The efficacy of vaccines is a complex issue and sometimes long range effects may be disastrous.
The situation is dramatic for the RTS,S vaccine which protects only against sporozoites but does not induce clinical immunity against blood-stage parasites. The vaccine showed evidence of 35,9% efficacy in the first year after vaccination, but efficacy fell to 2.5% in the fourth year. The cohort with a high exposure index even showed a negative efficacy during the fifth year, i.e. an higher level of infection
Olotu A, Fegan G, Wambua J, et al....