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

Tanner, Marcel; Greenwood, Brian; Whitty, Christopher J. M.; Ansah, Evelyn K.; Price, Ric N.; Dondorp, Arjen M.; von Seidlein, Lorenz; Baird, J. Kevin; Beeson, James G.; Fowkes, Freya J.I.; Hemingway, Janet; Marsh, Kevin; Osier, Faith

doi:10.1186/s12916-015-0384-6

Table 4 Research priorities for the development of vaccines for malaria elimination^a

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 candidates^b
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 efficacy^c
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 infection^d
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 activity^a
Combined P. falciparum and P. vivax vaccines
Vaccine approaches and technologies
Vaccine strategies or approaches to induce long-lasting immunity^e
Adjuvants and delivery systems for induction of potent immune responses
Antigen expression platforms optimised for production of multi-antigen vaccines^f
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 vaccines^g
Other
Tools to monitor vaccine coverage and predict protection
Understand the potential efficacy/impact of vaccines in different transmission settings

^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.
^bCorrelates of immunity would greatly facilitate prioritisation of antigens and combinations for vaccine development, and aid the evaluation of vaccines in clinical trials
^cThere is some evidence that pre-existing naturally-acquired immunity influences the protective efficacy of the RTS,S vaccine.
^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
^eThe longevity of immune responses reported for RTS,S and other malaria vaccines is shorter than many other licensed vaccines for other pathogens
^fA single platform for the production of vaccine antigens would be an advantage for achieving highly efficacious multi-antigen malaria vaccines
^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

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