Purpose of review: To focus on recent novel concepts in the development of malaria vaccines.
Recent findings: There is a renewed interest in whole attenuated sporozoite vaccines, either as irradiated or genetically modified sporozoites, because they consistently elicit solid protection against challenge infections. Enthusiasm about these vaccines is, however, tempered by technical, logistical, safety and even cultural hurdles that might need to be surmounted. Less than a score of Plasmodium falciparum proteins are currently in the development pipeline as malaria vaccines. There is an urgent need to ratchet up the process of candidate vaccine discovery, and reverse vaccinology and genome-wide surveys remain promising strategies. The development of malaria vaccines for placental malaria is an active area and chondroitin sulfate A-binding epitopes of the variant PfEMP1 have been identified. Live bacteria and viral vectors hold special promise for vaccine delivery.
Summary: Attenuated sporozoite vaccines have made a resurgence to center stage in malaria vaccine development. There is an urgent need to identify more subunit vaccine candidates that can enter into the development pipeline, identify surrogate markers of immunity and design vaccines which induce long-lasting immunity.