Efficiency of Malaria vaccine declines over time: study


March 23, 2012 (NAIROBI) - The efficiency of the RTS,S vaccine,
designed to protect humans from the malaria parasite, varies with
exposure to the disease and fades over time, a new study shows.

Researchers from KEMRI-Wellcome Trust Research Programme and Oxford
University carried out the follow-up study on the vaccine in Kenya.

The vaccine, which was first formulated in the 1980s in Belgium, was
reportedly designed to stimulate the immune system to defend the body
against the Plasmodium Falciparum malaria parasite, as soon as it
enters the bloodstream or infects the liver.

“The findings of the study will help to inform which populations are
likely to benefit most from the vaccine candidate,” Wellcome Trust
said in a statement.

“They also have important implications for the design of future
clinical trials of this and other vaccine candidates and highlight the
importance of long-term follow-up studies for assessing vaccine
efficacy.”

The study reportedly involved 447 children in Kilifi, Kenya, who were
part of an earlier phase two trial to assess the safety and efficacy
of the vaccine candidate. According to the study, of the 447 children,
320 completed four years of follow-up.

“The new findings on long-term follow-up of an earlier phase two study
reveal that the vaccine efficacy dropped from 43.6 percent protection
against malaria in the first year to zero by the fourth year after
vaccination,” it said.

Initial results from larger ongoing phase three studies showed that
the candidate RTS,S vaccine reduced malaria over 12 months of
follow-up by approximately half in young children and one-third in
infants, it added.

“Despite the falling efficacy over time, there is still a clear
benefit to the vaccine candidate. Many of the children will experience
multiple episodes of clinical malaria infection, but overall we found
that 65 cases of malaria were averted over the four-year period for
every 100 children vaccinated,” said Phillip Dejon, a research fellow
at the KEMRI Wellcome Trust Programme.

He added that researchers now need to look at whether offering a
vaccine booster can sustain efficacy over a longer period.

According to the statement, the study also shows that relative vaccine
efficacy declines with increasing exposure to malaria, from 45.1%
among children with below-average exposure to 15.9% among children
with above-average exposure to malaria.

“We need to consider whether relative efficacy or absolute number of
cases averted is the more informative measure. In any case, these are
important findings that will help to inform which populations are
likely to benefit most from the vaccine,” said Ally Olotu, lead author
of the study.

He said the ongoing phase three study will provide further insights to
the vaccine’s efficacy in different settings of malaria exposure and
also includes an assessment of a booster dose to sustain efficacy over
time.

Malaria remains the leading cause of illness and death among children
in Africa, with a child reportedly dying from the disease every
minute. Latest figures show that at least 1.4 billion people live in
regions of stable malaria transmission worldwide.

In Sudan malaria remains a major public health problem, with an
estimated 7.5 million cases resulting in 35,000 deaths per year,
according to the UN Development Programme (UNDP).

In South Sudan the disease is endemic, with malaria a significant
contributing factor to the country’s high infant mortality rate – the
fourth highest in the world.

(ST)

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