Acceptability of the R21/Matrix-M malaria vaccine alongside existing malaria interventions in the trial context

Background The R21/Matrix-M malaria vaccine has been shown to provide high protective efficacy against malaria in a phase III trial, and has been recommended for use by WHO. The vaccine will soon be deployed at scale in sub-Saharan Africa. This study aimed to understand the caregiver and community a...

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Main Authors: Jayne Webster, Brian Greenwood, Daniel Chandramohan, Alassane Dicko, Issaka Sagara, Djibrilla Issiaka, Adrian VS Hill, Halimatou Diawara, Fatoumata Koita, Seydou Traoré, Jane Grant, Mehreen Datoo, Mala Sylla, Abdrahmane Boncane Dicko
Format: Article
Language:English
Published: BMJ Publishing Group 2025-02-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/10/2/e015524.full
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author Jayne Webster
Brian Greenwood
Daniel Chandramohan
Alassane Dicko
Issaka Sagara
Djibrilla Issiaka
Adrian VS Hill
Halimatou Diawara
Fatoumata Koita
Seydou Traoré
Jane Grant
Mehreen Datoo
Mala Sylla
Abdrahmane Boncane Dicko
author_facet Jayne Webster
Brian Greenwood
Daniel Chandramohan
Alassane Dicko
Issaka Sagara
Djibrilla Issiaka
Adrian VS Hill
Halimatou Diawara
Fatoumata Koita
Seydou Traoré
Jane Grant
Mehreen Datoo
Mala Sylla
Abdrahmane Boncane Dicko
author_sort Jayne Webster
collection DOAJ
description Background The R21/Matrix-M malaria vaccine has been shown to provide high protective efficacy against malaria in a phase III trial, and has been recommended for use by WHO. The vaccine will soon be deployed at scale in sub-Saharan Africa. This study aimed to understand the caregiver and community acceptability of the R21/Matrix-M vaccine alongside existing malaria prevention interventions, according to the communities of participants in the seasonal R21/Matrix-M phase III trial in Mali.Methods Qualitative data were collected to assess the acceptability of the R21/Matrix-M vaccine alongside the three R21/Matrix-M or control vaccine priming injections given in the first year of the trial. A total of 33 in-depth interviews (IDIs), 12 focus group discussions (FGDs) and 45 exit interviews at the trial clinics were conducted with caregivers of trial participants, 18 IDIs and 8 FGDs were conducted with community members, 13 IDIs with community health workers and 8 IDIs with trial field staff. Data were coded using the constructs from Sekhon’s theoretical framework on acceptability.Results Acceptability of the R21/Matrix-M vaccine was driven mainly by the high burden of malaria in the highly seasonal study area and consequent demand for a malaria vaccine, a perceived high efficacy of the R21/Matrix-M vaccine, and a high level of trust and confidence in the trial and trial team. These perceptions of the acceptability of the R21/Matrix-M vaccine led to a reduced perceived importance of seasonal malaria chemoprevention (SMC) among some caregivers, while others viewed R21/Matrix-M, SMC and insecticide-treated nets as complementary.Conclusions The R21/Matrix-M vaccine was acceptable to caregivers and communities of participants in the R21/Matrix-M phase III trial in Mali. Implementation research is needed to evaluate and ensure co-coverage of complementary malaria control interventions, including SMC in seasonal settings, in the face of the scale-up of R21/Matrix-M and other malaria vaccines.
