Cameroon reports 25% fourth-dose malaria vaccine coverage for 2025

Cameroon's fourth-dose gap

Cameroon's fourth-dose coverage stood at 25% as of 2025, Cameroonian figures showed, less than half the 68% first-dose coverage reported for the same year. First-dose coverage rose from 66% to 68% from 2024 to 2025, second-dose from 53% to 58% and third-dose from 48% to 59%, according to Dr Bomba Amougou, head of prevention at the National Malaria Control Program.

Amougou said parents and even health workers sometimes forget the fourth dose, given around a child's second birthday, because it comes long after the third and the vaccine is relatively new. Receiving all four doses "makes the protection more potent," he said.

Cameroon became the first country to incorporate RTS,S into routine immunisation more than two years ago, the AP reported. It recorded an estimated 7.6 million malaria cases and 11,700 deaths in 2024. Health facilities logged 33,000 fewer cases in 2025 than in 2024, according to National Malaria Control Program data.

Amougou cautioned against crediting the vaccine alone. "Isolating the specific impact of malaria interventions requires modeling, and we do not yet have a model to quantify the vaccine's sole contribution," he said. The vaccine had contributed to the reduction in cases and deaths rather than being the exclusive cause, he said.

At Soa District Hospital, Mabel Djoumessi walked through mud with her 9-month-old son, Kenfack, strapped to her back, for his vaccination appointment. She said her other children who had not taken the vaccine frequently fall ill, and she planned to return for the fourth dose when he turns 2. Alice Tchuenmegne, a senior nurse in charge of vaccinations, said: "Our pediatric wards have become empty."

What the pilot showed

The World Health Organization recommended RTS,S for children in October 2021 after pilot studies in Ghana, Kenya and Malawi found it reduced deaths among eligible children by 13%, the AP reported. The vaccine is now part of routine immunisation programmes in 25 African countries, with more than 10 million children targeted each year, AllAfrica reported.

The WHO says the fourth dose, given months after the first three, is essential to prolong immunity. In the pilot across 158 districts in Ghana, Kenya and Malawi, coverage reached about 80% for the first dose, given at around six months of age, and fell to 46% for the fourth, given between 22 and 24 months, according to a Malaria Journal study published last year. Children missed later doses largely because of transport costs, lack of reminders, poor follow-up and competing work or childcare responsibilities, the AP reported.

A May 2026 Lancet study assessed RTS,S in Ghana, Kenya and Malawi over 46 months across 158 areas and estimated that about one in eight deaths among young children was prevented in the areas studied, AllAfrica reported. The World Malaria Report 2025 credits wider use of prevention tools, including vaccines, with preventing more than 170 million malaria cases and around 1 million deaths worldwide in 2024, mainly in Africa. Africa recorded around 579,000 malaria deaths in 2024, with children under five about three-quarters of them, according to WHO.

Supply constraint

Gavi, the Vaccine Alliance, says the rollout faces a "stark constraint" after sweeping foreign aid cuts by the Trump administration and others, and is guaranteeing supply to cover up to 70% of eligible children in the lowest-income countries. More than 52 million doses have reached 25 high-risk African countries with Gavi support, the AP reported.