WHO updated its recommendation for malaria vaccines in October 2023. This applies to both RTS,S/AS01 and R21/Matrix-M vaccines.

WHO recommends the programmatic use of malaria vaccines for the prevention of P. falciparum malaria in children living in malaria endemic areas, prioritizing areas of moderate and high transmission.

• The malaria vaccine should be provided in a schedule of 4 doses in children from around 5 months of age. (Vaccination programmes may choose to give the first dose at a later or slightly earlier age based on operational considerations.)
• A 5th dose, given one year after dose 4, may be considered in areas where there is a significant malaria risk remaining in children a year after receiving dose 4.
• In areas with highly seasonal malaria or areas with perennial malaria transmission with seasonal peaks, countries may consider providing the vaccine using an age-based administration, seasonal administration, or a hybrid of these approaches.
• Countries should prioritize vaccination in areas of moderate and high transmission, but may also consider providing the vaccine in low transmission settings. Decisions on expanding to low transmission settings should be considered at a country level, based on the overall malaria control strategy, cost-effectiveness, affordability, and programmatic considerations.
• Vaccine introduction should be considered in the context of comprehensive national malaria control plans.