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Malaria vaccine Wiki2Web Clarity Challenge

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Study Guide: Malaria Vaccines: Development and Deployment

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Malaria Vaccines: Development and Deployment Study Guide

Global Malaria Burden and Statistics

As of 2022, malaria affected fewer than 100 million people globally.

Answer: False

Explanation: The provided data indicates that in 2022, malaria affected approximately 249 million people globally, not fewer than 100 million.

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What was the estimated global death toll from malaria in 2022?

Answer: Approximately 608,000 deaths

Explanation: In 2022, malaria caused an estimated 608,000 deaths globally, alongside affecting approximately 249 million people.

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The RTS,S/Mosquirix Vaccine: Genesis and Implementation

Mosquirix is the first malaria vaccine to gain public approval.

Answer: True

Explanation: The RTS,S vaccine, marketed as Mosquirix, was indeed the first malaria vaccine to receive public approval, marking a significant milestone in global health efforts.

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By April 2023, over 5 million children had received at least one dose of the RTS,S vaccine.

Answer: False

Explanation: The supporting information indicates that by April 2023, approximately 1.5 million children had received at least one dose of the RTS,S vaccine, not over 5 million.

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The RTS,S vaccine requires a single dose for infants to provide adequate protection.

Answer: False

Explanation: The RTS,S vaccination schedule for infants requires a minimum of three doses, with an additional fourth dose administered for extended protection, rather than a single dose.

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The RTS,S vaccine has shown potential to reduce hospital admissions for severe malaria by approximately 30%.

Answer: True

Explanation: Clinical data supports that the RTS,S vaccine can reduce hospital admissions due to severe malaria by approximately 30% in young children.

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The RTS,S vaccine was developed solely by GlaxoSmithKline (GSK).

Answer: False

Explanation: The RTS,S vaccine was the result of a collaborative effort involving PATH Malaria Vaccine Initiative (MVI) and GlaxoSmithKline (GSK), with significant support from the Bill and Melinda Gates Foundation.

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RTS,S is a live-attenuated vaccine.

Answer: False

Explanation: The RTS,S vaccine is classified as a recombinant vaccine, not a live-attenuated one. It utilizes the circumsporozoite protein (CSP) antigen fused with a hepatitis B virus surface antigen.

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The RTS,S vaccine aims to prevent malaria by directly killing the parasite in the bloodstream.

Answer: False

Explanation: The RTS,S vaccine primarily functions by preventing the malaria parasite from invading liver cells, rather than directly killing the parasite within the bloodstream.

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Poor immunogenicity was a challenge addressed by fusing the CSP antigen with the hepatitis B virus surface antigen in the RTS,S vaccine.

Answer: True

Explanation: A significant challenge during the RTS,S trials was its poor immunogenicity. Researchers addressed this by fusing the CSP antigen with the hepatitis B virus surface antigen, creating a more potent vaccine formulation.

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Clinical trials showed RTS,S significantly reduced malaria cases in infants, but efficacy against severe malaria was high even without a booster.

Answer: False

Explanation: Clinical trials indicated that while RTS,S reduced malaria cases, its efficacy against severe malaria waned over time and was significantly reduced without a booster dose.

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The WHO recommended widespread use of the RTS,S vaccine for children in October 2021.

Answer: True

Explanation: The World Health Organization (WHO) officially recommended the widespread use of the RTS,S vaccine for children in October 2021, marking a significant public health endorsement.

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The malaria vaccine Mosquirix is listed on the WHO's List of Essential Medicines.

Answer: True

Explanation: The World Health Organization recognizes the importance of the malaria vaccine Mosquirix by including it on its List of Essential Medicines.

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After four years, the RTS,S vaccine provided substantial protection against severe malaria, even without a booster dose.

Answer: False

Explanation: The efficacy of the RTS,S vaccine against severe malaria waned over time, and substantial protection was not maintained without a booster dose after four years.

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Which vaccine is the first malaria vaccine to receive public approval and is marketed under the brand name Mosquirix?

