Musings on malaria morbidity and mortality after the new Mosquirix® vaccine.

Abstract

There are some facts relating to the new malaria vaccine (Mosquirix® or RTS,S/AS01) recently introduced in Ghana, which need to be more widely known. Contrary to expectations based on mathematical modelling and on the vaccine’s effect on clinical malaria and severe malaria, mortality was not reduced in children receiving the Mosquirix® vaccine in the phase 3 trial.1 This (surprising) result has been attributed to the fact that mortality was reduced in both the vaccinated and unvaccinated children due to better implementation of malaria control measures such as use of bed nets and prompt treatment of malaria.2 The startling implication of this finding is that when the existing malaria control measures are implemented more effectively, the vaccine in its current form does not offer any measurable mortality advantages. This means that if there were a willingness to implement malaria control measures intensively, there would be no need to expose our children to the unknown effects of a new vaccine.