Evidence map›Paper›PMID 37872492›Full record

ArticleBMC infectious diseases2023

Background malaria incidence and parasitemia during the three-dose RTS,S/AS01 vaccination series do not reduce magnitude of antibody response nor efficacy against the first case of malaria.

Griffin J Bell, Stephaney Gyaase, Varun Goel, Bright Adu, Benedicta Mensah, Paulin Essone, David Dosoo, Musah Osei, Karamoko Niare, Kenneth Wiru and 8 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00866619 (Efficacy of GSK Biologicals' Candidate Malaria Vaccine), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00866619 phase3completednot on this map

Efficacy of GSK Biologicals' Candidate Malaria Vaccine (257049) Against Malaria Disease Caused by P. Falciparum Infection in Infants and Children in Africa

TypeinterventionalSponsorGlaxoSmithKlineRan2009 to 2014Enrolled15,459ConditionsMalariaArmsMalaria Vaccine 257049, Meningococcal C Conjugate Vaccine, Cell-culture rabies vaccine, TritanrixHepB/Hib, Polio Sabin Oral Polio Vaccine (GSK)
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 8 citations in OpenAlex.

  1. Sustained efficacy of the RTS,S/AS01The Lancet. Global health · 2025
    Trial
  2. Trial
  3. Genotypic analysis of RTS,S/AS01The Lancet. Infectious diseases · 2024
    Trial
  4. Article
  5. Malaria: past, present, and future.Signal transduction and targeted therapy · 2025
    Review
  6. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 6 institutions in 4 countries.

Griffin J BellDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA. bell@unc.edu.
Stephaney GyaaseKintampo Health Research Centre, Kintampo, Ghana.
Varun GoelCarolina Population Center, University of North Carolina, Chapel Hill, NC, 27599, USA.
Bright AduNoguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
Benedicta MensahNoguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
Paulin EssoneCentre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.
David DosooKintampo Health Research Centre, Kintampo, Ghana.
Musah OseiKintampo Health Research Centre, Kintampo, Ghana.
Karamoko NiareDepartment of Pathology and Laboratory Medicine, Brown University, Providence, RI, 02912, USA.
Kenneth WiruKintampo Health Research Centre, Kintampo, Ghana.
Katerina BrandtCarolina Population Center, University of North Carolina, Chapel Hill, NC, 27599, USA.
Michael EmchDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA.
Anita GhansahNoguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
Kwaku Poku AsanteKintampo Health Research Centre, Kintampo, Ghana.
Tisungane MvaloUniversity of North Carolina Project, Lilongwe, Malawi.
Selidji Todagbe AgnandjiCentre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.
Jonathan J Juliano *Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA.
Jeffrey A Bailey *Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, 02912, USA.
University of North Carolina at Chapel Hill · USKintampo Health Research Centre · GHBrown University · USCentre de Recherche Médicales de Lambaréné · GAUniversity of Ghana · GHNoguchi Memorial Institute for Medical Research · GH

Funding

Impacts of Environment, Host Genetics and Antigen Diversity on Malaria Vaccine EfficacyR01AI137410 · NIAID · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI BAILEY, JEFFREY A., EMCH, MICHAEL · 2018 to 2023
$3.6M
NIAID NIH HHS R01 AI137410NIH HHS 1R01AI137410-01
6 · The paper itself

Abstract

backgroundRTS,S/AS01 has been recommended by WHO for widespread implementation in medium to high malaria transmission settings. Previous analyses have noted lower vaccine efficacies in higher transmission settings, possibly due to the more rapid development of naturally acquired immunity in the control group.

methodsTo investigate a reduced immune response to vaccination as a potential mechanism behind lower efficacy in high transmission areas, we examine initial vaccine antibody (anti-CSP IgG) response and vaccine efficacy against the first case of malaria (to exclude the effect of naturally acquired immunity) using data from three study areas (Kintampo, Ghana; Lilongwe, Malawi; Lambaréné, Gabon) from the 2009-2014 phase III trial (NCT00866619). Our key exposures are parasitemia during the vaccination series and background malaria incidence. We calculate vaccine efficacy (one minus hazard ratio) using a cox-proportional hazards model and allowing for the time-varying effect of RTS,S/AS01.

resultsWe find that antibody responses to the primary three-dose vaccination series were higher in Ghana than in Malawi and Gabon, but that neither antibody levels nor vaccine efficacy against the first case of malaria varied by background incidence or parasitemia during the primary vaccination series.

conclusionsWe find that vaccine efficacy is unrelated to infections during vaccination. Contributing to a conflicting literature, our results suggest that vaccine efficacy is also unrelated to infections before vaccination, meaning that control-group immunity is likely a major reason for lower efficacy in high transmission settings, not reduced immune responses to RTS,S/AS01. This may be reassuring for implementation in high transmission settings, though further studies are needed.

Indexed as

MalariaMalaria, FalciparumMalaria VaccinesAntibody FormationClinical Trials, Phase III as TopicHumansIncidenceParasitemiaPlasmodium falciparumVaccinationMalaria VaccinesAfricaDelayed MalariaGeographic information systemGISImmunologyRebound MalariaVaccine

Identifiers

PMID37872492
PMCPMC10594884
OpenAlexW4387891697

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.