Answer: RTS,S

Explanation: The RTS,S vaccine, marketed under the brand name Mosquirix, holds the distinction of being the first malaria vaccine to receive public approval.

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How many children had received at least one dose of the RTS,S vaccine by April 2023?

Answer: Approximately 1.5 million

Explanation: By April 2023, approximately 1.5 million children residing in areas with moderate to high malaria transmission had received at least one dose of the RTS,S vaccine.

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What is the minimum number of doses required for infants under the RTS,S vaccination schedule?

Answer: Three doses

Explanation: The RTS,S vaccine requires a minimum of three doses for infants by the age of two to establish initial protection.

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What percentage reduction in severe malaria hospital admissions has the RTS,S vaccine demonstrated?

Answer: Approximately 30%

Explanation: The RTS,S vaccine has demonstrated the ability to reduce hospital admissions resulting from severe malaria by approximately 30% in children.

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Who were the primary developers of the RTS,S malaria vaccine?

Answer: PATH MVI and GlaxoSmithKline (GSK)

Explanation: The RTS,S vaccine was developed through a significant collaboration between PATH Malaria Vaccine Initiative (MVI) and GlaxoSmithKline (GSK).

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What type of vaccine is RTS,S, incorporating which key antigen?

Answer: Recombinant vaccine using the circumsporozoite protein (CSP)

Explanation: RTS,S is a recombinant vaccine that utilizes the circumsporozoite protein (CSP) antigen from the pre-erythrocytic stage of the *Plasmodium falciparum* parasite.

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How does the RTS,S vaccine primarily function to prevent malaria?

Answer: By preventing the parasite from invading liver cells.

Explanation: The RTS,S vaccine primarily functions by stimulating an immune response that blocks the malaria parasite from invading liver cells, thereby preventing the initial stage of infection.

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What significant challenge during RTS,S trials was overcome by fusing CSP with the Hepatitis B surface antigen?

Answer: Poor immunogenicity

Explanation: The fusion of the CSP antigen with the Hepatitis B virus surface antigen was a key strategy to address the challenge of poor immunogenicity observed in early RTS,S vaccine trials.

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What was the approximate reduction in malaria cases for infants receiving the RTS,S/AS01 vaccine in clinical trials?

Answer: About 25%

Explanation: Clinical trials showed that the RTS,S/AS01 vaccine reduced malaria cases by approximately 25% in infants after receiving the initial three-dose regimen.

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The WHO endorsed RTS,S for widespread use in children in which month and year?

Answer: October 2021

Explanation: The World Health Organization (WHO) officially recommended the widespread use of the RTS,S vaccine for children in October 2021.

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What is the Anatomical Therapeutic Chemical (ATC) classification code for the malaria vaccine Mosquirix?

Answer: J07XA01

Explanation: The Anatomical Therapeutic Chemical (ATC) classification code assigned to the malaria vaccine Mosquirix is J07XA01.

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Which of the following is a key component of the RTS,S vaccine, derived from the malaria parasite?

Answer: Circumsporozoite protein (CSP)

Explanation: The RTS,S vaccine incorporates the circumsporozoite protein (CSP) antigen, which is derived from the pre-erythrocytic stage of the *Plasmodium falciparum* parasite.

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The R21/Matrix-M Vaccine: Advancements and Efficacy

The R21/Matrix-M vaccine has demonstrated lower efficacy than RTS,S in initial trials.

Answer: False

Explanation: Initial trials indicated that the R21/Matrix-M vaccine demonstrated higher efficacy compared to RTS,S, meeting the WHO's target efficacy goal.

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The R21/Matrix-M vaccine is the first malaria vaccine candidate to meet the WHO's target efficacy goal of 75%.

Answer: True

Explanation: The R21/Matrix-M vaccine achieved an efficacy rate of 77% in initial trials, making it the first candidate to meet the World Health Organization's target efficacy goal of at least 75%.

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Nigeria was the first country to approve the R21 vaccine for use in children.

