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**Pfs25 + Pfs230** is a combination transmission-blocking vaccine candidate targeting Plasmodium falciparum sexual stage antigens to prevent malaria transmission from humans to mosquitoes. Pfs25, expressed on zygotes and ookinetes post-fertilization, and Pfs230 (or its domain 1, Pfs230D1), a prefertilization gamete surface protein involved in male microgamete fertilization of female macrogametes, are conjugated to carrier protein ExoProtein A (EPA) and formulated in Alhydrogel adjuvant. In clinical trials, the combination was safe and well-tolerated but did not improve functional transmission-reducing activity (TRA) over Pfs230D1 alone, which outperformed Pfs25 alone in humans due to complement-dependent enhancement; preclinical studies in mice showed similar activity for both antigens.[1][5]
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