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Mosquirix, generic name RTS,S/AS01 is the first malaria vaccine approved by the World Health Organisation on 6 October 2021. The vaccine is developed by a Brentford (UK) based pharmaceutical company GlaxoSmithKline, in partnership with an international nonprofit organisation PATH Malaria Vaccine Initiative.
In this article, we will discuss Mosquirix in detail. Take a look.
What Is Malaria?
Malaria is a parasitic infection caused by mosquitoes (Anopheles) when they bite humans and transmit the parasite named Plasmodium to their bodies. There are around five Plasmodium species that are known to infect humans: P. ovale, P. malariae, P. falciparum, P. knowlesi and P.vivax.
When infected Anopheles mosquitoes bite humans, they transfer the parasite to the blood of the human host through their saliva. The sporozoites (motile malarial spores) then enter the liver within an hour and starts multiplying. They then enter the bloodstream and start causing malarial symptoms by invading the body's immune system. 
How Does Mosquirix Works?
According to the WHO, Mosquirix acts against one of the deadliest species of the malaria parasite Plasmodium falciparum which is highly prevalent in Africa, a country with maximum morbidities and mortalities due to the infection. 
Malaria caused due to Plasmodium falciparum is severe as it may result in symptoms such as impaired consciousness, multiple convulsions, abnormal bleeding, respiratory distress and jaundice.
The substance used in Mosquirix is made from the proteins found on the surface of the P. falciparum and hepatitis B virus. When administered, the vaccine helps the immune system to recognise the protein and make antibodies against them so that when the child is naturally exposed to the malaria parasites, their body can easily tackle the pathogen and produce relevant antibodies quickly.
Therefore, when the parasites are destroyed by the antibodies in the blood itself, the possibility of transmission of parasites to the liver for multiplication automatically declines, and thus, the risk of disease is reduced.
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Some Findings On Mosquirix
- Trial results: Mosquirix results were based on a pilot study conducted on children from three sub-Saharan African countries: Ghana, Malawi and Kenya through routine immunisation programmes. To date, around 2.3 million doses of the vaccine have been given.
- Reduces severity: The vaccine has highly reduced the severity of malaria and the rate of hospitalisation in children. This has made the vaccine demand strong and has increased its uptake.
- Safety profile: According to the data results based on around 2.3 million vaccine doses in three African countries, the safety profile of Mosquirix is considered favourable to be used worldwide. 
- Feasible: The delivery and introduction of this vaccine to the world are feasible, considering its strong data results.
- Exception: The vaccine is even benefitting those children who are not sleeping under the mosquito net.
- Reduced Cases: There was a reduction of 30 per cent in cases of severe malaria, even in areas where people were using insecticide-treated bets and has good medical facilities for diagnosis and treatment of the condition.
- Cost-Effective: The vaccine is considered to be cost-effective in areas that have moderate to high transmission rates.
- Delivery: The delivery of the vaccine just before the season to areas where the malaria rates are high can help reduce mortality to great extent, especially when combined with other preventive strategies.
- Age group: It can effectively save the lives of newborns aged between 6-17 weeks with the first vaccine dose, along with children of other age groups.
- Another virus: The vaccine also protects against the hepatitis B virus.
- Origin: The vaccine was actually created in 1987 but its pilot implementation began in 2019 in endemic countries.
How Mosquirix Vaccine Should Be Given
The WHO says that Mosquirix should be given to children who are living in areas where the malaria transmission rate is moderate to high.
It should be administered in a schedule of four doses from the age of five months. A 0.5 ml injection should be administered into a thigh muscle or in the muscle around the shoulder. The first three injections will be given with one month gap and the fourth one is recommended after one and a half years (18 months) after the third.
A study has shown that the Mosquirix vaccine has a modest efficacy of around 36 per cent in babies between ages 5-17 months and around 26 per cent in newborns between ages 6-12 weeks. The efficacy may vary with the country and type of malaria strain. 
In areas, where malaria peaks only during the season, the vaccine should be given in a five-dose strategy. The introduction of Mosquirix during seasonal peaks should be a control plan for malaria.
What Is an Additional Malaria Preventive Tool And Why Is It Important Now?
Additional malaria preventive tool refers to methods such as the use of insecticide-treated nets and indoor residual spraying, along with other environmental modification and control efforts such as wearing long sleeves and using mosquito repellents to reduce the entry to mosquitoes to the houses or avoid their biting. 
These safety measures are important now, together with vaccines, as they may help bring down cases of malaria. This is because, Mosquirix may help kill the malarial parasite inside the body or help prevent its invasion, but the aforementioned safety methods can add to the effectiveness of the vaccine and may accelerate the safety of children and save more lives.
Is There Any Risk Linked To Mosquirix?
Some of the side effects which was noted in children during the clinical studies include febrile seizures (occurred in 1 out of 1000 children), along with pain at the injection site, swelling and irritability, all considered to be the common symptoms during vaccination. 
Experts say that Mosquirix should not be given to those children who have had allergic reactions during their previous dose of Mosquirix or hepatitis B vaccine.
Mosquirix is a vaccine that provides short-term protection to children who are at greater risk of malaria and can potentially save lives and reduce mortality. However, experts say that its protection duration is limited- up to three months- and which is why a booster shot of the fourth dose is needed.
Mosquirix may help prevent malaria to a great extent, however, it should only be considered as one of the malaria preventive control methods rather than the only method to control the infection.
Mosquirix vaccine is the first vaccine for malaria approved by the WHO. According to the clinical data based on the vaccine, it is safe for children starting from the age of five months. Along with other preventive methods, Mosquirix can effectively reduce the malaria mortality rate in children.
Mosquirix is the first and considered to be the effective vaccine for malaria, as per the results of its successful clinical trials based on 2.3 million children.
When RTS,S is administered, it helps build antibodies against the malarial strains at an early stage, so that when the child is exposed naturally, their body can fight the infection quickly and save lives.
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