Malaria vaccines RTS,S/AS01 and R21/Matrix-M reduce malaria risk in childrenMalaria vaccines cut risk by 23% in infants, 39% in toddlers

Journal of infection and public health Published June 7, 2026 Study authors: Asjad Hafsah, Sadiq Muhammad Wahhaab, Siddiqui Saba, Sherali Sarosh, Yousafzai Muhammad Tahir, Tasee… PubMed ↗ DOI ↗ Editorial oversight: Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

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Key Takeaway

Consider both RTS,S/AS01 and R21/Matrix-M vaccines for malaria prevention in children, noting need for boosters and R21's higher adverse events.

This systematic review and meta-analysis included 8 eligible studies from a screening of 832 records, evaluating the RTS,S/AS01 and R21/Matrix-M malaria vaccines in children aged 6-12 weeks and 5-17 months. The primary outcome was malaria risk reduction and efficacy, with secondary outcomes including immunogenicity.

In the 6-12-week age group, RTS,S/AS01 provided significant protection with a malaria risk reduction of 23.0% (risk ratio [RR] = 0.77). In the 5-17-month age group, both vaccines demonstrated a malaria risk reduction with RR = 0.61. However, efficacy declined over time, highlighting the importance of a booster dose.

Both vaccines generated strong antibody responses in the 5-17-month age group. RTS,S/AS01 was reported as safe across age groups. The R21 vaccine showed high efficacy with a low event rate of 0.22 and strong antibody response, but was associated with more frequent adverse events.

The review did not report specific limitations, funding, or conflicts of interest. The findings support the use of these vaccines in young children, though clinicians should be aware of the need for booster doses and the higher adverse event rate with R21.

A new systematic review and meta-analysis of eight studies shows that two malaria vaccines, RTS,S/AS01 and R21/Matrix-M, can significantly reduce the risk of malaria in children. The review looked at data from over 800 records and focused on two age groups: infants aged 6 to 12 weeks and children aged 5 to 17 months.

In the younger age group, the RTS,S/AS01 vaccine reduced the risk of malaria by 23%. In the older group, both vaccines cut the risk by 39%. However, the protection from RTS,S/AS01 declined over time, which suggests a booster dose may be needed. The R21 vaccine also showed high efficacy and strong antibody responses, but it was linked to more frequent side effects.

The RTS,S/AS01 vaccine was found to be safe across all age groups. The review did not report any serious adverse events or discontinuations. The findings are based on a limited number of studies and a short follow-up period of about 2.8 months, so more research is needed to understand long-term protection and safety.

For families in malaria-prone areas, these vaccines offer a promising tool to reduce the burden of this deadly disease. However, the review does not compare the vaccines directly to a placebo or provide guidance on which vaccine is better. Readers should discuss vaccination options with their healthcare provider.

What this means for you:

Malaria vaccines can lower infection risk, but protection may wane and require boosters.

Study Details

Study typeMeta analysis

EvidenceLevel 1

Follow-up2.8 mo

PublishedJun 2026

PMID42001650

View Original Abstract ↓

BACKGROUND: Malaria is one of the most concerning issues of public health. Despite efforts in vector control and chemoprevention, it continues to remain a burden, and hence, a vaccine for malaria has the potential to reduce the overall parasite reservoir. Several types of vaccines have been developed; however, the two most novel ones are RTS,S/AS01 and R21/Matrix-M. The purpose of this study was to evaluate and compare the efficacy and immunogenicity of the two currently available malaria vaccines. METHODS: A literature search was carried out on PubMed, Scopus, and Cochrane databases searching for studies published between 2000 and 2024. After duplicate removal, 832 records were screened and 60 were selected for full-text screening, after which 8 were included in our final review, as they were eligible based on our inclusion and exclusion criteria. RESULTS: This systematic review and meta-analysis showed that the RTS,S/AS01 malaria vaccine provides significant protection in the 6-12-week age group, with a 23.0% malaria risk reduction and risk ratio (RR) of 0.77. In the 5-17-month age group, the RR for malaria risk reduction was 0.61 for both vaccines; the efficacy declined over time, showing the importance of a booster dose and how RTS,S/AS01 vaccines were safe and generated a strong antibody response across age groups. In comparison, R21 displayed high efficacy with a low event rate of 0.22 and a strong antibody response, but more frequent adverse events. CONCLUSION: As compared to prior reviews, our study highlights that both of the two breakthrough vaccines are paving the way for total malaria elimination and reduction in morbidity and mortality.

Malaria vaccines RTS,S/AS01 and R21/Matrix-M reduce malaria risk in childrenMalaria vaccines cut risk by 23% in infants, 39% in toddlers

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Malaria vaccines RTS,S/AS01 and R21/Matrix-M reduce malaria risk in childrenMalaria vaccines cut risk by 23% in infants, 39% in toddlers

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