SynthesisMalaria journal2026
Efficacy and safety of RTS, S and R21 malaria vaccines in children under five in Africa: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in Malaria journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
10 authors.
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Abstract
backgroundMalaria remains a major public health burden in Africa, particularly among children under five years of age. By consolidating findings across randomized controlled trials on the RTS,S and R21 malaria vaccines, this study seeks to provide an evidence based guide.
methodsWe conducted a systematic review and meta-analysis of studies of randomized controlled trials evaluating the RTS,S and R21 malaria vaccines in African children under five. Data sources included PubMed, Scopus, and Embase. Primary outcomes were the vaccine efficacies against first/only episodes of malaria, multiple episodes and severe malaria; and the incidence of severe adverse events following vaccination. Pooled effect estimates were calculated using random-effects models.
resultsEleven studies enrolling 27,178 participants (RTS,S: 21,589; R21: 5589) were included. For RTS,S, pooled efficacy against first clinical malaria episode was 32% (HR 0.68, 95% CI 0.61-0.76; I
conclusionBoth RTS,S and R21 vaccines demonstrate protective efficacy against clinical malaria in African children under five, with R21 showing higher efficacy in initial trials. RTS,S provides moderate, reproducible protection in clinical trials. Both vaccines have acceptable safety profiles, though continued pharmacovigilance is essential.
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