On Thursday, the Nigerian government received 846,200 doses of the R21/Matrix-M malaria vaccine from GAVI, the Vaccine Alliance.
This is the first batch of the vaccine to be delivered to Nigeria since it was endorsed by the World Health Organization (WHO) alongside the RTS,S vaccine in October 2023.
At the vaccine handover ceremony in Abuja, the Coordinating Minister for Health and Social Welfare, Muhammad Pate, described the development as a major milestone in Nigeria's fight against malaria.
He also stated that a balance of 153,800 more doses is expected on October 26 to reach one million malaria vaccines.
The minister said Nigeria plans to combine the vaccine with other existing tools that have proven effective in controlling and eliminating malaria in the country.
He said the country plans to “optimize available tools such as mosquito nets, seasonal chemoprevention, intermittent preventive treatment, expand case management and layer on newer tools such as vaccines and adapt efforts to different parts of the country.”
Nigeria made history with the delivery of 846,000 doses of the R21 malaria vaccine. [PHOTO CREDIT: @WHONigeria]
As the country prepares to administer the new malaria vaccine and expand its efforts to eliminate and control malaria, here are ten important facts about the new R21 vaccine that you should know. Article page with financial support promotion
1. The development of a malaria vaccine began 60 years ago
Malaria vaccines have been in development for almost 60 years. It started in the 1960s, but it wasn't until 2021 that the WHO approved the first vaccine, RTS,S (Mosquirix).
The RTS,S (Mosquirix) vaccine was developed by GlaxoSmithKline (GSK), a British multinational pharmaceutical company, in partnership with the PATH Malaria Vaccine Initiative, a non-profit organization focused on vaccine introduction.
The R21 malaria vaccine, on the other hand, is a newer vaccine developed by the University of Oxford and its spin-off company, Vaccitech. It was approved by the WHO in 2023. It was also approved by Nigeria's drug regulatory agencies last year.
2. Differences between RTS,S and R21
Both RTS,S and R21 are intended to protect against Plasmodium falciparum, the world's deadliest malaria parasite.
However, the R21 vaccine contains a high dose of malaria antigen and uses the Matrix-M adjuvant to stimulate the immune response, while the RTS,S uses the AS01 adjuvant system, which helps stimulate an immune response.
There is also a difference in the dosage needed to ensure protection against malaria.
However, the WHO has said these vaccines have similar effectiveness in clinical trials, preventing about 75 percent of malaria episodes in areas with a high burden of the disease.
The UN agency said there is no evidence to show that any vaccine works better as they have not been tested in a head-to-head trial.
3. Vaccine launch
RTS,S was first tested in Ghana, Malawi and Kenya in 2019, but the world's first mass malaria vaccination was carried out in Cameroon in January 2024.
There was another release in April. Three West African countries, Liberia, Sierra Leone and the Republic of Benin, received and distributed thousands of doses of the RTS,S malaria vaccine to children in those countries. However, Nigeria, despite bearing the largest global burden of the disease, did not participate in the vaccine rollout.
In Nigeria, malaria is responsible for 11 percent of maternal deaths and 25 percent of child deaths.
4. Malaria vaccine delayed in Nigeria
Other African countries, such as Sierra Leone and Cameroon, which received and administered the vaccine, were matched with the RTS,S vaccine. Nigeria, as Newslodgepreviously learned, has received the R21 vaccine.
Vaccines sent to Nigeria had been delayed because the malaria vaccine designated for distribution in the country by GAVI was not ready for distribution at that time.
GAVI's head of malaria vaccine Scott Gordon previously told Newslodgethat the three countries that began distributing malaria vaccine doses to children in their countries were the ones that received RTS,S. It was a vaccine ready for distribution at the beginning of the year.
5. Why R21 was designated for Nigeria
According to Gordon, countries were matched with vaccines based on cost along with their level of demand.
Mr Scott noted that GAVI considered the R21 vaccine to be the most suitable for Nigeria based on the country's needs and plans, as presented in its proposal to GAVI.
“The match is based in part on the cost of the vaccine and the available supply. It is to ensure that there is enough vaccine to scale up according to Nigeria’s needs and plans,” Scott had told PREMIUM TIMES.
6. How the R21 vaccine works
The R21/Matrix-M administered to Nigeria is a new malaria vaccine that works almost like the RTS,S vaccine. However, it is designed to provide stronger immunity against the malaria parasite while reducing responses to an unrelated part of the vaccine.
The R21 vaccine attacks the malaria parasite before it reaches the red blood cells, where the parasite often multiplies and causes common symptoms such as fever, headache and a general feeling of malaise.
The malaria parasite produces this protein, which helps it infect the liver, but the R21 vaccine helps the immune system recognize and fight this protein. In this way, the parasite is prevented from establishing an infection in the liver.
However, the required number of doses must be administered to ensure full protection.
7. The R21 vaccine is for children 5 to 15 months.
According to the World Health Organization, the R21 vaccine is recommended for babies between 5 and 17 months. However, National Primary Health Development Agency (NPHCDA) CEO Muyi Aina said the vaccine will be administered to children between 5 and 15 months through routine immunization.
Aina said each child would be given four injections of the vaccine to be safe from malaria.
He said the vaccine would be given first at five months, once at six and seven months and a final injection at 15 months of age “to be fully protected”.
8. The launch will begin in Kebbi, Bayelsa.
Nigeria intends to begin administering the new vaccine in November. The first doses of the vaccine will be administered to children in Bayelsa and Kebbi, two states where seasonal transmission of the disease is high.
According to the Minister of Health, the vaccine will be applied only in two states due to the limited number of doses.
“Kebbi because it has the highest prevalence rate in the country (52 percent); while Bayelsa has been selected because its target population of 69,935 people and Kebbi's population of 162,014 aligns with the one million doses available for this phase, thus ensuring that the vaccine supply is used effectively,” the NPHCDA stated.
9. Limited vaccine available
At the handover ceremony on Thursday, Pate indicated that the vaccine sent to Nigeria is limited compared to the level of prevalence.
The 846,200 doses of the R21 vaccine sent to Nigeria can only be administered to 211,550 children if each receives four injections.
Although there is no concrete data on the population of children between 5 and 15 months, according to the United Nations Children's Fund, at least 7 million babies are born in Nigeria every year.
However, a remainder of 153,800 more doses will be sent to Nigeria in about a week or two to reach the million mark.
The prevalence of malaria in Nigeria is significantly high. In 2022, it was ranked as the country with the highest prevalence of malaria among 29 countries. The country accounts for 27 percent of the global burden and 31.3 percent of global deaths.
10. 'The vaccine will be combined with existing tools'
The country plans to combine the vaccine with other existing tools that have been shown to be effective in controlling and eliminating malaria.
According to the Minister of Health, the country plans to “optimize available tools, such as mosquito nets, seasonal chemoprevention, intermittent preventive treatment, expand case management and layer newer tools such as vaccines and adapt efforts to different parts of the country. .”
National Primary Health Development Agency (NPHCDA) CEO Muyi Aina has said the R21 vaccine would accelerate national malaria control and elimination efforts.
“We expect a reduction of around 13 per cent in all-cause mortality in children under five and a 22 per cent reduction in severe hospitalized malaria cases,” Mr Aina said.