Malaria Vaccine Phase 2b Clinical Trial Results Published in Preprints with The Lancet

Novavax, Inc. (Nasdaq: NVAX), a biotechnology company developing next-generation vaccines for serious infectious diseases, today announced the pre-print publication of data from a Phase 2b clinical trial in children demonstrating 77 percent efficacy for a malaria vaccine candidate, R21, created by the University of Oxford that includes Novavax’ Matrix-M™ adjuvant and is licensed to Serum Institute of India (SII). Published online in Preprints with The Lancet, this vaccine’s high levels of protective efficacy hold promise of becoming an important tool for global malaria eradication.

The Phase 2b randomized, controlled, double-blind trial was conducted at the Clinical Research Unit of Nanoro (CRUN) / Institut de Recherche en Sciences de la Santé (IRSS), Burkina Faso, and recruited 450 participants from the catchment area of Nanoro, a setting with highly seasonal malaria transmission.

In three study arms, participants aged 5-17 months received 5 mg of R21 with either 25 mg or 50 mg of Matrix-M, or a rabies vaccine as a control. The researchers reported a vaccine efficacy of 77 percent in the higher adjuvant dose group and 71 percent in the lower adjuvant dose group. The publication reports that both adjuvant dosage levels were well tolerated in young children with no reported severe reactions to the vaccine. In addition, participants vaccinated with R21/Matrix-M showed high titers of malaria-specific anti-N-acetylneuraminic acid phosphatase (NANP) antibodies 28 days after the third vaccination, which were almost doubled with the higher adjuvant dose. After a fourth dose, administered one year later, antibody levels were boosted to levels similar to the peak titers achieved following the primary series of vaccinations.

The Matrix-M component of the malaria vaccine will be manufactured and supplied to SII by Novavax. Under Novavax’ agreement with Serum Institute, SII has rights to use Matrix-M in the vaccine in regions where the disease is endemic and will pay Novavax royalties on its market sales of the vaccine. Additionally, Novavax will have commercial rights to sell and distribute the SII-manufactured vaccine in certain countries, primarily in the travelers’ and military vaccine markets.

“These significant results support our high expectations for the potential of this vaccine, which included reaching the WHO-stated goal for a malaria vaccine with at least 75 percent efficacy,” said Adrian Hill, Lakshmi Mittal and Family Professorship of Vaccinology; Director of the Jenner Institute at the University of Oxford; Co-Director, Oxford Martin Programme on Vaccines, and co-author of the publication. “With the commitment by our commercial partner, Serum Institute of India, to manufacture at least 200 million doses annually in the coming years, we believe this vaccine could have a major public health impact.”

There were an estimated 229 million cases of malaria worldwide in 2019, with an estimated 409,000 deaths. Children under the age of five are the most vulnerable, accounting for 67 percent of deaths worldwide in 2019. A Phase 3 trial of the vaccine has begun recruitment across five trial sites in four countries of differing malaria transmission rates and seasonality in Africa to study large-scale safety and efficacy.

“The team at Novavax is gratified to be a part of the collaboration that has led to today’s important advance for this longstanding global health problem,” said Gregory M. Glenn, M.D., President, Research and Development, Novavax. “Novavax’ Matrix-M adjuvant used with the Oxford R21 antigen both minimizes the dose required and thereby increases the number of doses available, and stimulates a highly effective immune response that could protect the world’s most vulnerable population, children.”

“We are excited to be working with Oxford University and Novavax on the successful development of a malaria vaccine,” said Dr. Cyrus Poonawalla, Chairman and Managing Director, Serum Institute of India. “We are committed to supplying 200 million doses of the vaccine annually after licensure at a very cost-effective price.”

The results, detailed in, ‘Efficacy of a low dose candidate malaria vaccine, R21 in adjuvant Matrix-M^TM, with seasonal administration to children in Burkina Faso: a randomized controlled trial,’ are available online here.