Malaria eradication and elimination: views on how to translate a vision into reality

Table 3 The role for different vaccine approaches in preventing malaria infection, disease, and transmission

Vaccine objective	Vaccine targets
	Pre-erythrocytic	Blood-stage	Gametocytes and mosquito stages	Combined Pre-E and BSV	Combined: All stages
Protection against infection	++^a	+^b	−^c	+++	+++
Protection against disease	++	++	-	+++	+++
Reduce transmission	++	?^d	++	++	+++

Legend to scoring : +, weak effect; ++ modest effect; +++, strong effect
^aPre-erythrocytic vaccines have shown significant efficacy against symptomatic malaria and infection, but it has proved to be difficult to achieve a strong degree of protection against infection
^bBlood-stage vaccines primarily aim to prevent clinical illness and have generally only been weakly protective, on their own, against infection per se
^cTransmission-blocking vaccines do not directly protect individuals from infection or disease
^dBlood-stage vaccines may reduce transmission because they reduce parasite density [80], but this remains to be quantified
Abbreviations: Pre-E pre-erythrocytic, BSV blood-stage vaccines

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