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Why haven't we made an efficacious vaccine for malaria?

Michelle N Wykes

Author Affiliations

  • Michelle N Wykes, 1 The Queensland Institute of Medical Research, Queensland, Australia

Malaria, caused by Plasmodium spp., is annually responsible for approximately 780,000 deaths and more than 225 million clinical infections worldwide. In the past ten years, over 40 malaria vaccines designed to generate immunity against subunit components of liver or blood‐stage parasites, or whole sporozoites, have undergone clinical trials. Many show excellent protection in pre‐clinical and initial phase I and phase IIa trials, but none have progressed to the stage of a vaccine that protects in the field. Even the leading malaria vaccine candidate RTS,S was found in phase IIIb trials to provide only modest protection against both clinical and severe malaria in young infants. Which leads to the question: why haven't we been able to make an efficacious malaria vaccine?

Plasmodium spp. are efficient at establishing repeated, new and chronic clinical and sub‐clinical infections, despite …

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