One year anniversary of malaria vaccine rollout underscores remarkable progress, offers new data on potential impact

One year since the launch of routine malaria vaccinations in Africa, over 9.8 million doses of malaria vaccines (in total 12 million since 2023) have been delivered to 17 endemic countries through the Gavi malaria vaccination programme. 

Surpassing the initial target of 15 countries, the pace of rollout is an indication of the high demand for this new tool as well as years of preparation by countries and partners. In total, an estimated 5 million children in these 17 countries that collectively represent more than 70% of the world’s malaria burden have been protected. 

And one year into the programme, promising early results are emerging.

Early data underscores potential vaccine impact

Lessons from the “pilot” malaria vaccination programme in Ghana, Kenya and Malawi which ran from 2019 to 2023 are helping guide country rollouts. Coordinated by WHO and funded by Gavi and partners, this pilot reached over 2 million children, and demonstrated that the malaria vaccine led to a significant reduction in malaria illnesses, a 13% drop in overall child mortality and even higher reductions in hospitalizations.?

In January 2024, Cameroon became the first country to launch the vaccine as part of their routine immunisation programme, beginning with 42 districts. By the end of 2026, the country aims to scale up to all 205 districts. Now early results from the rollout in Cameroon are giving us a first look at the vaccine’s potential impact in a high-burden country.

Data released this month by Cameroon’s Expanded Programme on Immunisation (EPI) found that districts included in the first wave of vaccination saw a higher drop, of 17% in all-cause hospital/clinic consultations for children under five years than those areas without the vaccine. About 60% of the malaria-vaccinating districts recorded a drop in all-cause under-five deaths, and 57% recorded a drop in deaths linked to malaria in children aged under five.

With the vaccine administered so far to over 130,000 children in the country, experts caution that – while these results are promising and consistent with MVIP findings – additional data, study and follow-ups are needed to demonstrate the direct impact of the vaccine. Additionally, data on malaria burden in children under five, aggregated at the global, regional and national levels, will likely underestimate overall vaccine impact for another few years.??This is because rollouts have just begun, meaning only the youngest children in this under five age group have begun to receive the malaria vaccine – and due to the phased approach taken by countries.

Dr Sania Nishtar, Chief Executive Officer at Gavi, the Vaccine Alliance, comments:???

?“In a high-burden country like Cameroon, where malaria claims more than 13,000 lives each year and represents close to 30% of all hospital consultations, each percentage point reduction in cases, deaths and consultations represents lives transformed.??That is why Gavi is supporting countries to rollout the malaria vaccine: because it is a tool that can save lives and relieve the terrible burden this deadly disease places on families, communities, and health systems.?This early data is a small indicator of the potential public health impact of a programme we hope to scale up dramatically by the end of the decade – protecting tens of millions of children around the world, and reducing the stress malaria places on African health systems.”??

Protecting children and communities

However, these early anecdotal results from countries that have introduced the vaccine are promising, with health care workers and speaking of reductions in malaria cases. Indeed, the data from Cameroon’s EPI found that that in-person follow-ups with children who already received three doses of the vaccine showed none had suffered from further episodes of malaria after vaccination. 

18-month old twins Daniel and Daniella were the first children in Cameroon to receive the malaria vaccine on January 22, 2024. They have since taken two additional doses of the vaccine and are poised to take the fourth and last dose when they turn two in June this year. Since being vaccinated, they haven’t caught malaria. In an interview with Gavi’s VaccinesWork platform, their mother discusses the impact of this on her family, saying “My twins are so lucky. Many members of my family, including myself, have suffered from malaria in the past. And treating it usually costs us a fortune.”??

Designing tailor-made programmes to reach those at highest risk

Delivering 4 doses of the vaccine means finding ways to consistently reach those at highest risk in every country. Most countries are scaling up vaccination in a step-by-step phased approach, implementing tailor made strategies that work best for their own unique contexts and challenges.

 For example:

• Last month, with support from Gavi and Partners, Nigeria, a country with the highest burden of malaria globally, began a phased rollout in Kebbi and Bayelsa states, where malaria prevalence is particularly high. Over 800,000 vaccine doses are set to be distributed in this first phase, a critical step towards reducing the devastating impact of the disease.

• In Chad, Gavi supported the integration of the malaria vaccine as part of an ambitious and pioneering triple vaccine roll-out against three deadly childhood diseases: Malaria, pneumonia and diarrhoea — maximising impact and efficiency in lower-resourced settings.

• In fragile contexts across Sudan and the Democratic Republic of the Congo (DRC), rollout has been incorporated into other response plans. A first consignment of 186,000 doses arrived in Sudan amidst the ongoing conflict; while DRC successfully integrated the malaria vaccine into its national routine immunization programme amid other urgent health priorities including the mpox response.?

Vaccine delivery alongside other malaria interventions?

When the malaria vaccine is used alongside other proven malaria prevention strategies – such as insecticide-treated nets and seasonal malaria chemoprevention during periods of high transmission in the year (for example, June to November in the North and Far North Regions in Cameroon) – countries have the potential to reduce clinical malaria cases by more than 90% in areas with high seasonal transmission.?

Thus, Gavi works closely with countries and partners such as the Global Fund to ensure malaria vaccines are delivered as part of a holistic malaria control and prevention package – offering the highest levels of protection to impacted communities.??

The future of malaria vaccination

Gavi anticipates a significant expansion of the malaria vaccine program in 2025, with the introduction of the vaccine in 6 to 8 new countries, including in Uganda, Ethiopia, Guinea, Mali, and Burundi, as well as the scale of the vaccine in countries that have already included the vaccine in their routine immunisation programs. This expansion is expected to protect an additional 13 million children with the malaria vaccine by the end of 2025.?

From 2026 to 2030, Gavi aims to help countries protect a further 50 million children with four doses of the malaria vaccine. Achieving that critical objective hinges on successful replenishment of Gavi's funding for its next strategic period. In March 2025, Gavi, the European Union, and the Bill & Melinda Gates Foundation will co-host an event to secure at least US$9 billion from donors towards the Alliance’s mission to protect more people, against more diseases, faster than ever before.??

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