RTS,S/AS01 vaccination may prevent spread of COVID-19, writes M.D. Choudhury & A. Bhattacharjee

— Manabendra Dutta Choudhury¹ & Amitabha Bhattacharjee²—

March 31: A recent article in the journal nature (https://naturemicrobiologycommunity.nature.com/users/17778-ben-johnson/posts/62491-an-old-drug-for-malaria-kills-the-new-coronavirus) mentioned that hydroxycholoroquine, which is used to treat malaria, kills new corona virus.

However, an interesting data from the website called our world in data (https://ourworldindata.org/coronavirus and https://ourworldindata.org/search?q=malaria) showed malaria high risk countries and regions have less fatalities due to COVID 19 which may be due to herd immunity to malaria. Two pictures are given below:

The RTS,S, the malaria vaccine consists of the P. falciparum circumsporozoite protein (CSP) from the pre-erythrocytic stage. The CSP antigen causes the production of antibodies capable of preventing the invasion of hepatocytes and additionally elicits a cellular response enabling the destruction of infected hepatocytes.

RTS,S/AS01  is a recombinant malaria vaccine which was engineered using genes from the outer protein (CSP) of P. falciparum malarial parasite and a portion of a hepatitis B virus plus a chemical adjuvant to boost the immune response. This was approved in 2015 and pilot testing was done in three countries of  Africa viz; Kenya, Ghana and Malawi in 2019 (https://www.who.int/news-room/detail/19-06-2019-letter-to-partners-june-2019 and https://www.afro.who.int/news/malaria-vaccine-launched-kenya-kenya-joins-ghana-and-malawi-roll-out-landmark-vaccine-pilot).

Surprisingly, in the current global situation of COVID 2019 spread, these three countries showed very low number of cases as recorded in the website where till 28^th March 2020 Ghana recorded 141 cases and Kenya with 38 whereas no report from Malawi. (https://www.worldometers.info/coronavirus/#countries)

Another finding that support this theory is the data of European Centre for Disease Control and Prevention, which showed South Sudan, Botswana and Western Sahara which are COVID 19 free as of 29^th March 2020.

These three countries are high risk zone of Malaria. 95% of South Sudan is endemic for Malaria whereas 100% of Malaria cases in Botswana are due to Plasmodium falciparum. Below is WHO world malaria report 2019 global map. Exactly similar situation may be seen from the above map regarding COVID-19 case per million in India , most of African countries and Mayanmar where as of 29^th March the rate is within 0.01 to 0. 10 per million and all those areas are high malaria prone in general. This theory also holds good for Mexico, Panama, Saudi Arabia and Malagassy. However similar situation in Russian Federation and Northern Part of Latin America where COVID-19 case per million is 0.11 to 5.00 can not be explained by this theory as former one is Malaria free but the later one is high malaria prone.

More interestingly, in India, Northeastern states and Jharkhand is known to be the high risk endemic regions for malaria. As on 31st March, only three cases reported from North East of which cases from Mizoram and Manipur are travellor and the case reported from Assam is known to be immunocompromised.

From above observations, OUR PROPOSITION IS that the current malaria vaccine  (RTS,S/AS01  ) be tried in the region to boost immunity against this virus. The initial priority wise target populations for vaccination may be

1. Senior Citizens
2. Security staffs who are often in close contact with general public due to their nature of duty
3. Health workers
4. Shop keepers and vendors
5. Migrant workers who has high chance of exposure

Our proposition was communicated to PMO, Principal Scientific advisor to Govt of India, CM, Assam, Health Minister Assam and others. 

Acknowledgement: Several online information sources

(¹Department of Microbiology, Assam University, Silchar and ²Department of Life Science and Bioinformatics.)