Challenges and strategies for developing efficacious and long-lasting malaria vaccines

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substantial challenges remain to advance beyond the generally modest efficacy demonstrated by existing vaccines tested in malaria-endemic areas and achieve the goal of a highly efficacious and durable vaccine, preferably for both P. falciparum and P. vivax. A deeper understanding of mechanisms and key targets of immunity is needed to underpin this, and research to reveal new strategies for the induction of a higher level of protective functional immunity. Achieving higher efficacy may require vaccines to induce multiple functional mechanisms and may require the inclusion of multiple antigens (of the same stage or across multiple stages), whole attenuated parasites, or innovative vaccine design to induce responses that better target specific protective epitopes compared to established strategies. A lack of correlates of protection to evaluate current vaccines and inform the development of new candidates is a constraint that hinders more expedient progress. Furthermore, most vaccines to date have induced protective immune responses of only short or modest duration, and new insights into how long-lasting immunity can be generated are urgently needed. Ideally, future vaccines will be low cost and affordable and administered in practical formulations and regimens suitable for mass vaccine campaigns and inclusion in childhood EPI. Although challenges remain, recent exciting progress and emerging knowledge promise great hope for the future

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