Measuring malaria vaccine effectiveness: Incorporating environmental and genetic contexts into trials

Authors: Michael Emch*, University of North Carolina at Chapel Hill, Griffin Bell, University of North Carolina at Chapel Hill, Irving Hoffman, University of North Carolina at Chapel Hill
Topics: Medical and Health Geography
Keywords: medical geography, vector-borne disease, malaria
Session Type: Paper
Day: 4/12/2018
Start / End Time: 3:20 PM / 5:00 PM
Room: Studio 6, Marriott, 2nd Floor
Presentation File: No File Uploaded


Global malaria elimination has little chance of success in the absence of an effective vaccine. The leading candidate vaccine (RTS,S) has shown only moderate efficacy. The vaccine does not work equally well in different populations; this variability may be due to parasite, environmental, or host factors. Furthermore, any malaria vaccine will not be used in isolation, but rather as part of an integrated program leveraging other control measures. Therefore, understanding the combinations of factors which modulate the effectiveness of a malaria vaccine is essential to guide appropriate vaccine use and formulating next-generation vaccines. We investigate ecological factors that may influence vaccine efficacy at three RTS,S trial sites in Malawi, Ghana, and Gabon. These data, in conjunction with Phase III trial data, geographic information system data, and a concurrent transmission intensity study, allow us to discern the impacts of individual and neighborhood factors on vaccine effectiveness in an “ecological” analysis of the trial. We also investigate how human host and parasite genetic variation in different geographic contexts influence the efficacy of the vaccine. This study is the most comprehensive evaluation to date of factors, including host, parasite and environmental, that affect RTS,S effectiveness. This information will be critical for future malaria vaccine trials.

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