Côte d’Ivoire became the first country to roll out the new R21/Matrix-M vaccine with the first child vaccinated in Abidjan on Monday.

The vaccine, co-developed by the University of Oxford and Serum Institute of India (SII), was granted prequalification status by the World Health Organization (WHO) in December last year.

This follows the approval of the malaria vaccine, RTS,S. Both vaccines are expected to have a high public health impact. 

Every year 600,000 people die of malaria in Africa, according to the WHO. Children under five years of age make up at least 80% of those deaths. 

Although the number of malaria-related deaths has fallen from 3,222 in 2017 to 1,316 in 2020 in Côte d’Ivoire, the mosquito-borne disease kills four people a day, mostly small children, and “remains the leading cause of medical consultations”, according to the Ministry of Health.

Wide implementation of the malaria vaccines, in conjunction with existing prevention methods like the use of bed nets, is expected to save tens of thousands of young lives each year.

 SII has manufactured 25 million doses of the vaccine and is committed to scaling up to 100 million doses annually, offering the vaccine at less than $4 per dose. 

“Reducing the malaria burden is finally within sight. Today’s start of the R21/Matrix-M™ vaccine roll-out marks a monumental milestone after years of incredible work with our partners at Oxford and Novavax,” said SII CEO Adar Poonwalla.

The vaccination “signifies the culmination of years of dedicated research and manufacturing efforts” by the two partners, they said in a joint media release.

 “The roll-out of the R21/Matrix-M™ malaria vaccine marks the start of a new era in malaria control interventions with the high efficacy vaccine now accessible at a modest price and very large scale to many countries in greatest need. We hope that very soon this vaccine can be provided to all countries in Africa who wish to use it,” said Professor Adrian Hill, Director of the Jenner Institute at Oxford University.

A total of 656,600 doses have been sent to the country, which will initially vaccinate 250,000 children aged up to 23 months across all 16 regions. 

The R21/Matrix-M vaccine has also been authorised by Ghana, Nigeria, Burkina Faso, and the Central African Republic. 

Gavi, WHO, UNICEF, the Global Fund and others are working with countries on their plans for vaccine roll out as part of holistic malaria control and prevention plans.

Fifteen African countries are expected to introduce malaria vaccines with Gavi support in 2024, and countries plan to reach around 6.6 million children with the malaria vaccine in 2024 and 2025. Gavi and partners are working with more than 30 African countries that have expressed interest in introducing the malaria vaccine.

 Gavi CEO Dr Sania Nishtar said: “Africa has borne the brunt of malaria for far too long, and Côte d’Ivoire has suffered more than most. With two safe and effective vaccines now available alongside other interventions, we have an opportunity to finally turn the tide against this killer disease.”

Image Credits: Miléquêm Diarassouba/ Gavi.