Health talk | The new malaria vaccine can reduce morbidity and death, study finds

Malaria is a life-threatening disease. It is preventable and curable. And yet, the disease ends up taking lives. This too can be stopped

Malaria is a life-threatening disease spread to humans by some types of mosquitoes. It is mostly found in tropical countries. It is preventable and curable. And yet, the disease still ends up taking lives. A recent study found that in areas with seasonal malaria, approximately 200,000 cases and 650 deaths from malaria could be prevented per 100,000 children, if they were vaccinated with all four doses of the R21/Matrix-M vaccine over 15 years.

A nurse holds malaria vaccine vials before administering it to an infant at the Lumumba Sub-County hospital in Kisumu, Kenya.(Reuters)

Additionally, the vaccine, which was recently recommended for use by the World Health Organisation, could prevent roughly 180,000 cases and 630 deaths from malaria for every 100,000 children vaccinated in regions where malaria transmission occurs throughout the year, the findings of ‘The public health impact and cost-effectiveness of the R21/Matrix-M malaria vaccine: a mathematical modelling study’ read. The study was published in The Lancet Infectious Diseases on Thursday.

The results make a case for introducing the vaccine — developed by Oxford University and manufactured by Serum Institute of India — into the routine immunisation programme in malaria-endemic countries as a key preventive measure.

Malaria, a mosquito-borne disease, places a particularly high burden on children in the African Region, where nearly half a million children die from the disease each year. The WHO African Region, with an estimated 234 million cases in 2021, accounted for about 95% of global cases.

India is one of the countries where the disease is endemic. According to the UN health agency data, India accounted for 79% of 5 million malaria cases reported in the Southeast Asia region in the corresponding period.

The infection is caused by a parasite and does not spread from person to person. Symptoms can be mild or life-threatening. Mild symptoms are fever, chills and headache. Severe symptoms include fatigue, confusion, seizures, and difficulty breathing. Infants, children under 5 years, pregnant women, travellers and people with HIV or AIDS are at higher risk of severe infection.

Cases have seen a decline over the past few years because of the active interventions made by the government.

India launched its National Framework for Malaria Elimination (NFME) in 2016.

As per data provided by the Union government, India reduced 83.34% in malaria morbidity and 92% in malaria mortality between 2000 (2,031,790 cases, 932 deaths) and 2019 (338,494 cases, 77 deaths).

Now this vaccine can likely bring down both morbidity and deaths even further.

“In perennial settings, we estimated that a four-dose age-based implementation could avert between 30% and 44% of cases in children younger than 5 years. In seasonal settings, we estimated that between 29% and 45% of cases could be averted in children younger than 5 years under a four-dose regimen administered via age-based implementation,” read the paper.

“...The median percentage of deaths from malaria averted in children younger than 5 years ranged from 21% to 43% in perennial settings and from 19% to 46% in seasonal settings across all implementations…”

The Indian government has set a target of 2030 for malaria elimination. According to experts, an effective vaccine against malaria is an important tool that must be included in the country's malaria elimination action plan. However, the said vaccine needs trials in a domestic setting to see how well it will work.

“A vaccine is definitely needed and will be an important factor in disease elimination in the long run, but for this particular vaccine that is mainly for use in children, we need more India-specific data. Right now, the data is from the African region. Trials should be conducted in India, at least pilot studies should be done here, to know how well it works in the Indian context and to see whether it suits our larger purpose or not,” said PK Sen, former director, National Vector Borne Disease Control Programme.

Rhythma Kaul, national deputy editor, health, analyses the impact of the most significant piece of news this week in the health sector