Following the approval by the World Health Organization (WHO) of two new vaccines, RTS,S/AS01 and R21/Matrix-M, for malaria prevention in children, they are being administered in 12 malaria-endemic African countries, prioritizing areas with moderate to high transmission. These vaccines will be a game changer in the efforts to attain global elimination of malaria in the 35 or more malaria-endemic countries and achieve the Sustainable Development Goal of a 90% reduction in malaria incidence and mortality by 20301. The vaccines are expected to prevent half a million child deaths annually. Addressing the cost and production limitation of the prior malaria vaccine (RTS,S/AS01), the new R21/Matrix-M vaccine will be mass produced and delivered at an affordable, minimal cost2. These new vaccines come at a critical moment when malaria prevention and control programs are challenged by the impacts of climate change, the emergence of insecticide and drug-resistant strains, and new variants of mosquitos, particularly in urban areas.

An additional challenge in Africa is vaccine hesitancy, which has been seen for other new vaccines, including against COVID-19. The COVID-19 vaccines activated widespread dissemination of vaccine conspiracies and misinformation3. Consequently, the general public have questioned the safety and quality of vaccines. For example, in Cameroon, the COVID-19 pandemic led to a substantial drop in pediatric attendance for routine childhood immunizations between 2020 and 2022, and these numbers have not yet returned to pre-pandemic levels4. In some cases, vaccinators have been targeted and attacked due to misinformation and conspiracies against vaccines, including the killing of polio vaccination workers in Afghanistan, Pakistan and Nigeria, with the attackers alleging that the vaccines are administered to sterilize Muslims5,6,7. This disinformation can quickly spread through communities, including via social media.