Interactions between COVID-19, malaria and other infections that impact vaccine immunity in Malawi

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Major infectious diseases such as malaria, COVID-19 and other respiratory infections have a major health impact in populations in Africa. This is partly due to the moderate efficacy of vaccines being implemented in many countries, as well as waning immunity and incomplete vaccine coverage.

Vaccines against COVID-19 and other diseases can lead to varying levels of protection among different individuals and populations. The longevity of the immune response, or how long the vaccine lasts, can also vary.

Knowledge on vaccine immunity in African populations, and factors that impact immunity, is limited but still important for controlling and preventing major infectious diseases such as COVID-19 and malaria.

Repeated exposure to malaria, intestinal parasites and respiratory viruses, as well as specific nutritional deficiencies, are common in Sub-Saharan Africa. These factors can impact both innate and adaptive immunity to influence the magnitude and longevity of vaccine-induced immunity.

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Understand key gaps in immunity

As part of an international collaborative program, this project will investigate immunity in cohorts of naturally infected and vaccinated individuals in Malawi (central Africa) and address important knowledge gaps. The project will involve laboratory based studies in Melbourne that assess the acquisition and longevity of immunity generated by SARS-CoV-2 infection and vaccination and determine how malaria and intestinal parasite infections, undernutrition, and anemia impact on immunity.

We will use a comprehensive range of immunoassays including quantification of antibody magnitude (subclasses and isotypes), neutralizing antibodies to different variants, avidity and antibody-dependent cellular cytotoxicity. Additionally, studies will profile specific epitopes targeted by immunity and their relationship to immune escape by virus variants.

The overall objective of this work is informing strategies to improve protection from COVID-19, and identifying those most at risk, by understanding key gaps in natural and vaccine induced immunity.