Fig. 1

Main simulated strategies and drug and vaccine efficacy profiles. a Illustrated strategies: MDA alone, vaccine alone, or MDA with vaccine. MDA application alone is 3 rounds coinciding with the pattern of seasonal transmission, with 2–3 years of 3 rounds or 3 rounds for only the first year followed by 1–2 years of 1 round at the beginning of the transmission season; RTS,S-like-duration vaccine or longer duration vaccine application alone is 3 rounds coinciding with the pattern of seasonal transmission with 1–2 years of 1 dose at the beginning of the season or as 3 rounds before the pattern of seasonal transmission, with 1–2 years of 1 dose at the beginning of the season; and strategies combining MDA with RTS,S-like-duration vaccine or longer duration vaccine are a combination of all MDA and vaccine implementations combined together. b Efficacy against infection profiles of 2 years of intervention with MDA, RTS,S like vaccine, vaccine with longer duration of protection, and vaccine with lower initial efficacy. x-axis represents the time in months, and efficacy against infection is indicated on the y-axis for MDA given at 1 months interval during 3 months the first year and 1 (yellow) or 3 (orange) rounds the second year, and for mass vaccination with a RTS,S like vaccine (purple), a longer duration protection vaccine (pink), or vaccines with lower initial efficacy against infection (dashed lines). Mass vaccination is delivered either before the peak of transmission the first year (bottom plot) or during the transmission season (middle plot). The first year 3 doses of vaccination are administered, but only the 3rd dose of vaccination is modeled, and the second year only one dose is administered. Initial efficacy against infection for both vaccines are 91% or 50% and the half-life, which is the time in which protection against infection has decayed to half the value of the initial level, is 7.3 months for the RTS,S like vaccine and 18 months for the vaccine with extended duration of protection, indicated with arrows on the diagram. Period of peak transmission are indicated by black boxes