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International efforts to control malaria include developing and testing new vaccines directed against the pre-erythrocytic stage of Plasmodium falciparum. RTS,S/AS02D, a candidate manufactured by GlaxoSmithKline, has reached the stage of preliminary testing in humans, and early results look promisingpromising.. In a small randomised trial, the vaccine did no discernible harm to babies born in Mozambique and induced enough antibodies to give them at least moderate protection from infection during the three months after they completed their immunisations (adjusted vaccine efficacy 65.9%, 95% CI 42.6% to 79.8%).
The trial studied 214 babies who were given three doses of the new vaccine by 18 weeks or a licensed vaccine against hepatitis B (Engerix-B), in addition to their routine vaccinations (diphtheria, tetanus, whole cell pertussis; Haemophilus influenzae type b; and oral poliovirus). All the vaccinations were equally painful. The malaria vaccine caused no more swelling, irritability, loss of appetite, fever, or drowsiness than the control vaccine. Around 30 children in each group had a serious adverse event during the six month study, and two in each group died. None of these events was related to vaccination, say the authors. This early trial was focused on safety. Bigger trials to assess efficacy could be next.