challenges and proposed solutions to the effective implementation of the RTS, S/AS01 Malaria Vaccine Program in sub-Saharan Africa: A systematic review. PLoS One. 2019; 13(12):e0209744. PMC: 6312235. DOI: 10.1371/journal.pone.0209744. View

11.

Asmare G . Willingness to accept malaria vaccine among caregivers of under-5 children in Southwest Ethiopia: a community based cross-sectional study. Malar J. 2022; 21(1):146. PMC: 9097094. DOI: 10.1186/s12936-022-04164-z. View

12.

Agnandji S, Lell B, Fernandes J, Abossolo B, Methogo B, Lumeka Kabwende A . A phase 3 trial of RTS,S/AS01 malaria vaccine in African infants. N Engl J Med. 2012; 367(24):2284-95. PMC: 10915853. DOI: 10.1056/NEJMoa1208394. View

13.

Bejon P, White M, Olotu A, Bojang K, Lusingu J, Salim N . Efficacy of RTS,S malaria vaccines: individual-participant pooled analysis of phase 2 data. Lancet Infect Dis. 2013; 13(4):319-27. PMC: 3771416. DOI: 10.1016/S1473-3099(13)70005-7. View

14.

Olotu A, Urbano V, Hamad A, Eka M, Chemba M, Nyakarungu E . Advancing Global Health through Development and Clinical Trials Partnerships: A Randomized, Placebo-Controlled, Double-Blind Assessment of Safety, Tolerability, and Immunogenicity of PfSPZ Vaccine for Malaria in Healthy Equatoguinean Men. Am J Trop Med Hyg. 2017; 98(1):308-318. PMC: 5928718. DOI: 10.4269/ajtmh.17-0449. View

15.

Datoo M, Natama M, Some A, Traore O, Rouamba T, Bellamy D . Efficacy of a low-dose candidate malaria vaccine, R21 in adjuvant Matrix-M, with seasonal administration to children in Burkina Faso: a randomised controlled trial. Lancet. 2021; 397(10287):1809-1818. PMC: 8121760. DOI: 10.1016/S0140-6736(21)00943-0. View

16.

Neafsey D, Juraska M, Bedford T, Benkeser D, Valim C, Griggs A . Genetic Diversity and Protective Efficacy of the RTS,S/AS01 Malaria Vaccine. N Engl J Med. 2015; 373(21):2025-2037. PMC: 4762279. DOI: 10.1056/NEJMoa1505819. View

17.

Kabakama S, Konje E, Dinga J, Kishamawe C, Morhason-Bello I, Hayombe P . Commentary on COVID-19 Vaccine Hesitancy in sub-Saharan Africa. Trop Med Infect Dis. 2022; 7(7). PMC: 9318427. DOI: 10.3390/tropicalmed7070130. View

18.

Bingham A, Gaspar F, Lancaster K, Conjera J, Collymore Y, Ba-Nguz A . Community perceptions of malaria and vaccines in two districts of Mozambique. Malar J. 2012; 11:394. PMC: 3519522. DOI: 10.1186/1475-2875-11-394. View

19.

Schwartz L, Brown G, Genton B, Moorthy V . A review of malaria vaccine clinical projects based on the WHO rainbow table. Malar J. 2012; 11:11. PMC: 3286401. DOI: 10.1186/1475-2875-11-11. View

20.

Immurana M, Boachie M, Klu D, Dalaba M, Manyeh A, Alhassan R . Determinants of willingness to accept child vaccination against malaria in Ghana. Int J Health Plann Manage. 2022; 37(3):1439-1453. DOI: 10.1002/hpm.3406. View