Answer: False

Explanation: Ghana was the first country to approve the R21 vaccine for children in April 2023. Nigeria subsequently provided provisional approval.

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The R21/Matrix-M vaccine was developed by researchers at the University of Oxford and manufactured by Novavax.

Answer: False

Explanation: While Novavax was involved in the development of the R21/Matrix-M vaccine, the primary manufacturing is undertaken by the Serum Institute of India, in collaboration with the University of Oxford and other institutions.

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The Matrix-M adjuvant used in the R21/Matrix-M vaccine is also used in the Pfizer-BioNTech COVID-19 vaccine.

Answer: False

Explanation: The Matrix-M adjuvant used in the R21/Matrix-M vaccine is also utilized in the Novavax COVID-19 vaccine, not the Pfizer-BioNTech COVID-19 vaccine.

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A phase III trial showed the R21/Matrix-M vaccine achieved 74% efficacy against severe malaria episodes in children.

Answer: True

Explanation: A phase III trial involving 4,800 children across four African countries demonstrated that the R21/Matrix-M vaccine achieved 74% efficacy against severe malaria episodes.

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The Serum Institute of India plans to produce up to 50 million doses of the R21/Matrix-M vaccine annually.

Answer: False

Explanation: The Serum Institute of India plans to produce between 100 and 200 million doses of the R21/Matrix-M vaccine annually, which is significantly more than the stated 50 million.

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The Matrix-M adjuvant used in the R21/Matrix-M vaccine enhances the immune response.

Answer: True

Explanation: The Matrix-M adjuvant is incorporated into the R21/Matrix-M vaccine specifically to augment and strengthen the elicited immune response.

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Which malaria vaccine candidate showed the highest efficacy in initial trials with a rate of 77%?

Answer: R21/Matrix-M

Explanation: The R21/Matrix-M vaccine demonstrated the highest efficacy in initial trials, achieving a rate of 77%, surpassing the WHO's target efficacy goal.

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Which country was the first to approve the R21/Matrix-M vaccine for children?

Answer: Ghana

Explanation: Ghana was the first country to grant approval for the R21/Matrix-M vaccine for use in children in April 2023.

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Which institution, besides the University of Oxford, was involved in the development of the R21/Matrix-M vaccine?

Answer: Serum Institute of India

Explanation: The Serum Institute of India was a key collaborator in the development of the R21/Matrix-M vaccine, alongside the University of Oxford and other research institutions.

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The R21/Matrix-M vaccine utilizes which adjuvant to enhance immune response?

Answer: Matrix-M

Explanation: The R21/Matrix-M vaccine incorporates the Matrix-M adjuvant, which is designed to enhance the immune system's response to the vaccine's antigens.

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What was the efficacy rate of the R21/Matrix-M vaccine against severe malaria episodes in a large phase III trial?

Answer: 74%

Explanation: A large phase III trial demonstrated that the R21/Matrix-M vaccine achieved an efficacy rate of 74% against severe malaria episodes in children.

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What is the projected annual production capacity for the R21/Matrix-M vaccine?

Answer: 100-200 million doses

Explanation: The Serum Institute of India is projected to produce between 100 and 200 million doses of the R21/Matrix-M vaccine annually.

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Core Principles of Malaria Vaccine Design

Malaria vaccines primarily aim to induce 'anti-toxic immunity' by neutralizing parasite by-products.

Answer: False

Explanation: While some malaria vaccines may aim for 'anti-toxic immunity,' the primary goal is often 'anti-parasitic immunity,' which directly targets the parasite itself through immune responses.

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The genetic diversity of the malaria parasite is not a significant factor in vaccine development.

Answer: False

Explanation: The genetic diversity of the malaria parasite is a highly significant factor in vaccine development, as it contributes to the parasite's ability to develop resistance and evade immune responses, thereby diminishing vaccine effectiveness.

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Vaccine development can target the gametocyte stage of the malaria parasite to prevent transmission.

Answer: True

Explanation: Targeting the gametocyte stage, the sexual stage of the parasite, is a key strategy for developing transmission-blocking vaccines aimed at interrupting the parasite's lifecycle in mosquitoes.

