Explained: What the WHO-approved malaria vaccine for children means for disease eradication efforts

The World Health Organization (WHO) last week gave approval for the widespread use of RTS,S/AS01, the first malaria vaccine, in children under the age of five. This green signal is said to be a game-changer in the fight against the disease that affects many regions around the world including India.

However, according to WHO's World Malaria Report 2020, India reported the largest drop in cases - 70 percent - from 20 million cases in 2000 to 6 million in 2019. In 2020, as many as 116 districts reported zero malaria cases in the country, former Union Health Minister Harsh Vardhan said earlier this year. India aims to reach the WHO's ‘Zero Malaria Target' by 2030.

While India has shown a reducing trend in the number of malaria cases over the last few years, the condition in African countries is still worrisome. As per the WHO report, approximately 409,000 people died from malaria in 2019 around the world, while the continent of Africa accounted for 94 per cent of all cases and deaths.

The RTS,S/AS01 approval, which comes after success in a pilot programme conducted in Kenya, Ghana and Malawi since 2019, is expected to be a major boost for curbing the disease. In earlier trials, among children aged 5-17 months who received four doses of it, the vaccine prevented about 4 in 10 or 39 percent of cases of malaria and about 3 in 10 or 29 percent cases of severe malaria, according to the WHO. The vaccine has been given the go-ahead for use in sub-Saharan Africa and other regions which have moderate to high malaria transmission from Plasmodium falciparum, considered the deadliest malaria parasite.

Although India has been faring better in combatting the disease, malaria is still a cause of concern. Mumbai has seen as many as 4,172 cases in 2021 till now. Mid-day reached out to Dr Vikrant Shah, consulting physician, intensivist and infectious disease specialist, Zen Multispeciality Hospital in Chembur to understand the importance of the vaccine. Shah also explains why people need to take the disease more seriously.

The World Health Organization has approved the first-ever malaria vaccine RTS, S/AS01 for children. What do we know about the vaccine and its effectiveness?
The World Health Organization (WHO) recommended RTS, S/AS01, or Mosquirix, made by a British drugmaker GlaxoSmithKline (GSK), an anti-malaria vaccine for children. This vaccine is touted as a gift to the world and can be a boon for children to fight malaria. It is for the first time that the vaccine has been recommended for a human parasite.It is considered a massive breakthrough and is found to be safe and effective in trials. This can save many lives every year.

What is the significance of this malaria vaccine approval, in terms of controlling infections anddeathsin India and Mumbai?
A malaria vaccine will have to be given in four doses in children from 5 months and will help in the reduction of mortality and morbidity rates. When it comes to India, the vaccine will help reduce the disease burden as it has a favourable safety profile, is also feasible to deliver and can reach each and every child.

The vaccine will be beneficial in Mumbai to prevent unwanted deaths. Many lives will be saved as the vaccine is found to be effective.

Has the vaccine ever been used in India before? If not, when is it likely to be available here?
No, this kind of vaccine has not been used in India before. However, the vaccine will soon be available for children in the country.

How is it administered?
One will have to take 4 doses of the vaccine. Before taking this vaccine, please speak to your doctor.

The number of cases has seen a decline over the years in India. What have been the previously available countermeasures or treatments available for malaria in the country?

A line of treatment for malaria is based on the age, symptoms, which type of malaria parasite you have, and whether you are pregnant. Chloroquine phosphate was given for dealing with malaria, artemisinin-based combination therapies (ACTs) are offered, antimalarial drugs, and malaria prophylaxis is the preventive treatment of malaria. Apart from that, a well-balanced diet to boost immunity, wearing full-sleeved clothes, using mosquito nets and repellents, and avoiding water stagnation near houses are some of the vital tips to prevent malaria.

What are the common misconceptions surrounding malaria in India?

Myth 1: I am fully immune if I get malaria once.

Fact: Do not believe this myth at all. Being infected does not suggest that you are immune to the disease. It is not at all right to assume that you don't need protection if you have had malaria once.

Myth 2: Staying in an air-conditioned room will do the trick.

Fact: Yes, being in air-conditioned rooms may reduce the chances of being bitten by a mosquito at night. Still, you need extra protection to keep malaria at bay.

Myth 3: Malaria is not dangerous at all.

Fact: Not every case is life-threatening, but malaria can kill if not treated at the right time. Moreover, it has also claimed many lives in the past.

Myth 4: It is risky for every age group.

Fact: Young children and infants are more susceptible to malaria when compared to adults as their immune systems aren't fully developed.

Instead of believing in myths, people need to take charge of their health, they need to be educated regarding the benefits of getting vaccinations and safety. They need to be encouraged to get vaccinated to avoid hospital admissions and fatalities due to the disease. Be proactive about getting vaccinated, and staying healthy.

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