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You are here: Home / Anderson On Health Insurance / A BFD for the tropical world

A BFD for the tropical world

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This is, truly a BFD for the tropical world.

Malaria kills hundreds of thousands of people per year and infects millions. A reliable and relatively inexpensive vaccine will be a massive improvement in the quality of life for hundreds of millions of people. It still needs to go through Phase 3 trials, but getting out of the Phase 2 trial stage means that this vaccine has surmounted a significant hurdle.

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44Comments

  2. 2.

    Nicole

    That is awesome, awesome news.

    My son learned this year in school that the deadliest animal threat to mankind is the mosquito. I can’t wait to share this positive step towards a malaria vaccine with him.

  3. 3.

    satby

    That’s thrilling news! On par (eventually) with eradicating small pox.

    Great news for those of us who volunteer in malaria zone countries too, because the prophylactic medicines aren’t well tolerated by a lot of people.

  5. 5.

    jonas

    I know the Gates Foundation has been pouring money over the past decade or more into finding a malaria vaccine. Anyone know if this particular vaccine is a product of that effort?

  6. 6.

    NotMax

    “George Washington had malaria, why can’t we?”
      – RWNJ squawking point in 3…2…1…

  12. 12.

    Another Scott

    @MisterForkbeard: From the paper, it doesn’t sound like mRNA to me:

    Methods: We conducted a double-blind, randomised, controlled trial of a low-dose circumsporozoite protein-based vaccine, R21, with two different doses of adjuvant, Matrix-M™ (MM), in children aged 5-17 months in Nanoro, Burkina Faso, a highly seasonal malaria transmission setting.

    Good news, whatever it is!

    Cheers,
    Scott.

  14. 14.

    JCJ

    This is fantastic.  In 1989 I spent two months of medical school in northern Thailand with one week of that in the small town of Mae Sariang.  In that week I saw two people die of malaria.  I also spent a week in a village (Karen) near the border with Myanmar where malaria was quite common.

  15. 15.

    Ken

    @satby: “750 million genetically modified insects to be released”. What could possibly go wrong?l

    Naw, just kidding, I’m sure the scientists are on top of this and the state will carefully — OMG, it’s in Florida?

  16. 16.

    Mousebumples

    I think this is way too early to have results for an mrna malaria vaccine, but I had heard that was in the works. Considering that malaria prevention to date is “Don’t get bitten by mosquitoes” and Sickle Cell Anemia** is somewhat because of the genetic mutations to help prevent malaria… Big Fucking Deal.

    **genetically, there is a mutation where if an individual is heterozygous (1 dominant gene & 1 recessive) they have added protection against malaria. 2 recessive genes results in Sickle Cell Disease. There’s an evolutionary benefit at the moment to select for heterozygous genetic makeup wherever malaria is endemic. With 2 heterozygous parents, that’s a roughly 1 in 4 chance of Sickle Cell.

  17. 17.

    Barbara

    Not just a big deal because a vaccine would eradicate the disease burden itself, which is vast, but it would also eradicate the need to spend so many resources, in sometimes environmentally destructive ways, to combat the spread of malaria.

  18. 18.

    Ken

    @Frank Wilhoit: We have not processed the consequences of the last one.

    Though there are some preliminary indications that success breeds failure. For example, vaccinating absolutely everyone against measles and rubella in the 1950s and 60s led to two generations with no experience of outbreaks, and a “why bother vaccinating” attitude.

  19. 19.

    satby

    @jonas: It does not appear to be directly funded by the Gates Foundation, but their funding undoubtedly contributed to some of the previous breakthroughs that led to this one.

    One potential downside right now is that it’s being produced by the Serum Institute of India, which is currently overwhelmed with trying to produce enough covid vaccines.

  20. 20.

    Barbara

    @Ken: ​ Yes, but it’s also the case that public health authorities recognize that once diseases really have been eradicated, it’s okay to stop vaccinating people. The hope was that measles and polio would join that very small club, which now includes only small pox. Wars and international travel have waylaid those plans, which were probably always too optimistic.

  21. 21.

    wenchacha

    My brother and his ex traveled in Kenya and Tanzania many years back; his ex had spent time in a village during/after college. Anyway, my brother fell ill, went to the doctor who checked him out. “Oh, you have a LOT of malaria! Ha ha ha ha!” Sorta the Dr. Hibbert style.

