Costs, delivery strategies and implementation challenges for malaria vaccines: a rapid review of literature.

Background: The burden of malaria remains high, particularly in sub-Saharan Africa, where it accounts for over 200 million cases annually. Vaccination is the latest tool in the armamentarium to prevent malaria. Although a couple of malaria vaccines have been deployed in some countries, gaps in knowledge about their delivery, cost, and effectiveness remain. This rapid review synthesized evidence on issues on malaria vaccines implementation to inform strategies for optimising their accessibility.

Methods: A comprehensive search of PubMed, Google Scholar, and Cochrane Library was conducted to identify studies that examined malaria vaccine delivery mechanisms, costs, and logistical challenges from 2000 to 2024. The articles underwent duplicates removal, title/abstract screening, and full-text review. Eligible studies included those on currently approved and emerging malaria vaccines. Data were extracted systematically and synthesized descriptively.

Results: Thirty studies met the inclusion criteria, with 21(%) conducted in Africa. RTS, S/AS01 was the most commonly reported vaccine (n = 23, 76.67%), with reported efficacy rates of 30% - 75%. Cost-effectiveness estimates for the vaccines varied from $20 - $50 per DALY averted, but higher costs were reported in some settings. Delivery strategies largely involved routine immunization (n = 12, 40%), although innovative methods, including drones, showed promise in one study. Key barriers were logistical constraints, community acceptance, and healthcare infrastructure limitations.

Conclusions: The findings highlighted delivery and cost-effectiveness challenges for malaria vaccination. Ways and means of reducing the costs and improving the effectiveness of different sustainable malaria vaccine delivery strategies, especially in remote and underserved communities should be developed. Limitations of this rapid review include restriction to English-language studies, exclusion of grey literature, and variability in study designs, which may have limited comprehensiveness and comparability of findings.