Setting the goalpost high: Estimating the Number of potentially eligible malaria vaccine recipients
Existing data on age and malaria risk from WHO and other international sources enable a rough estimate of total potential vaccine recipients. Of course, it takes significant time and resources to vaccinate people, and 100% vaccination against any disease has never been achieved — but even so, the lives at stake mean it is imperative that we set our sights high.
According to the WHO’s World Malaria Report 2022 (Annex 4G), approximately 91.7% of the population in Sub-Saharan Africa — 1.01 billion people* — were at risk of contracting malaria as of 2021. The U.S. Census Bureau’s International Database estimates that approximately 178.6 million people in Sub-Saharan Africa are children under the age of five as of 2023. 91.7% of this is 163.78 million. Assuming half fall between 5 and 36 months old — the optimal vaccination age range for R21 — approximately 81.89 million should thus be eligible for a malaria vaccine next year.
Note that some children may be covered by the other vaccine, RTS,S, though the total number of RTS,S expected to be available in the coming years is significantly lower than projected R21 manufacturing capacity. 6 million RTS,S doses have been allocated for 2024. If three doses are administered to 1.5 million children, another a remaining 1.5 million vaccinated previously can be administered the booster dose. Excluding these 3 million (a very rough estimate), the total number of potentially R21-eligible children in Africa is around 78.89 million.
* This is the sum of at-risk populations in all countries in the WHO African Region (AFRO) in the Annex 4G spreadsheet (Algeria, which is in AFRO but is not Sub-Saharan, is not listed to begin with) plus Somalia, a Sub-Saharan country in the WHO Eastern Mediterranean Region.