R21/Matrix-M: Second malaria vaccine approved by WHO – What you need to know

The World Health Organization (WHO) has endorsed a second malaria vaccine, R21, designed to safeguard children against this deadly disease that claimed the lives of 619,000 individuals in 2021.

1. Easier to Make and Cost-Effective: Researchers have hailed R21 as a more cost-effective and easier-to-produce alternative to the first approved malaria vaccine, RTS,S. This translates to a reduced cost per dose, making it more accessible.

2. Efficacy and Trial Results: R21 demonstrated a 75% efficacy in preventing malaria during a trial involving 4,800 children, each receiving three doses ahead of a seasonal malaria peak. A booster dose administered after 12 months maintained this protection.

3. Impact on Lives: The WHO predicts that adding R21 to existing preventive measures will save tens of thousands of children’s lives annually, significantly reducing the malaria mortality rate.

4. Affordable Access and Widespread Availability: Expected to be available by mid-2024, R21 is priced at a range of US$2–4 per dose, making it a more affordable option than RTS,S, which costs around $9.80 per dose. The Serum Institute of India is set to produce more than 100 million doses annually.

5. Structural Differences and Potency: R21, a modified form of RTS,S, contains a more potent malaria antigen, with each dose having five micrograms compared to 25 micrograms in a single dose of RTS,S.

6. Manufacturing and Supply Capability: Manufactured by the Serum Institute of India, R21 aims to meet the demand for malaria prevention by producing a significant number of doses each year.

7. Choice Between Vaccines: R21 and RTS,S will offer countries a choice, with R21’s ease of manufacturing and cost-effectiveness making it a viable option.

8. Ongoing Challenges: While these vaccines mark a significant step, challenges such as ensuring widespread distribution and administration, especially in high malaria transmission regions, remain to be addressed.

In conclusion, R21 offers a promising avenue to bolster malaria prevention efforts, providing a cost-effective, easier-to-produce vaccine that can potentially save numerous lives.