Pre-pregnancy malaria injection could protect women and their babies

Women in Africa who are given a malaria vaccination before they get pregnant could be protected against infection for almost two years without the need for a booster, a study has found.

Researchers said the findings are a “tremendous advance” in protecting women against the potentially deadly disease.

Estimates suggest severe malaria infection – or plasmodium falciparum – during pregnancy leads to 50,000 deaths and 200,000 stillbirths in Africa every year.

For the study, the team recruited 300 women in Mali who were planning to get pregnant in the coming year.

Of the group, 100 were given a low dose of the vaccine, while 100 were given a high dose and 100 were given a placebo.

After receiving the injection, the women stopped using birth control and were followed up over two malaria seasons spanning almost two years.

Of the women who became pregnant, their babies were also followed up to their first birthday.

In the high-dose group, the efficiency of the vaccine against malaria infection was 86 per cent during the first year in women who went on to get pregnant.

The efficiency in the low-dose group during pregnancy was 57 per cent. Researchers also found efficiency in the low-dose group to be as high, or higher, in the second year as in the first year at 61 per cent without boosting.

Malaria vaccine – in pictures

“This is a tremendous advance for protecting women against malaria before and during pregnancy,” Alassane Dicko, who leads the team at the Malaria Research and Training Centre in Bamako, Mali, said.

Vaccinated patients also became pregnant sooner, researchers found.

“We were excited to see significant vaccine efficacy against Pf infection not only in the first year but through a second intense malaria transmission when administered preconception,” Mr Dicko said.

“We were also surprised to find an additional positive outcome, that pregnancies developed sooner in vaccinated participants.”

The African region reported 233 million cases of malaria and 580,000 deaths in 2022, according to the World Health Organisation. This equated to 94 per cent of cases and 95 per cent of deaths globally.

Babies, children under the age of five, pregnant women and people with HIV or Aids are all at higher risk of severe infection. The first malaria vaccine – RTS, S – was recommended by the WHO to prevent malaria in children in October 2021.

It has reached almost two million youngsters in Kenya, Ghana and Malawi through the WHO’s Malaria Vaccine Implementation Programme.

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

“The results of this study in women of child-bearing potential demonstrate clearly its potential to save the lives of women and their unborn babies in Africa,” Stephen L Hoffman, founder and chief executive of Sanaria, said.

Prof Rose Leke, of the University of Cameroon, added: “While pregnant women are typically excluded from many clinical studies, given the scale of the problem and the profound effects of malaria on women of child-bearing potential, there is an ethical imperative to design and test interventions for this vulnerable group.

“I applaud this research team for successfully pioneering the safe testing of PfSPZ vaccine in young women and achieving such promising results on preventing malaria in pregnancy.”