‘Vaccine roll-out can help us end malaria deaths’
As families across Scotland ease into this spring Sunday, few may be aware their African counterparts are waking to a monumental new dawn.
Twenty-five million doses of a new life-saving vaccine are about to be rolled out to halt a shape-shifting predator with a hunger for children. Three years ago, The Sunday Post told how an international team led by Oxford University – including Scots scientist Dr Alison Lawrie – was, for the first time in medical history, close to ending the malaria that kills one child under five every minute in Africa. We revealed how its 2021 phase two trials in Burkina Faso were the first to show the vaccine R21/ Matrix-m – designed in 2011 as an improvement to the existing RTS,S/ AS01 – not only reached the World Health Organisation (WHO) efficacy target of 75%, but exceeded it. With phase three data now having confirmed the findings – leading to regulatory approvals and licensing of the new vaccine in a string of African countries – the Oxford team’s partners, The Serum Institute of India (SII), has confirmed it has 25 million doses ready to go.
And it is poised to produce a further 100 million every year. It is understood R21 can be made in greater quantities and at less cost than RTS,S, which was rolled out in Cameroon in the world’s first routine malaria vaccine programme in January.
And while the WHO says the two have not been compared in “head to head” trials, it admits R21 is key. This is because 40-60 million doses will be needed by 2026, soaring to 80–100 million doses each year by 2030. The WHO – who prequalified the Glaxosmithkline-manufactured RTS,S in 2022, followed by the new vaccine in 2023 – stated: “The addition of the second malaria vaccine (R21) to complement the ongoing roll-out of
the first malaria vaccine (RTS,S) is expected to result in sufficient vaccine supply to meet demand.”
Dr Lawrie, from Alloa and Head of Regulatory Affairs at the university’s Jenner Institute, said: “It is exciting. Children in Africa will be vaccinated imminently. We developed the R/21 Matrix-m vaccine at the Jenner Institute with Professor Adrian Hill’s Group. It has a very high efficacy and its roll-out will have a huge impact in preventing malaria deaths. Over 600,000 young children die annually across sub-saharan Africa and malaria is the largest cause.” Dr Lawrie, whose team is not involved in the roll-out, but in which Unicef will play a part, continued: “c It is an effective tool, and it is hoped our vaccine could help the WHO reach its goal to prevent deaths from malaria by 90% by 2030.” Although the vaccine was made in Oxford, it brought in SII – the world’s biggest vaccine manufacturer – to “upscale” production but still maintains control of the vaccine. “They can make 100 million doses per year, and to date 25 million doses are ready for the roll-out,” Dr Lawrie said.
Dr Lawrie studied biology at the University of Paisley, later gaining a doctorate in baculovirus molecular virology in 1993 at Oxford Brookes University. But it was while working for the gene therapy company Oxford
Bio-medica that she gained experience in clinical trials using vaccines, including regulatory affairs and manufacturing. She joined Professor Hill’s team in 2006.
Her current role involves working on the clinical development of vaccines against not only malaria but other diseases including ebola and Covid-19.
Phase one of their malaria research began at Oxford in 2010 and early “challenge” trials followed several years later, with healthy volunteers in Oxford, London, and Southhampton who agreed to be infected with malaria to test the vaccine’s safety.
The latest phase three trials of R/21 – which uses Novavax’s Matrix-m, an ingredient that helps enhance the immune response – involved more than 4,800 children in Burkina Faso, Kenya, Mali and Tanzania, and found on average a 78% vaccine efficacy over the first year of follow-up in the fiveto-17-month age group. There were no adverse effects linked to immunisation. Researchers said no other vaccine had reported over 55% efficacy in the same age group, and a booster dose at a year maintained good efficacy over the following six to 12 months.
The vaccine also reduced infection rates in children measured at 12 and 18 months after vaccination suggesting “a potentially beneficial effect in reducing malaria transmission.”
Unicef said its agreement to secure supply of malaria vaccine R21 is: “a critical step towards protecting more children from this deadly disease which still kills one child under five every minute.”