The announcement by the WHO that a vaccine against malaria, more than thirty years in the making, could finally be recommended was greeted with joy in the media.
But our vaccine efficacy expectations, raised aloft by the COVID-19 vaccines’ stunning results, need to be tampered down in this case.
And while anti-vaccination activists claim, wrongly, that the approved RNA vaccines are “experimental” and are administered to people without their informed consent, the way in which the malaria vaccine’s implementation was pilot-tested in three African countries has raised the ethical questions of what constitutes research and whether or not proper consent was indeed secured in those children.
And more disturbingly, in the biggest trial of the vaccine, three safety signals were picked up: there was a ten times higher rate of meningitis, a higher chance of cerebral malaria, and a doubling of deaths from all causes in girls who had received the vaccine and not the placebo. Were these effects real or chance artefacts?
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It is high time Africa got a safe and effective vaccine against malaria, but ethical standards and transparency cannot be sacrificed. A vaccine’s protection does not simply come from its building blocks. It also comes from trust.