    He recovered. It will be great if this vaccine works to the nd this scourge.

  24. 24.

    Matt McIrvin

    I’ve heard that malaria has such a high reproduction rate that a vaccine with this level of effectiveness might not make much of a dent in the spread of the disease. But it’d save a lot of lives just by keeping most people from getting sick.

  25. 25.

    Cheryl Rofer

    Slightly OT, but the Surgeon General wants you to read this thread about the rumor that the US is refusing to send vaccine manufacturing components to India. Bottom line is what I’ve thought: We are ramping up global vaccine production VERY quickly, and there are some shortages. We’re sending some of what is needed to India.

  27. 27.

    Mary G

    Oh noes! What will happen to all the idiots who cornered the market on hydroxycloroquine? [Cough cough TFG, Kushner & pillow guy]

  28. 28.

    TomatoQueen

    @Ken: Huh? A short history of modern vaccine development from CHOP (Children’s Hospital of Philadelphia) Vaccine History: Developments by Year | Children’s Hospital of Philadelphia (chop.edu) contains:  In 1963, the measles vaccine was developed, and by the late 1960s, vaccines were also available to protect against mumps (1967) and rubella (1969). These three vaccines were combined into the MMR vaccine by Dr. Maurice Hilleman in 1971.  Your point about people becoming rapidly stupid about childhood diseases omits the deterioration of public education in the same generation as well as Republican depredations, which in many places have been sufficient to create the circumstances for serious outbreaks, especially of measles. I hope this trend is subsiding but doubt it.

  29. 29.

    mali muso

    Yeah, can confirm from personal experience living in Mali…this is a BFD.  I remember going into my workplace to find that an otherwise healthy colleague I had just seen the previous week had died over the weekend due to malaria complications.  It’s so prevalent.  This would be amazingly good news for so many people!

  30. 30.

    Anonymous At Work

    Phase 2 is the high hurdle, I think, for a malaria vaccine.  Safety and toxicity data verified, now efficacy verified.  Phase 3, real-world and comparative efficacy, is comparing the vaccine to…nothing.

  31. 31.

    Another Scott

    @Another Scott:

    ScienceMag has more:

    […]

    The children in the current trial, aged 5 months to 17 months, received three doses of vaccine at 4-week intervals and a booster dose at 12 months. Of the 146 children who received vaccine containing a high dose of an immune-boosting compound called an adjuvant, 38 developed malaria, versus 105 of 147 children in a control group who received rabies vaccine. (That protocol ensured the control group also received value from being in the trial.)

    The 77% efficacy against malaria dipped to 74% in children who received the malaria vaccine with a lower dose of adjuvant. The children’s levels of specific antibodies to malaria waned over 12 months, but the booster dose restored them.

    WHO has called for the development of vaccines capable of reducing malaria cases by 75% by 2030. But the malaria parasite’s complex life cycle and shifting surface proteins have challenged vaccine developers. The highest efficacy previously published for a vaccine at 1 year after dosing was 56%, Hill notes. That was for Mosquirix, made by GlaxoSmithKline, which is structurally similar to the Oxford vaccine and, like the Oxford vaccine, also targets the parasite right after infection. Mosquirix is being deployed with WHO support in areas of Malawi, Kenya, and Ghana. (At 4 years out, that vaccine’s efficacy declined to 36%.)

    The Oxford vaccine, made in yeast, consists of hepatitis B surface protein combined with a piece of a protein that coats the surface of the malaria parasite when it first invades its human host. The hepatitis B surface proteins self-assemble into a “viruslike particle” studded with the malaria proteins.

    The Oxford group has partnered with the Serum Institute of India, which is making vaccine for a planned phase 3 trial and has pledged to produce 200 million doses in the coming years; Hill says those doses can be manufactured cheaply. “The price [will be] less per dose than anything ever before,” he says. The adjuvant, a purified plant compound called a saponin made by Novavax, is already being manufactured at scale as part of that company’s COVID-19 vaccine.

