Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.See all posts »
Malaria Vaccine Trial
An effective vaccine against malaria would be a major breakthrough in the realm of global health, on par with effective vaccination against smallpox and other historical disease scourges of mankind. Creating such a vaccine has been a challenge for decades, but perhaps we are finally getting closer. For persons who travel and explore outdoors, the best options to prevent malaria remain avoidance against mosquito bites and taking prophylactic drugs, both of which are at best inconvenient and in the case of taking medications, fraught with troublesome side effects.
There is encouraging news. “First Results of a Phase 3 Trial of RTS,S/AS01 Malaria Vaccine in African Children” by The RTS,S Clinical Trials Partnership was published in the New England Journal of Medicine (2011;365:1863-75). This study reported on an ongoing phase 3 study of the efficacy, safety, and immunogenicity (ability to provoke an immune response) of the malaria vaccine RTS,S/AS01 that is being conducted in seven African countries. This vaccine has been developed by a partnership beween GlaxosSmithKline and the Program for Appropriate Technology (PATH) Malaria Vaccine Initiative, supported financially by the Bill and Melinda Gates Foundation. Over a nearly 2-year period, 15,460 children in two age categories – 6 to 12 weeks of age and 5 to 17 months of age – were enrolled for vaccinatioin with either RTS,S/AS01 vaccine or a non-malaria comparator vaccine (in this study, rabies vaccine was used for the older age group and meningococcal vaccine for the younger age group).
The results showed some efficacy against malaria. Vaccine efficacy against severe malaria over an 11 month follow-up period in the combined age categories was nearly 35%. It also showed efficacy against non-severe clinical malaria, notably that it reduced malaria by half in the older age group during the 12 months following vaccination.
There is still much to be learned about this vaccine, such as the duration of effect, whether a booster dose will improve results, and the real world issues of who will pay for the vaccine, total incidence of side effects, and whether or not it will be cost-effective. We should all keep our fingers crossed that this vaccine continues to show progress and improve, and that the efforts of the developers of this vaccine and everyone else fighting malaria help reduce the global burden of this disease.
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