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expert reaction to the World Health Organization recommending the R21/Matrix-M vaccine for malaria prevention

The World Health Organisation have recommended the new R21/Matrix-M vaccine for malaria prevention. 


Sir Brian Greenwood, Professor of Clinical Tropical Medicine, London School of Hygiene & Tropical Medicine, said:

“The wait for an effective malaria vaccine has been a long one and it was only in October 2021 that WHO recommended deployment of the world’s first malaria vaccine RTS,S. Now, two years later, a second malaria vaccine, R21, has also been approved by WHO. 

“No direct comparison of the two vaccines has been done, but it is likely that the level and duration of protection that each provides are similar, as they both induce a comparable immune response to their target antigen on the surface of the Plasmodium falciparum parasite.

“The manufacture and deployment of two similar malaria vaccines is not redundant. Restriction of vaccine production at a single site, or by a single company, carries a risk of interrupted supply should there be an unanticipated external event and further research will still be needed to study the long-term safety of R21. Production of the R21 vaccine is likely to be cheaper than RTS,S which will help improve the reach of vaccination.

“Neither RTS,S or R21 is a perfect vaccine and research must continue to develop vaccines which provide a higher and more persistent duration of protection against P. falciparum, and also to develop vaccines which protect against P.  vivax.

“The positive recommendation by WHO for the deployment of R21 is another important step in malaria vaccine development on the long road to achieving malaria elimination and congratulations are warranted for the many people whose initiative and hard work has made this possible.”    


Dr Charlie Weller, Head of Prevention, Infectious Disease, at Wellcome, said:

“Malaria is still a significant threat to global health, which is further exacerbated by impact of climate change on vector-borne diseases.  The WHO recommendation for the use of the R21/Matrix-M malaria vaccine is promising progress.  The demand for malaria vaccines outweighs the supply of the RTS’S vaccine, so having another safe, effective and affordable vaccine available could help protect those living in malaria-endemic areas.

“While further research is needed to fully understand the vaccine and its potential impact on reducing the impact of the disease, this outcome is a great example of how researchers and policymakers can work collaboratively to enhance our preparedness and prevention against escalating infectious diseases.”


Prof Azra Ghani, Director of the MRC Centre for Global Infectious Disease Analysis, and Professor in Infectious Disease Epidemiology, Imperial College London, said:

“Despite over a decade of successful intervention, the burden from malaria in children in Sub-Saharan Africa remains unacceptably high, with approximately 600,000 deaths a year in children under the age of 5 years.  Today’s announcement of a second malaria vaccine – R21/Matrix-M – that has demonstrated high efficacy in clinical trials across the continent is therefore extremely exciting.  One of the challenges to date with delivery of the first malaria vaccine, RTS,S/AS01, has been that demand has outstripped supply.  By relieving these supply pressures, this new vaccine will enable many more countries to introduce the vaccine in at-risk populations.  By doing so – alongside maintaining other core malaria interventions including the provision of insecticide-treated bed nets and chemoprevention – this offers the potential to reduce malaria deaths by up to a third and set the world back on track towards the global target of a 90% reduction malaria deaths by 2030.”


Declared interests

Sir Brian Greenwood: “Brian made significant contributions to the development of the first malaria vaccine, RTS,S. He is also involved in an ongoing study of the R21 vaccine.”

Prof Azra Ghani: “I have collaborated with the Jenner Institute and trial investigators for R21/Matrix-M to generate estimates of the broader public health impact and cost-effectiveness of this vaccine that were part of the evidence submitted to WHO.  This work was funded by an investigator award from the Wellcome Trust.  I am a member of the WHO Malaria Policy Advisory Group but did not participate in the decision due to this conflict.”

For all other experts, no reply to our request for DOIs was received.

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