Abstract
Vaccines could be a crucial component of efforts to eradicate malaria. Current attempts to develop malaria vaccines are primarily focused on Plasmodium falciparum and are directed towards reducing morbidity and mortality. Continued support for these efforts is essential, but if malaria vaccines are to be used as part of a repertoire of tools for elimination or eradication of malaria, they will need to have an impact on malaria transmission. We introduce the concept of "vaccines that interrupt malaria transmission" (VIMT), which includes not only "classical" transmission-blocking vaccines that target the sexual and mosquito stages but also pre-erythrocytic and asexual stage vaccines that have an effect on transmission. VIMT may also include vaccines that target the vector to disrupt parasite development in the mosquito. Importantly, if eradication is to be achieved, malaria vaccine development efforts will need to target other malaria parasite species, especially Plasmodium vivax, where novel therapeutic vaccines against hypnozoites or preventive vaccines with effect against multiple stages could have enormous impact. A target product profile (TPP) for VIMT is proposed and a research agenda to address current knowledge gaps and develop tools necessary for design and development of VIMT is presented.
Highlights
Vaccines are the most cost-effective tools for public health and have been instrumental in previous elimination campaigns against smallpox [1], polio [2], and measles [3,4]
Vaccines have been useful for sustained control of diseases such as neonatal tetanus [5], and vaccines such as Haemophilus influenzae type b conjugate vaccine have the potential to lead to elimination in some settings [6]
Current efforts to develop malaria vaccines are primarily directed towards reducing the morbidity and mortality that are associated with malaria and focus on P. falciparum
Summary
Vaccines are the most cost-effective tools for public health and have been instrumental in previous elimination campaigns against smallpox [1], polio [2], and measles [3,4]. VIMT should reduce transmission rates so that Reffective for both P. falciparum and P. vivax is driven to less than 1 and should provide protection against clinical malaria caused by both parasite species.
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