In discussions about the new malaria vaccine, R21, officiated on Sept. 8, there may have been a question — why did it take researchers so long to make a vaccine for a deadly disease spread worldwide?

From WHO's 2021 World Malaria Report, malaria poses risks to the populations of 87 countries, leading to 627000 deaths, 95 percent being in the WHO Africa region, such as Uganda and Mozambique. Even though people accuse mosquitoes of causing Malaria, the insects are a mere means of transmitting the disease — they are only the causing organism, called a vector (so only semi-guilty).

The microorganism that actually causes malaria is called Plasmodium and is targeted in the current most successful vaccine, called the RTS,S. And the way this microorganism functions to destroy our cells is way different than bacteria or viruses since it is a protozoan, a completely different class of microorganisms.

It is vital to understand how scary Plasmodium is because it lives for quite a while in your liver and red blood cells, so your immune system cannot look for it in your bloodstream.

Each of its forms has new surface chemical markers or antigens (a lot of them), so if medicine was made for one form, e.g., Form A, then Form B may remain unharmed. Fortunately for us, the most successful vaccine that has been released till date is one that targets special proteins (called CSP) secreted by the earliest form that exists.

Researchers have been working on Malaria vaccines for quite a while. The R21 vaccine has been researched for a long time but is now in its final stage before mass rollout. It has more essential proteins than before for the patient's immune system to make antibodies against the CSP proteins. When the antibodies and proteins meet, they stick to each other and get digested by cells in your immune system, so that you can combat this disease faster. It is also formed upon a hepatitis B virus protein that is present at the virus's surface (a chemical marker called an antigen), which may be surprising because R21 is not a vaccine for hepatitis B. They do this because hepatitis B proteins "self-organize to form virus-like particles" in the vaccine making process.

By doing so, the vaccine reaches your important cells easily, ironically, just as a virus would.

According to a research article in Frontiers, they can fuse to help display the CSP protein to the immune system so it can form antibodies against it. Since the attack is towards the CSP protein that the earliest form secretes as it just enters the human body, there is a quicker response against malaria before it even goes to the liver cells.

Just so you know, a viral protein cannot cause disease. It only informs your immune system of the threat of an illness, which vaccines often use to trick your body into thinking there is a disease so that it undergoes an immune response. Disease is usually caused by the whole organism, not a protein sticking out at its surface. So why did researchers need so much time to come up with the right vaccine?

The previous vaccine contained a lot of useless chemicals that actually ended up causing side-effects to a few patients, but the newer vaccine, R21, has a better ratio of useful CSP particles that will help fight the disease. Moreover, the inclusion of CSP-like proteins and hepatitis B proteins fused together will ensure the vaccine will cause your body to fight against the vaccine particles. Antibodies and cells called memory cells will also be made, which means that if you are infected with malaria later, those cells will come into action by increasing the speed of the response against the disease, so you have a lesser chance of a severe infection.

The previous vaccine had a “30 percent rate of protection against clinical malaria in children one to four years of age,” so this is a definite jump forward, considering the fact that people were given the previous vaccines for a couple years through a vaccination campaign. Hopefully, with time, researchers will be able to develop better vaccines and medicine to combat diseases affecting such a vast majority of the world.

Once we attempt to unmask the work that goes into the making of vaccines, the immense studying and response, trials and sampling, one can appreciate the research and thinking of scientists who managed to introduce R21 this year as the first malaria vaccine to reach WHO's efficacy benchmark of 75 percent.