Current status of Plasmodium vivax vaccine.

From a total of 2.6 billion people at permanent risk of suffering malaria infection worldwide, 80-300 million experience Plasmodium vivax infections every year, with clinical manifestations ranging from asymptomatic to mild and chronic infection that in some cases lead to severe disease and death. The increasing P. vivax drug resistance and reports of severe and lethal cases, the relapsing parasite behavior and the existence of Plasmodium spp. co-infections must prompt more investment and greater efforts for the development of P. vivax vaccine. Currently there are only two P. vivax vaccine candidates being tested in clinical trials and few others are being assessed in preclinical studies which contrast with the numerous P. falciparum vaccines candidates under evaluation. The recent availability of the P. vivax genome and ongoing proteomic analysis are likely to accelerate P. vivax vaccine development. Recent development of human sporozoite-challenge models would contribute to move clinical development forward and to identify mechanisms of immunity.