The development of a
malaria vaccine is a priority for improved and sustained
malaria control. Optimal use of a
vaccine in Africa will only be achieved if it can be delivered through the Expanded Programme of Immunization (EPI). We have completed a trial of the
peptide vaccine SPf66 in Tanzanian infants, given alongside the EPI
vaccines. This paper describes the humoral responses to SPf66 and the EPI
vaccines. A total of 1207 infants were recruited into a two-arm, double-blind, individually randomized placebo-controlled trial of SPf66. The objectives of the trial were to determine the safety, immunogenicity and efficacy of SPf66 and to assess interactions with EPI
vaccines when three doses of SPf66 were delivered alongside the EPI
vaccines. Cross-sectional surveys were carried out to asses seroconversion rates to the EPI
vaccines and the antibody response to SPf66 (NANP)50 and Plasmodium falciparum lysates. Seroconversion rates to EPI
vaccines were high and no statistically significant differences in prevalence or titres were found between SPf66 and placebo recipients.
IgG antibodies against SPf66 (NANP)50 and whole P. falciparum lysate were present in high titres in mothers of recruited children at the time of birth. Vaccination with SPf66 stimulated a good anti-SPf66
IgG response which declined to preimmunization levels by 2 years of age and which was not associated with protection against clinical
malaria. The
vaccine induced no
IgG antibodies against (NANP)50 or P. falciparum lysates. SPf66 stimulated a humoral immune response when given to very young infants and did not interfere with seroconversion to EPI
vaccines. The response to SPf66 was qualitatively different from that seen in older children, in whom SPf66 has been shown to be moderately efficacious. This difference raises concerns about the difficulties of immunizing very young infants who need to be targeted by
antimalarial vaccination programs.