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High hopes

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Care must be taken not to raise unrealistic expectations for RTS,S malaria vaccine. Vaccines have been an unparalleled public-health success: they have eradicated smallpox and driven polio to near extinction, and routine childhood immunization saves millions of children a year from death from diseases such as measles, diphtheria, tetanus and whooping cough. So it is not surprising that the public tend to view vaccines as synonymous with elimination, or near elimination, of our microbial foes.

This may help to explain last week’s extensive and often upbeat media coverage of the 18-month results of a huge phase III trial of the malaria vaccine candidate RTS,S/AS01 in more than 15,000 children across 7 African countries. In the United Kingdom, for example, the front page of The Guardian stated that the vaccine “could save lives of millions of children”. Unfortunately, however, it won’t. The 18-month results only confirm the disappointing results seen after 12 months.

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