New malaria jab could be a turning point

Dar es Salaam. The government is stepping  up efforts to monitor manufacturers of malaria vaccines in order to decide on the right one, which will be rolled out in the country.
Chief Medical Officer Aifello Sichalwe made the statement yesterday when commenting on the high level of protection provided by a booster dose of a new malaria- R21/Matrix-M vaccine developed by Britain’s Oxford University.
The international research team suggests that the vaccine could represent a turning point in the fight against the mosquito-borne parasitic disease, which killed 627,000 people -- mostly African children -- in 2020 alone.
But, speaking to The Citizen yesterday, Dr Sichalwe said malaria vaccines are new and have not  been rolled out.
“The number of vaccines manufacturers keep increasing every day. But, as a country, we are already  monitoring costs of the vaccines, accessibility and their respective quality through the National Immunisation Technical Advisory Groups (NITAGs),” he said.
“This will provide us with valuable information that will enable us to decide on the vaccine that will be authorised for domestic use,” he said.
However,  the National Institute of Medical Research (Nimr) principal research officer, Dr Daniel Minja allayed fears, stressing that clinical trials are usually conducted in over four phases.
He said the current trial with a protective efficacy of around 70 and 80 percent upon administration of a  booster dose is still on phase two, which means that there are still two more phases to go.
“This will entail vaccinating several thousands and in different regions... What we have here I would term it as a breakthrough for yet another milestones to achieve in phases three and fourcompared with RTSS vaccine which has gone to the stage of licensure and rolling it out pending other logistics,” he said.
“I would term the effectiveness of the current vaccine as a proof of concept and once large scale trials are implemented, we will be able to tell whether the former or latter is superior..... Needless to say the performance is exemplary and if it’s replicated during the subsequent phases it will be of massive boost in complimenting the currently available malaria control interventions,” he added.
According to him, there is no standalone intervention that has been proven to avert malaria burden in endemic regions when taken singly but as a package.
“My view is that these interventions should be used in tandem and none is considered as superior to the other but we should think of complementarity and synergies between bed net uses, vaccine uses, early case detection and prompt treatment with effective antimalarial drugs,” he said.
“Letting aside intermittent preventive treatment during pregnancy IPTp....Intermittent preventive treatment in Infants... IPTi and IPsc in school children or IPTmsc... Malaria seasonal chemoprophylaxis,” he added.
Furthermore, he said treatments that have been shown to work in phase II clinical trials must succeed in one more phase before they’re approved for general use.  According to him, Phase III clinical trials compare the safety and effectiveness of the new treatment against the current standard treatment.
For his part, the Medical Association of Tanzania (MAT) President, Dr Shadrack Mwaibambe said providing the country with efficient malaria vaccine in the country’s context would be would be a significant boost in the anti-malaria war.
“It is important for the government to satisfy itself on different issues. But, getting efficient anti-malaria jab will be a huge boost in the war against the killer disease,” he said.
Last year a different vaccine produced by British pharmaceutical giant GSK became the first to be recommended for widespread use against malaria by the World Health Organisation, and has now been administered to more than a million children in Africa.
However research has found that the effectiveness of GSK’s vaccine is around 60 percent, and significantly wanes over time even with a booster dose.
Oxford’s R21/Matrix-M vaccine meanwhile was found to be 77 percent effective at preventing malaria in research published last year -- the first time the WHO’s roadmap goal of 75 percent had been met.

‘Fantastic’
For the research, 450 children aged five to 17 months in Burkina Faso -- where malaria accounts for around 22 percent of all deaths -- were given three doses in 2019.
They were split into three groups, two receiving different doses of the Matrix-M adjuvant, a vaccine ingredient patented by Novavax also used in the US biotech firm’s Covid jab. The third control group received a rabies vaccine.
Ahead of the 2020 rainy season -- when malaria cases surge -- 409 children returned to get a booster shot. For the group that received the higher dose of adjuvant, the booster rose the protection level to 80 percent, according to the results of a phase Two trial published in The Lancet Infectious Diseases journal on Thursday. The lower dose had 70 percent efficacy.
And crucially, the booster returned antibody levels to a similar level seen after the first round of doses, the study said.
The study’s lead investigator Halidou Tinto of the Burkina Faso health research institute IRSS said: “It is fantastic to see such high efficacy again after a single booster dose.”
Tinto, who was involved in trialling both malaria vaccines, said GSK’s vaccine had an optimal efficacy of around 60 percent.
 “So I can confirm that R21 is doing much better,” he told a press conference.