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Table 4 Research priorities for the development of vaccines for malaria eliminationa

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

Knowledge of human immunity
Identification of correlates of immunity for pre-erythrocytic, blood-stage, and transmission-blocking vaccine candidatesb
Mechanisms of immunity: protection against infection and disease, and transmission-blocking
How long-lasting immune responses and immunological memory are generated through natural exposure
Influence of existing naturally-acquired immunity on responses to vaccines and vaccine efficacyc
Quantify the significance of antigenic diversity and the potential for vaccine escape
Vaccine antigens and combinations
Developing CSP-based vaccines, or other pre-erythrocytic vaccine candidates, for greater efficacy against infectiond
Identification and prioritisation of blood-stage and transmission-blocking vaccine candidates for inclusion in combination vaccines
Antigen combinations that induce high levels of immunity against infection and disease, and strong transmission-blocking activitya
Combined P. falciparum and P. vivax vaccines
Vaccine approaches and technologies
Vaccine strategies or approaches to induce long-lasting immunitye
Adjuvants and delivery systems for induction of potent immune responses
Antigen expression platforms optimised for production of multi-antigen vaccinesf
Vaccine technologies to simplify the implementation of mass vaccination (e.g. needle-free systems, reduced cold-chain requirements)
Integration of malaria antigens into existing childhood vaccinesg
Other
Tools to monitor vaccine coverage and predict protection
Understand the potential efficacy/impact of vaccines in different transmission settings
  1. aThe broad aims for malaria elimination vaccines would be vaccines with a high level (>80 %) of efficacy against malaria infection and disease, and a strong potential to reduce malaria transmission by preventing infection or blocking transmission, or a combination of both.
  2. bCorrelates of immunity would greatly facilitate prioritisation of antigens and combinations for vaccine development, and aid the evaluation of vaccines in clinical trials
  3. cThere is some evidence that pre-existing naturally-acquired immunity influences the protective efficacy of the RTS,S vaccine.
  4. dThe RTS,S vaccine has established the potential of vaccines based on the circumsporozoite protein (CSP), but efficacy may be improved by different constructs, vaccine formulations, or additional antigens
  5. eThe longevity of immune responses reported for RTS,S and other malaria vaccines is shorter than many other licensed vaccines for other pathogens
  6. fA single platform for the production of vaccine antigens would be an advantage for achieving highly efficacious multi-antigen malaria vaccines
  7. gWhile malaria vaccines could be given concurrently within the childhood EPI programme, the inclusion of malaria antigens into existing childhood vaccines, to be administered as a single product, would facilitate mass administration and simplify EPI regimens