Safety of the RTS,S/AS02A malaria vaccine in Mozambican children during a Phase IIb trial

Vaccine. 2008 Jan 10;26(2):174-84. doi: 10.1016/j.vaccine.2007.11.003. Epub 2007 Nov 26.

Abstract

RTS,S/AS02A is a pre-erythrocytic vaccine candidate based on the Plasmodium falciparum circumsporozoite surface antigen and is currently the most advanced malaria vaccine candidate in development. A proof of concept phase IIb trial of the RTS,S/AS02A in Mozambican children aged 1-4 years determined a vaccine efficacy against risk of clinical malaria of 35.3% (95% CI 21.6-46.6; p<0.0001) and against severe malaria of 48.6% (95% CI 12.3-71.0; p=0.02). We evaluated the safety of the RTS,S/AS02A vaccine. 2022 children that received at least one vaccine dose of RTS,S/AS02A or control vaccines were included in the intention to treat safety analysis. Vaccine safety was evaluated using active and passive follow-up. Participants were observed for at least 1h after each dose. Trained field workers visited children at home daily for the next 3 days to record solicited and unsolicited local and general symptoms. Investigators followed-up participants with severe adverse events until month 21. Overall, we recorded 1712 unsolicited adverse events after vaccination, 53% in the intervention and 47% in the control group. Most unsolicited adverse events reported with RTS,S/AS02A were self-limited, and participants recovered without sequelae. Local reactogenicity increased with the number of doses. The proportion of children experiencing serious adverse events was lower in the RTS,S/AS02A recipients compared to the control group (Engerix-Btrade mark or Prevnartrade mark and Hiberixtrade mark). Overall, these results indicate that the RTS,S/AS02A vaccine has a good safety profile and well tolerated when given in three doses to semi-immune children living in malaria-endemic areas.

Publication types

  • Clinical Trial, Phase II
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child, Preschool
  • Double-Blind Method
  • Follow-Up Studies
  • Humans
  • Infant
  • Malaria Vaccines / administration & dosage
  • Malaria Vaccines / adverse effects*
  • Malaria Vaccines / immunology
  • Malaria, Falciparum / epidemiology
  • Malaria, Falciparum / immunology
  • Malaria, Falciparum / prevention & control*
  • Mozambique / epidemiology

Substances

  • Malaria Vaccines
  • RTS,S-AS02A vaccine