Jaime Jesús Pérez Martín
Specialist in Preventive Medicine and Public Health, Deputy Director General of Public Health of the Region of Murcia and President of the Spanish Association of Vaccinology
It is an excellent study, a clinical trial conducted in four African countries with a sample size of almost 5,500 children.
On the one hand, this vaccine had published results from phase 2 clinical trials and the results were concordant. Moreover, as the authors state, the vaccine is already licensed by the WHO and use has started in several African countries. The data are also concordant with those of another malaria vaccine already in use, namely Mosquirix, which was the first malaria vaccine licensed, so with this new vaccine we now have two. The most important new feature is that the efficacy data are higher than those obtained with Mosquirix, which has figures of 45-55% protection. Here we have increased to between 70 and 80%, that is to say, it offers a notable improvement in terms of protection.
Therefore, as a novelty, it provides greater protection and, at the same time, it will allow more extensive vaccination programmes against malaria than we have had up to now, because we will have a second vaccine with a large number of doses ready for use. Also as an added benefit we could have an increased duration of protection.
In addition, the vaccine uses a new adjuvant, Matrix-M, which so far has not been in use but may be a very promising adjuvant for use in many vaccines. In our country this adjuvant has only been used in Novavax covid vaccines, but unfortunately we have had few available, so our experience with this preparation is limited. Hopefully the benefits of this adjuvant can be confirmed in other vaccines.
As for limitations, there are those given by the authors themselves, such as not measuring efficacy against mortality, but that is very difficult in a clinical trial because logically these are ideal situations in which treatment should be given early. However, by measuring efficacy against the disease in real life we will achieve significant reductions in mortality, so I don't think this is a major limitation.