Abstract:
A recent working group convened by the World Health
Organization recommended that time to first or only episode
of clinical malaria should be used to evaluate vaccine
efficacy in phase III trials. However, calculating vaccine
efficacy based on this endpoint misses important aspects of
malaria disease and transmission. Here, we discuss the gaps
that this approach leaves in predicting the potential public
health impact of a vaccine and the challenges faced by
vaccine trial designers. We examine the implications of
current vaccine trial design on effectiveness studies and the
next generation of malaria vaccines