    Others cautioned that many unknowns remain, and some called out what they called deficiencies in the Lancet preprint. “Where’s the biology?” asked Rhoel Dinglasan, who studies malaria at the University of Florida’s Emerging Pathogens Institute. He is developing a different malaria vaccine, aimed at stopping transmission of the parasite from humans to mosquitoes. He applauded the clinical results but wanted to see, among other things, genomic data from the malaria parasite that infected the vaccinated children.

    Dinglasan says that without sequence data, it’s not clear whether the vaccine will be effective against all parasite strains. The efficacy of the GlaxoSmithKline malaria vaccine fell by one-third, to 33.4%, when there was a mismatch between a key part of the protein used in the vaccine and the corresponding protein in the parasite, he notes. And a mismatched vaccine could drive selection for vaccine-resistant parasites, potentially thwarting the quest for a highly effective vaccine once again.

    (Emphasis added.)

    Bodies are complicated. Figuring out how to make them work better even moreso. Kooks that say diet and exercise and payer are all that is needed are dangerous.

    Cheers,
    Scott.

  32. 32.

    Anonymous At Work

    Two more things.

    First, this puts malaria eradication in reach, without the ethical question of mosquito eradication.  Places traditionally only did the former with the latter (Cuba, ~1900), with mosquito reintroduction allowing the disease to be return.

    Second, the technology here seems similar to mRNA vaccines’ “surface protein without the creamy disease filled center”.  Between this and CRSPR-Cas9 advances, being able to selectively disable viruses and disease-causing microorganisms could lead to a new frontier in disease eradication.

     

    Finally, screw mosquitos.  Aegypti should go.

  34. 34.

    JCJ

    Another huge benefit would be that medications taken as prophylaxis can cause psychosis.  I saw someone having this problem from mefloquine.  I believe there was a soldier in Afghanistan (Bales?) that killed a bunch of people in a village where this psychiatric side effect was considered as the cause of his action.

  35. 35.

    randal m sexton

    I have read some climate change reporting that the malaria mosquitos range would be able to spread much further towards the poles when warming really kicks in, so this is potentially good news to all of us.

  38. 38.

    matt

    I read the bolded part in the comment I replied to as saying the “vaccine” directly binds to the malaria parasite. That would make it more of an antibiotic. But maybe there’s more elsewhere about how it works.

  40. 40.

    PhoenixRising

    @germy: Precisely.

    We’re going to wipe out malaria in this generation. This is a BFD to me because it means my kid’s country of birth can achieve economic development that has been impossible to date given the ripple effects of malaria infections (land lost to moneylenders who cover cash costs of treatment, families separated by travel to work to pay back medical fees, etc) and that babies like her won’t lose their hearing to the available treatments for malaria, as she did.

    But it’s gonna happen because malaria is coming north for the summers and the money to get this vaccine distributed is going to be peanuts compared to trying to eradicate Aedues egyptii from Florida.

  41. 41.

    A woman from anywhere (formerly Mohagan)

    @Nicole: I have just read a review of a history of mosquitos and disease in an old London Review of Books, and it said the same thing. The second deadliest animal for humans was other humans, of course. Malaria, Yellow Fever, etc. have had a great influence on world history. As one example, because malaria is endemic in much of Africa, many Africans carry the sickle-cell anemia disease gene. If you have 2 copies of the gene, the disease will kill you, but one copy gives protection against malaria. Thus Africans could survive better working in the fields in the Caribbean and southern United States where malaria was widespread than whites, giving great impetuous to the slave trade.
    News of a vaccine would be world-changing in Africa. Even with the prophylactic medicines we took on our trip to East Africa, every night we slept behind mosquito curtains.

  42. 42.

    A woman from anywhere (formerly Mohagan)

    @JCJ: The anti Malaria medicine I took during a trip to East Africa killed my appetite after a while (which is remarkable for me :-)). Didn’t notice any other side effects, but it was only a 3 week trip.

  43. 43.

    satby

    @satby:  Late addition, but in answer to Jonas’s question the Gates Foundation had heavily funded GSK, which developed Mosquirix. And from @Another Scott:  was this nugget:

    Mosquirix, made by GlaxoSmithKline, which is structurally similar to the Oxford vaccine and, like the Oxford vaccine, also targets the parasite right after infection. Mosquirix is being deployed with WHO support in areas of Malawi, Kenya, and Ghana.

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