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spelling doaj-art-19cee6e5f07e4017865a201f1ac19a9e2025-02-04T04:00:13ZengBMJ Publishing GroupBMJ Global Health2059-79082025-02-0110210.1136/bmjgh-2024-015524Acceptability of the R21/Matrix-M malaria vaccine alongside existing malaria interventions in the trial contextJayne Webster0Brian Greenwood1Daniel Chandramohan2Alassane Dicko3Issaka Sagara4Djibrilla Issiaka5Adrian VS Hill6Halimatou Diawara7Fatoumata Koita8Seydou Traoré9Jane Grant10Mehreen Datoo11Mala Sylla12Abdrahmane Boncane Dicko132 London School of Hygiene & Tropical Medicine, London, UK2 London School of Hygiene & Tropical Medicine, London, UK2 London School of Hygiene & Tropical Medicine, London, UK1 Malaria Research and Training Centre, University of Sciences Techniques and Technologies of Bamako, Bamako, Mali1 Malaria Research and Training Centre, University of Sciences Techniques and Technologies of Bamako, Bamako, Mali1 Malaria Research and Training Centre, University of Sciences Techniques and Technologies of Bamako, Bamako, Mali3 Centre for Clinical Vaccinology and Tropical Medicine, The Jenner Institute, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK1 Malaria Research and Training Centre, University of Sciences Techniques and Technologies of Bamako, Bamako, Mali1 Malaria Research and Training Centre, University of Sciences Techniques and Technologies of Bamako, Bamako, Mali1 Malaria Research and Training Centre, University of Sciences Techniques and Technologies of Bamako, Bamako, Mali2 London School of Hygiene & Tropical Medicine, London, UK3 Centre for Clinical Vaccinology and Tropical Medicine, The Jenner Institute, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK4 Ministry of Health and Public Hygiene, Bamako, Mali4 Ministry of Health and Public Hygiene, Bamako, MaliBackground The R21/Matrix-M malaria vaccine has been shown to provide high protective efficacy against malaria in a phase III trial, and has been recommended for use by WHO. The vaccine will soon be deployed at scale in sub-Saharan Africa. This study aimed to understand the caregiver and community acceptability of the R21/Matrix-M vaccine alongside existing malaria prevention interventions, according to the communities of participants in the seasonal R21/Matrix-M phase III trial in Mali.Methods Qualitative data were collected to assess the acceptability of the R21/Matrix-M vaccine alongside the three R21/Matrix-M or control vaccine priming injections given in the first year of the trial. A total of 33 in-depth interviews (IDIs), 12 focus group discussions (FGDs) and 45 exit interviews at the trial clinics were conducted with caregivers of trial participants, 18 IDIs and 8 FGDs were conducted with community members, 13 IDIs with community health workers and 8 IDIs with trial field staff. Data were coded using the constructs from Sekhon’s theoretical framework on acceptability.Results Acceptability of the R21/Matrix-M vaccine was driven mainly by the high burden of malaria in the highly seasonal study area and consequent demand for a malaria vaccine, a perceived high efficacy of the R21/Matrix-M vaccine, and a high level of trust and confidence in the trial and trial team. These perceptions of the acceptability of the R21/Matrix-M vaccine led to a reduced perceived importance of seasonal malaria chemoprevention (SMC) among some caregivers, while others viewed R21/Matrix-M, SMC and insecticide-treated nets as complementary.Conclusions The R21/Matrix-M vaccine was acceptable to caregivers and communities of participants in the R21/Matrix-M phase III trial in Mali. Implementation research is needed to evaluate and ensure co-coverage of complementary malaria control interventions, including SMC in seasonal settings, in the face of the scale-up of R21/Matrix-M and other malaria vaccines.https://gh.bmj.com/content/10/2/e015524.full
spellingShingle Jayne Webster
Brian Greenwood
Daniel Chandramohan
Alassane Dicko
Issaka Sagara
Djibrilla Issiaka
Adrian VS Hill
Halimatou Diawara
Fatoumata Koita
Seydou Traoré
Jane Grant
Mehreen Datoo
Mala Sylla
Abdrahmane Boncane Dicko
Acceptability of the R21/Matrix-M malaria vaccine alongside existing malaria interventions in the trial context
BMJ Global Health
title Acceptability of the R21/Matrix-M malaria vaccine alongside existing malaria interventions in the trial context
title_full Acceptability of the R21/Matrix-M malaria vaccine alongside existing malaria interventions in the trial context
title_fullStr Acceptability of the R21/Matrix-M malaria vaccine alongside existing malaria interventions in the trial context
title_full_unstemmed Acceptability of the R21/Matrix-M malaria vaccine alongside existing malaria interventions in the trial context
title_short Acceptability of the R21/Matrix-M malaria vaccine alongside existing malaria interventions in the trial context
title_sort acceptability of the r21 matrix m malaria vaccine alongside existing malaria interventions in the trial context
url https://gh.bmj.com/content/10/2/e015524.full
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