Status of vaccine research and development of vaccines for GBS

Area of Science:

• Neonatal infectious diseases
• Vaccinology
• Microbiology

Background:

• Streptococcus agalactiae (GBS) is a primary cause of neonatal sepsis and meningitis globally.
• Intrapartum antibiotic prophylaxis (IAP) reduces early-onset GBS but not late-onset disease (LOD).
• The burden of GBS in low/middle-income countries, particularly Southern Africa, is significant and potentially underestimated.

Purpose of the Study:

• To highlight the limitations of current GBS prevention strategies.
• To advocate for the development and implementation of a maternal GBS vaccine.
• To emphasize the potential of vaccination to address both early and late-onset GBS infections in all settings.

Main Methods:

• Review of existing literature on GBS epidemiology and prevention.
• Analysis of the efficacy and limitations of intrapartum antibiotic strategies.
• Discussion of the potential impact and cost-effectiveness of a maternal GBS vaccine.

Main Results:

• IAP strategies are ineffective against late-onset GBS infections.
• Rapidly fulminating GBS cases can be missed, leading to underestimation of disease burden.
• Maternal vaccination presents a promising and potentially cost-effective solution for GBS prevention.

Conclusions:

• A maternal GBS vaccine is a superior strategy for preventing neonatal sepsis and meningitis compared to current IAP.
• Vaccination could provide a comprehensive solution for both early and late-onset GBS disease across diverse healthcare settings.
• Current vaccine development includes CPS-protein conjugate and protein-based candidates, with some in clinical trials.