There is some really promising results published this week’s NEJM that suggest that we might be one step closer to an effective malaria vaccine…for real!

There has been a long history of attempts to come up with an effective malaria vaccine, but all of those efforts have so far failed. There are many reasons for this, but unlike many diseases for which we had vaccines early on, there are much more complicated biological processes that mediate infection and disease progression in malaria making the quest for a vaccine much more difficult.

The first important finding was a trial that looked at whether or not the vaccine candidate under investigation was protective against clinical malaria end points in young children in Kenya and Tanzania. Although the trial was small, they found that the vaccine was roughly 60% efficacious in reducing clinical cases of malaria.

Perhaps as important, the second study showed that the malaria appears to work when combined with standard EPI vaccines, suggesting that this vaccine, should it ever get the green light, could likely be combined into current vaccination programs.

I’ve been meaning to get around to write a more detailed posting on the truly remarkable progress that appears to be happening across Africa on reducing malaria incidence using physical protection strategies such as bed nets and indoor residual spraying, and I will shortly. Some of the drops appear to be really dramatic, which could lead one to ask the question of whether our efforts are better spent on these types of interventions.

I don’t think so. I think this is one of those cases where the two interventions together – vaccination and physical protection – can really work off one another to control transmission. Neither intervention will likely be entirely effective so we may need more than one intervention. Plus, spillover effects may mean that these interventions are highly complimentary.

I can’t wait to hear more about these results…I am really exciting about these new findings.

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