New study makes economic case for placental malaria vaccine, with first-time mothers standing to benefit most

New research study from the ADVANCE_VAC4PM consortium provides compelling evidence that a vaccine against placental malaria could be a cost-effective tool for protecting mothers and newborns in sub-Saharan Africa, with the greatest benefit seen when the vaccine is given to women before their first pregnancy.

Placental malaria poses a serious threat to pregnant women and their newborns across the region. Of an estimated 36 million pregnancies in sub-Saharan Africa in 2023, around 12.4 million were exposed to malaria infection. Existing preventive tools are increasingly undermined by drug and insecticide resistance, making new approaches urgently needed.

The study, led by researchers from Kamuzu University of Health Sciences in Malawi and the European Vaccine Initiative in Heidelberg, and published in the journal Vaccines in April 2026, used mathematical modelling to estimate the potential value of a placental malaria vaccine before full efficacy trial data are available. Two vaccine candidates, PAMVAC and PRIMVAC, have already demonstrated safety and immune responses in Phase I clinical trials. However, no empirical data yet exist on their broader public health value.

By integrating regionally relevant epidemiologic, clinical, and cost data, the findings show that a vaccine targeting women who have never been pregnant before could deliver strong value for money, even under conservative vaccine efficacy, uptake and price assumptions. . Women pregnant for the first time are at highest risk because they have not yet built up natural immunity, making them, and their babies, the most important group to protect.

Additional evaluations will be needed to address some  limitations, including the exclusion of maternal outcomes and long-term infant morbidity from the model, and the use of assumed rather than observed vaccine efficacy. Also, the lack of disaggregated data prevented a separate cost-effectiveness analysis for secundigravidae, who still experience a meaningful burden of placental malaria and adverse perinatal outcomes, potentially underestimating the benefits of vaccination in this group.

“Robust cost-effectiveness evidence is essential for sustainable vaccine roll-out in low- and middle-income countries, ensuring that new interventions deliver meaningful public health benefits while remaining affordable and accessible. These findings reinforce the importance of continued investments in placental malaria vaccine development and the need for real-world trial data to support future economic evaluations.” - states Dr Flavia D'Alessio, EVI’s Head of Vaccine Research and author.

The paper is available open access: Chinkhumba J et al., Vaccines 2026, 14(5), 378. https://doi.org/10.3390/vaccines14050378

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