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Transmission-blocking vaccines are designed to protect the vaccinated individual from severe illness.

Answer: False

Explanation: Transmission-blocking vaccines are designed not to protect the vaccinated individual directly from severe illness, but rather to prevent the parasite's development within the mosquito vector, thereby interrupting disease transmission.

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The PfSEA-1 vaccine candidate aims to prevent the parasite from invading liver cells.

Answer: False

Explanation: The PfSEA-1 vaccine candidate is designed to block the schizont's exit from red blood cells, not to prevent the parasite from invading liver cells.

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The Duffy binding protein (DBP) is a key target for vaccines against *Plasmodium vivax*.

Answer: True

Explanation: The Duffy binding protein (DBP) is crucial for *Plasmodium vivax*'s invasion of red blood cells, making it a primary target for vaccine development against this species.

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A Type 1 malaria vaccine is primarily intended for travelers visiting low-transmission areas.

Answer: False

Explanation: A Type 1 malaria vaccine is designed for regions with high malaria transmission, such as sub-Saharan Africa, aiming to reduce severe malaria cases and deaths in infants and young children.

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The SPf66 vaccine demonstrated significant protective benefits in a large trial in Southeast Asia.

Answer: False

Explanation: The largest placebo-controlled trial for the SPf66 vaccine in Southeast Asia found it to be ineffective and demonstrated no protective benefit.

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The PfRH5 antigen is considered a promising vaccine target due to its high genetic diversity.

Answer: False

Explanation: The PfRH5 antigen is considered promising precisely because of its *low* genetic variation, suggesting it could be a reliable target for broad-spectrum antibodies.

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Which stage of the malaria parasite's lifecycle is targeted by transmission-blocking vaccines?

Answer: Gametocyte stage

Explanation: Transmission-blocking vaccines specifically target the gametocyte stage of the malaria parasite, which is responsible for transmission to mosquitoes.

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Why is the genetic diversity of *Plasmodium falciparum* a challenge for malaria vaccines?

Answer: It leads to the development of resistance against vaccines over time.

Explanation: The high genetic diversity of *Plasmodium falciparum* allows the parasite to evolve rapidly, potentially leading to the development of resistance against vaccine-induced immune responses and diminishing vaccine effectiveness.

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What is the primary goal of a Type 2 malaria vaccine, often called a 'travelers' vaccine'?

Answer: To provide complete protection against all clinical symptoms for non-immune individuals.

Explanation: A Type 2 malaria vaccine, commonly referred to as a 'travelers' vaccine,' is designed to offer comprehensive protection against all clinical manifestations of malaria for individuals with no prior immunity.

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What was the finding of the largest placebo-controlled trial for the SPf66 vaccine in Southeast Asia?

Answer: It was found to be ineffective and showed no protective benefit.

Explanation: The largest placebo-controlled randomized trial conducted for the SPf66 vaccine in Southeast Asia concluded that it was ineffective and provided no significant protective benefit.

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The low genetic variation of the PfRH5 antigen makes it a potentially reliable target for vaccine development because:

Answer: Antibodies generated against it are likely to neutralize multiple parasite strains.

Explanation: The limited genetic variation of the PfRH5 antigen suggests that antibodies generated against it could effectively neutralize a wide range of parasite strains, making it a promising target for vaccine development.

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The U.S. Food and Drug Administration (FDA) granted 'fast track designation' to which malaria vaccine candidate in September 2016?

Answer: PfSPZ

Explanation: In September 2016, the U.S. Food and Drug Administration (FDA) granted 'fast track designation' to the PfSPZ malaria vaccine candidate.

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Stakeholders and Global Health Initiatives in Malaria Control

The Bill & Melinda Gates Foundation has provided significant funding for malaria vaccine development.

Answer: True

Explanation: The Bill & Melinda Gates Foundation has been a major financial supporter of malaria eradication initiatives, providing substantial funding critical for the development of vaccines like RTS,S.

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