Implementation strategies for the introduction of the RTS,S/AS01 (RTS,S) malaria vaccine in countries with areas of highly seasonal transmission: workshop meeting report
Authors: Merle Corinne S. ,   RTSS-SMC working group, Badiane Ndeye A. , Affoukou Cyriaque Dossou , Affo Souliatou Yolande , Djogbenou Salako Luc , Hounto Aurore , Kompaore Sidzabda Christian Bernard , Ouedraogo Issa , Ateba Marcellin Joel , Njoh Andreas Ateke , Bomba Dominique , Tchokfe Shalom Ndoula , Ali Innocent Mbulli , Camara Fatou , Mbodj Momar , Sosler Stephen , Rono Josea , Noonan Lizzie , Venu Muniratu , Tanko Mohamed Naziru , Gyan Thomas , Gyapong Margaret , Nante Jose Ernesto , Intchala Humberto Imbunda , Camara Mohamed Binné , Cisse Gassim , Loua Jonas Emile , Jalang’o Rose , Milligan Paul , Scott Susana , Baker Kevin , Sande John , Mhone Brenda Lupafya , Kone Aissata , Coulibaly Yacouba , Diarra Ibrahima , Tchouatieu Andre Marie , Aliaprieto Miriam , Diallo Ibrahim G. , Abou Yahaya , Assan Abdoul Nasser , Jibril Hadiza , Nmep Nigeria , Eze Nelson Chibueze , Bakunawa Garba Bello , Shekarau Emmanuel , Nikau Jamilu , Gordon Scott , Wilskie Elizabeth Ann , Bawa John , Badiane Ndeye Astou , Sturm-Ramirez Katharine , Kidwang Jean Pierre , Sene Doudou , Nabykaly Jean Standeur , Abdoulaye K. A. , Diar Mahamat Saleh Issakha , Addi Abdraman Mahamat , Hennig Branwen J. , Yahouedo Gildas A. , Kolley Olimatou , Fofana Sidat , Atcha-Oubou Mbye Nijetinah , Djobo Hezouwe Looky , Mbaye Rokhaya , Ousmane S. Y. , Ndiaye Jean Louis Abdourahim , Amadou S. E. C. , Mbaye Ibrahima Mariétou , Sall Fatimata Bintou , Fatoudiop Ndèye , Bakhoum Léontine Ndogou , Diouf El Hadji M. B. , Almamy Youssouph L. Y. , Ndiaye Khady , Amankwa Belynda , Ong Les , Oh Cecilia , Wirngo Bill , Kung Liang , Hedje Judith , Tuitai Lydia , Efe-Aluta Oniovo , Magafu Mgaywa , Ntabangana Spes , Kande Mouctar , Okine Rafiq , Hamel Mary , Walldorf Jenny , Furrer Eliane , Kelleher Kristen , Lindsey W. U. , Takamiya Mayuko , Bergstrom Cynthia 
Published: August 2023

A workshop on implementation strategies for the introduction of the RTS,S/AS01 (RTS,S) malaria vaccine in countries with areas of highly seasonal transmission, was held as a hybrid meeting in Dakar, Senegal, and online, 23–25 January 2023. Delegates from Expanded Programmes on Immunization (EPI) and National Malaria Control Programmes (NMCPs) from 13 African countries, and representatives from key stakeholders participated. RTS,S is the first malaria vaccine to be recommended by the World Health Organization (WHO). The recommendation followed pilot implementation of the vaccine in Ghana, Kenya and Malawi, which showed that introduction of the vaccine was highly effective at scale, and was associated with a 30% reduction in hospital admissions with severe malaria in age groups eligible to have received the vaccine and no evidence of the safety signals that had been observed in the phase 3 trial. Clinical trials in Mali and Burkina Faso, showed that in children receiving Seasonal Malaria Chemoprevention (SMC), providing the vaccine just prior to high transmission seasons, matching the period of highest efficacy to the peak transmission season, resulted in substantial reduction in the incidence of clinical malaria and of severe malaria. While SMC has been successfully scaled-up despite the challenges of delivery, there is no established platform for seasonal vaccine delivery and no real-world experience. The objectives of this workshop were, therefore, to share experiences from countries that have introduced the RTS,S vaccine in routine child vaccination programmes, with SMC-implementing countries as they consider malaria vaccine introduction, and to explore implementation strategies in countries with seasonal transmission and where EPI coverage may be low especially in the second year of life. Practical implementation challenges, lessons learned for vaccine introduction, and research questions, towards facilitating the introduction of the RTS,S (and other malaria vaccines) in countries with seasonal malaria transmission were discussed.