[Antimalarial vaccination: advances and controversies]

Since 1993 the new worldwide position of WHO is to encourage the development of an anti-malaria vaccine. The antigenic complexity of the parasite makes such development difficult. Twenty or more candidate molecules are being tested with different stages of development. They are directed against pre-erythrocyte or erythrocyte stages, or gametes, multivalent, or directed against the pathogenic metabolites of the parasite. Recent results have shown the interest of further study of the adjuvants. Controversy was crystallised by the disappointing results of the Pattaroyo vaccine, Spf66, which associates antigens of the sporozoite and the erythrocyte stage. These results nevertheless showed that vaccination against malaria is possible, but they underlined the undesirable effects of performing clinical studies too early or making premature recommendations.