Study shows: Malaria vaccination before pregnancy could protect women and their babies

According to scientists, a malaria vaccine could protect women in Africa from infection for almost two years before pregnancy without the need for a booster vaccination.

The results represent a “tremendous advance” in protecting women from the potentially fatal disease, the researchers said.

They estimate that severe infection with malaria – or Plasmodium falciparum – during pregnancy in Africa leads to 50,000 deaths and 200,000 stillbirths each year.

For the study, the team recruited 300 women in Mali who wanted to become pregnant in the coming year.

Of the group, 100 received a low dose of the vaccine, 100 received a high dose and 100 received a placebo.

After vaccination, the women stopped using contraception and were followed up over two malaria seasons spanning almost two years.

In the women who became pregnant, the babies were also monitored until their first birthday.

In the high-dose group, the vaccine's effectiveness against malaria infection in the first year in women who subsequently became pregnant was 86%.

The efficacy of vaccination in the low dose group during pregnancy was 57% across the two seasons.

The researchers also found that efficacy in the low-dose group was as high or higher in the second year than in the first year, reaching 61% without a booster.

Alassane Dicko, team leader at the Malaria Research and Training Centre (MRTC) in Bamako, Mali, said: “This is a huge step forward in protecting women from malaria before and during pregnancy.”

The researchers found that vaccinated patients also became pregnant more quickly.

Mr Dicko added: “We were pleased with the significant efficacy of the vaccine against Pf infection, not only in the first year, but also during a second, intense malaria transmission when given before conception.”

“We were also surprised to find another positive result: pregnancies occurred earlier in the vaccinated participants.”

According to the World Health Organization (WHO), 233 million cases of malaria and 580,000 deaths were reported in the African region in 2022.
This represents 94% of cases and 95% of deaths worldwide.

Babies, children under five, pregnant women and people with HIV or AIDS are at higher risk of serious infection.

The first malaria vaccine – RTS,S – was recommended by WHO in October 2021 to prevent malaria in children.

The WHO malaria vaccination programme has reached almost two million young people in Kenya, Ghana and Malawi.

In October last year, WHO recommended the programmatic use of malaria vaccines for children in endemic areas, including the vaccines RTS, S/AS01 and R21/Matrix-M.

Stephen L. Hoffman, founder and CEO of Sanaria, added: “The results of this study in women of childbearing age clearly demonstrate that the drug has the potential to save the lives of women and their unborn babies in Africa.”

Professor Rose Leke of the University of Cameroon added: “While pregnant women are typically excluded from many clinical trials, given the scale of the problem and the severe impact of malaria on women of childbearing age, there is an ethical obligation to develop and test interventions for this vulnerable group.

“I welcome the fact that this research team has pioneered successful safe testing of the PfSPZ vaccine in young women and has achieved promising results in malaria prevention during pregnancy.”