Update on malaria vaccine deployment and challenges in the field

Malaria is a life-threatening but preventable and treatable parasitic disease that remains a serious global health challenge. To meet the World Health Organisation (WHO) Global Technical Strategy for Malaria 2016-2030, which aims to achieve a 90% reduction of global malaria incidence by 2030, accelerated efforts are required. Interestingly, the advent of the first two licensed malaria vaccines, RTS,S/AS01 (RTS,S) and R21/Matrix-M (R21), has marked a new era in the global fight against malaria.

To provide an update on malaria vaccine deployment and challenges in the field.

This narrative review is based on a relevant literature search spanning the last 5 years, as well as reports and policy documents from global health organisations, including WHO and GAVI (The Vaccine Alliance).

The following topics are covered: (1) what is known about the first two WHO-recommended malaria vaccines (RTS,S and R21), (2) current delivery strategies used for malaria vaccine deployment in the field, (3) challenges in current malaria vaccine deployment, (4) current malaria vaccine implementation studies, and (5) upcoming perspectives in the field of malaria vaccine development.

The roll-out of the first two malaria vaccines at large scale is progressing rapidly in sub-Saharan Africa, with 25 countries having introduced the vaccines in their routine immunisation programmes as of February 2026. However, current implementation challenges, including funding constraints, manufacturing capacity, delivery strategies, and vaccine hesitancy, should be quickly addressed to gain significant impact in targeted populations. Next-generation vaccines might improve the protective efficacy and durability against clinical malaria and reduce the transmission activity of the vectors to support global elimination efforts.