It is obvious that there is a critical need for an efficient
malaria vaccine to accelerate malaria eradication. Currently,
recombinant subunit vaccination against malaria using proteins and
peptides is gaining attention. However, one of the major drawbacks of
this approach is the lack of an efficient and durable immune response.
Therefore, subunit vaccines require adjuvants to make the vaccine
sufficiently immunogenic. Considering the history of the RTS,S vaccine,
it seems likely that no single adjuvant is capable of eliciting all the
protective immune responses required in many malarial subunit vaccines
and the use of combination adjuvants will be increasingly important as
the science of malaria vaccines advances. In light of this, it appears
that identifying the most effective mixture of adjuvants with minimal
adverse effects offers tremendous opportunities in improving the
efficacy of vaccines against malaria. Owing to the importance of a
multi-adjuvanted approach in subunit malaria vaccine development, this
review paper outlines some of the best known combination adjuvants used
in malaria subunit vaccines, focusing on their proposed mechanisms of
action, their immunological properties, and their notable results. The
aim of the present review is to consolidate these findings to aid the
application of these combination adjuvants in experimental malaria
vaccines.