Malaria is one of the major public health concerns in Ghana. With year round transmission, the entire population is at risk. It is the primary cause of illness and death, especially among children under five years; however, malaria is both preventable and treatable.

The global health community continues to expand access to existing malaria control strategies, one of which is the introduction of the malaria vaccine. This vaccine will be used alongside existing effective anti- malaria interventions such as insecticide- treated nets, indoor residual spraying and seasonal malaria chemoprevention. The Malaria Vaccine implementation in Ghana will start in selected districts in four regions (Central, Volta, Brong Ahafo, and Upper East Regions)

What is the malaria vaccine (RTS,S also known as Mosquirix)?

It is an injectable vaccine that has been added to existing malaria preventive measures for children. This is the first time a malaria vaccine is being provided to children in routine immunization.

What are the benefits of the malaria vaccine?

This vaccine reduces the number of times a child gets malaria
It reduce the chances that the child will get severe malaria

How is the malaria vaccine given?

The malaria vaccine is given in four (4) doses at age 6 months, 7 months, 9 months and 24 months.

The malaria vaccine is given as an injection on the child’s left thigh by a trained health worker.

A child must receive all 4 doses to get the most protection.

Can the malaria vaccine be administered at the same time with other vaccines?

The malaria vaccine can be given safely along with other childhood vaccines.

How safe is the malaria vaccine?

The malaria vaccine has been rigorously tested for safety and efficacy in thousands of children in Africa, including Ghana. The malaria vaccine has been found to have an acceptable safety profile.

What are some of the possible side effects?

Some children who receive the malaria vaccine may react mildly to the vaccine. Some of the common reactions include:

- Fever
- Pain at the injection site
- Redness and swelling at the injection site
- Report to the nearest health facility if your child has any of these signs or any other reaction.

Which countries are participating in the MVIP?

Ghana, Kenya and Malawi are the three countries participating in the MVIP, with each of the 3 countries selecting the areas to be included in the pilots.

Why is the MVIP being rolled out only in Africa, and not in other regions?

The WHO African region bears the greatest burden of malaria worldwide. Most malaria illness and deaths in this region are caused by the parasite targeted by Mosquirix (P. falciparum). In recent years, malaria death rates in the region have dropped significantly following a major scale-up of long-lasting insecticidal nets (LLINs), artemisinin- combination therapies (ACTs) and other malaria control measures. However, the disease continues to take a heavy toll: in 2017, the region was home to 93% of all malaria deaths globally (or an estimated 403,000 deaths), mainly among young children. Mosquirix was developed for use in Africa and for African children. Additional studies will be needed before the vaccine can be recommended for use outside Africa.

Why is Ghana taking part in the MVIP?

In December 2015, the WHO put out a call for interested countries in Africa to apply to participate in the MVIP. Ghana responded to this call for expressions of interest. Ghana’s application was based on the country’s malaria burden as well as this country’s experience with Mosquirix during the clinical trials.

The existence of robust regulatory, ethical, malaria control and immunization systems and infrastructure in Ghana played a critical role in its selection as one of the three countries on the African continent to participate in this programme.

What is the expected duration of the programme?

The MVIP is expected to continue through 2022. During this time, the MVIP will provide data on the programmatic feasibility of delivering the vaccine in real-life settings, the safety profile of Mosquirx in the context of routine use, and the vaccine’s impact on child survival. Taken together, this information will inform future decisions on the wider-scale deployment of the vaccine.

In which countries were the Phase 3 clinical trials conducted?

The Phase 3 trial of Mosquirix enrolled over 15,000 infants and young children in seven sub-Saharan African countries (Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique, and the United Republic of Tanzania). The clinical trial sites within these countries represented a range of malaria transmission settings (low, medium and high) in order to determine the vaccine’s efficacy in these different settings.

What role did Ghanaian researchers play in the development of Mosquirix?

Researchers from the Kintampo Health Research Centre and the School of Medical Sciences, Kwame Nkrumah University of Science and Technology, participated in the Phase 2 and Phase 3 clinical trials to determine the safety, immunogenicity and efficacy of Mosquirix. The clinical trials in Ghana recruited a total of 3,439 infants and children within the ages of 6-12 weeks and 5-17 months.

What were the results from the Phase 3 clinical trials?

Vaccine efficacy

Among children aged 5–17 months who received three doses of Mosquirix administered at 1-month intervals, followed by a fourth dose 18 months later, the vaccine reduced malaria by 39%, equivalent to preventing nearly 4 in 10 malaria cases.

In addition, the four-dose vaccine schedule reduced severe malaria by 29% in this age group, with 37.2% reduction in malaria-related hospitalizations and 14.9% reduction in all- cause hospitalizations. A 29% reduction in blood transfusions, required to treat life- threatening malaria anemia, was also seen.

It is worthy to note that no vaccination is 100% protective; in that light Mosquirix does not prevent 100% of malaria cases. Mosquirix will therefore add to the existing malaria prevention efforts. It is meant to complement existing malaria control efforts.

Facts to Remember

- Vaccines save lives
- The malaria vaccine reduces the num- ber of times a child gets malaria
- A child who receives malaria vaccine may still get malaria; it is therefore important to continue with other preventive measures, such as sleeping under an insecticide treated net every night and throughout the night
- The malaria vaccine does not cause malaria
- The malaria vaccine is free
- Ensure your child receives all vaccines, including the malaria vaccine by age two
- Take along the maternal and child health record book (weighing card) any time you visit the health facility
- Malaria can be treated. Take your child with a fever to the nearest health facility for a malaria test and treatment