WHO publishes first-ever malaria vaccine recommendation in position paper

The World Health Organization (WHO) has published an updated position paper on the RTS,S/AS01 (RTS,S) malaria vaccine that includes the October 2021 recommendation calling for the wider use of the vaccine among children living in areas of moderate-to-high P falciparum malaria transmission. The paper complements the recent addition of the recommendation to the WHO guidelines for malaria, a statement from WHO said.

It further said that the paper, published in WHO’s Weekly Epidemiological Record, summarises essential background information on the global malaria context and disease patterns. It presents available RTS,S evidence and addresses the role of RTS,S, among other preventive measures; and outlines recommendations for broader deployment of the vaccine.

In addition, the paper identifies research priorities for the vaccine and considerations for immunisation and health systems. It briefly describes the development of a framework to guide the allocation of the initial limited doses of malaria vaccine; supplies of RTS,S are expected to be limited in the short-to-medium term, the statement added.

“The first malaria vaccine is a major step forward for malaria control, child health and health equity. If implemented broadly, the vaccine could save tens of thousands of lives each year,” said Dr Kate O’Brien, Director, Department of Immunization, Vaccines and Biologicals, in the statement. “This guidance is essential to countries as they consider whether and how to adopt the vaccine as an additional tool to reduce child illness and deaths from malaria,” she added.

The malaria vaccine recommendation was recently added to WHO’s consolidated malaria guidelines on the MAGICapp platform. The guidelines bring together the organisation’s most up-to-date recommendations for malaria in one user-friendly online platform, mentioned the statement.

It also said that countries are encouraged to adapt to the recommendation to local settings. “In recent years, WHO has been advising countries to move away from a ‘one-size fits all’ approach to malaria control, applying instead a mix of tools informed by local data and disease patterns,” said Dr Pedro Alonso, Director, Global Malaria Programme, WHO. “The malaria vaccine is a breakthrough addition to the malaria toolkit,” he added.

The position paper and the update to the WHO guidelines for malaria incorporate the October 2021 WHO recommendation on the malaria vaccine, which was informed by a full evidence review of RTS,S by WHO’s global advisory bodies for malaria and immunisation – the Strategic Advisory Group of Experts (SAGE) on immunisation and the Malaria Policy Advisory Group (MPAG) – and approved by the WHO Guidelines Review Committee, the statement further said.

This newly published guidance will be followed in the coming months by additional tools and information to guide countries that have decided to adopt the malaria vaccine – including a new malaria vaccine introduction guide and an operational manual for sub-national tailoring of malaria control tools, it concluded.