Cameroon has begun a large-scale malaria vaccination campaign that's supposed to see 250,000 children immunized this year and next. Experts say it will save lives, even though the vaccine isn't perfect.
On Monday, health authorities in Cameroon kicked off a vaccination campaign against malaria, a parasitic disease that kills hundreds of thousands of people every year, most of them children. Around 95% of all deaths occur in Africa.
"The vaccination will save lives," said Aurelia Nguyen, chief program officer at the Gavi Vaccine Alliance, as reported by ABC News. "It will provide major relief to families and the country's health system."
Cameroon is the first country with such a vaccination campaign outside of clinical trials.
Malaria is carried by the anopheles mosquito. In 2022, the disease killed 608,000 people worldwide and infected 250 million. Resistances against common malaria medications are on the rise. The vaccine campaign comes in addition to steps like raising awareness, spraying insecticide and distributing protective mosquito nets.
What malaria vaccine is used in Cameroon?
The vaccine, which will be given to children across Cameroon routinely, is called Mosquirix, or RTS,S, and is produced by pharmaceutical company GlaxoSmithKline (GSK). In 2021, it was the first malaria vaccine ever to be recognized as efficient and be recommended by the World Health Organization (WHO). In 2022, Mosquirix was included in the WHO's list of "prequalified vaccines," a requirement to enter the distribution programs of humanitarian organizations like the United Nations Children's Fund (UNICEF) and the Gavi Vaccine Alliance.
A Mosquirix pilot trial started in Malawi, Ghana and Kenya in 2019 showed promising results, with a total of more than two million children aged five months old and up were vaccinated in the countries. The Gavi Vaccine Alliance said that child mortality declined significantly, as did the number of severe malaria cases.
The WHO reported in 2021 that among children aged 5-17 months who received four doses of RTS,S, the vaccine prevented approximately 39% of malaria cases over four years of follow-up and about 29% of severe malaria cases.
Cameroon's new campaign is a milestone, as demand for a malaria vaccine has grown high across the region.
"Everyone in sub-Saharan Africa wants these vaccines," Marie-Ange Saraka-Yao, Gavi's Chief Resource Mobilization and Growth Officer, told DW in October 2023.
How many shots are needed and for how long does protection last?
GSK has said they'll be able to produce about 15 million doses of Mosquirix a year. That might sound like a lot, but a full course of the vaccine includes four shots. An official at Cameroon's Ministry of Public Health told parents on Monday to make sure their 6-month-old children received the first doses of malaria vaccines available in several government hospitals. The official said the second and third doses would be administered when children are 7 and 9 months, and the fourth and final dose when children are 24 months old.
With that many doses required, the risk of children missing one and not getting full protection against infection is high. And even in children who receive all their shots, protection against the disease will fade after several months.
Another malaria vaccine, R21/Matrix-M, developed by scientists at Oxford University in the UK, requires only three shots. India's Serum Institute estimated they could make up to 200 million doses a year, ABC News reported. R21 is not yet being used in Cameroon's vaccination campaign because it was not added to the WHO's list of "prequalified vaccines" until the end of 2023.
Still, the fact that there are two options in the fight against malaria is reason for joy among health officials.
"Demand for the RTS,S vaccine far exceeds supply, so this second vaccine is a vital additional tool to protect more children faster, and to bring us closer to our vision of a malaria-free future," WHO Director-General Tedros Adhanom Ghebreyesus said in October 2023 when R21 received the WHO recommendation.
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Why the focus on children?
Malaria hits small children hardest. In 2020, children younger than 5 years of age accounted for 80% of malaria deaths in Africa.
"In terms of children, [malaria] is probably the deadliest disease right now," Saraka-Yao said.
People who live where there is a lot of malaria and who get infected repeatedly as they grow up can naturally develop some level of immunity. Cases in children are more severe and end in death more frequently because children have not yet been able to build up this immunity. That's why vaccination campaigns like the one now started in Cameroon are vital to protecting young lives.
Edited by: Clare Roth.
Moki Kindzeka contributed reporting from Yaounde, Cameroon.
