Many people might mistakenly believe that because of the development of the first licensed malaria vaccine, GSK's Mosquirix (RTS,S), its rollout and implementation will be a simple feat. However, this is far from the truth. As wily a pathogen as malaria -- which has killed half the humans that have ever lived -- shouldn't be expected to go down so quietly.
Make no mistake the RTS,S vaccine is an important step forward and its development, which represents the 1st licensed vaccine for a parasitic disease, will add to the armamentarium of anti-malaria control measures. The problem, however, is that the vaccine's efficacy after the required 4 doses is only 40%.
More recent data shows that this 40% figure might slip lower when the malaria parasite's penchant for mutation is taken into account. In a study of over 4500 vaccinees, the efficacy of the vaccine slipped to about 33% when there was a mismatch between the malaria parasite's circumsporzoite C-terminal and the corresponding vaccine component giving rise to the idea of vaccine-resistant malaria.
This puts malaria control personnel into a difficult situation. How does one allocate funds with a somewhat protective (but limited) vaccine in the mix? Should less emphasis be placed on indoor spraying? Bed nets? Will the vaccine instill false confidence in the population prompting them to be less compliant with insecticide treated bed nets which unequivocally work.
All are difficult questions that will require a lot of thought.