Kenya administers 450,000 doses of malaria vaccine in pilot programme

A health worker vaccinates a child against malaria in Homa Bay County, western Kenya, in September 2019. The vaccine (Mosquirix) is the world’s first malaria jab shown to provide partial protection against malaria in children and has been rolled out by the World Health Organization (WHO). PHOTO | AFP

Summary

• Kenya, alongside Ghana and Malawi, were the only countries globally that the World Health Organization (WHO) selected to participate in the RTS,S malaria vaccine pilot.
• The pilot was not a clinical trial but a vaccination programme closely monitored to collect more data to ensure that it was safe and effective before given to the broader population.

By The EastAfrican

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Since the malaria vaccine launch in Africa in September 2019, Kenya has managed to administer the total four doses to 4,017 children, says the Ministry of Health.

The data, not publicly available but shared with The EastAfrican ahead of the World Malaria Day, shows that Kenya has administered more than 450,000 doses of the RTS,S malaria vaccine.

Dr George Githuka, head of the Division of National Malaria Programme in Kenya told The EastAfrican that Covid-19 affected the movement to facilities for mothers and their children.

Dr Githuka said RTS,S, known by its brand name Mosquirix, was only deployed in eight counties with the highest malaria burden in western and southern Kenya: Bungoma, Busia, Homa Bay, Kakamega, Kisumu, Migori, Vihiga, and Siaya.

“The fewer people going to the hospital due to Covid-19 and the small region that employed the vaccine could explain the low numbers,” he said.

Safe and effective

Kenya, alongside Ghana and Malawi, were the only countries globally that the World Health Organization (WHO) selected to participate in the RTS,S malaria vaccine pilot. The pilot was not a clinical trial but a vaccination programme closely monitored to collect more data to ensure that it was safe and effective before given to the broader population.

According to WHO projections, more than 190,000 children in Kenya will have received the first dose, given to the children at six months. The children get the other doses at seven, nine and 24 months. After a full dose, the vaccine offers 30 percent protection.

The WHO models also show that Kenya will have given more than 450,000 doses by the end of this month. This is the lowest of the three countries: Ghana will have administered more than 680,000 doses, with nearly 240,000 children having received the first dose; Malawi will have given more than 620,000, and nearly 230,000 children getting the first dose.

Kenya expects word from WHO at the end of this year to know whether and how the Ministry of Health will vaccinate the larger population.

Although lower than was targeted, experts in the field have lauded the number registered. They have also encouraged the government not to lose sight of the other interventions aimed at eliminating malaria, a disease that kills two people every minute globally.

In Kenya, malaria is the second leading cause of why people visit and spend time in the hospital and sometimes die: in 2019, there were 4.7 million confirmed cases, an 18 per cent increase from 2018. Seven in ten of these cases (74.4 per cent) come from the eight counties mentioned above where the vaccine is deployed in Kenya.

Path, an international health innovation organisation that works with Britain-based pharma GlaxoSmithKline to manufacture the vaccine, termed the Kenya results as “very encouraging.”

In a statement sent to The EastAfrican from their Kenya office, Path said Kenya started the exercise almost five months after Ghana and Malawi.

Dr Dickson Mwakangalu, a public health specialist and malaria expert at the international health organisation Jhpiego, said that the vaccine is “one of the great arsenal” against malaria.

Routine interventions

Dr Mwakangalu, who also heads the US-funded Impact Malaria project in Kenya, said Kenya must continue to control the Anopheles mosquito, which carries the malaria parasite.

“We must continue spraying houses, advising and supporting communities to clear compounds and drain water where the mosquito breeds, sleep under treated nets and ensure pregnant mothers get the prophylactic Fansidar to prevent them from getting malaria,” Dr Mwakangalu said.

Thirty-three years of research and $700 million have gone into developing the vaccine but the cunning and agile nature of the malaria parasite makes it difficult to target with vaccine alone.

The parasite’s life cycle begins when an infected female mosquito bites a person and then spits Plasmodium cells into the bloodstream. The cells then multiply in the liver and come out as another cell type (merozoites) which attack the red blood cells. Their large numbers cause the blood cells to burst, causing fever, headache, chills, muscle aches, and often anaemia.

In this entire process, the parasite changes the proteins on its surface, making it hard for the body’s immune system and the vaccine to target it.

That is why, Dr Mwakangalu added, ministries of health in East Africa must ensure the community and national health systems can identify and treat people on time when they contract malaria.