The first malaria vaccine is a major milestone despite all the hurdles ahead. Scientists have been working at it for decades – here's why they say it's been so difficult:
The new malaria vaccine will be most effective when it’s used along with existing prevention methods, including bed nets, chemical insecticides, and the frontline artemisinin-combination treatment, or ACT. The threat of resistance remains.
Disrupting the evolutionary relationship between humans and malaria is further complicated by unprecedented drug resistance. Although some variants have emerged naturally, most of the parasites' evolution has been the result of humans getting better at evading it. “The fact that artemisinin resistance emerged independently is something completely new; it makes it more complicated to contain,” Ringwald says. “Imagine a fire. If you have one forest burning, it's easier to contain, but if you have five different forests burning at the same time, it makes things far more complicated.”
A resurgence of interest in developing a vaccine against malaria is an incredibly important piece of the puzzle that is malaria treatment and prevention, Fidock says. In the coming years, he says we can expect more groundbreaking developments, but the challenge remains complicated and will likely still require a multi-pronged approach.Most people in areas where malaria prevalence is high develop a certain amount of immunity to the disease by the time they reach adolescence.
“It’s not unlike what we’ve seen with the coronavirus. It's very effective against the original version, and less effective against the Delta variant,” Wirth says. “We expect this could happen with malaria vaccines.”“The pneumococcal vaccine contains as many as 24 different antigen types to protect against all the different strains.
David A. Fidock, PhD, C.S. Hamish Young professor of microbiology and immunology, Columbia University, New York City.
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