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The development of a group B Streptococcus (GBS) vaccine for maternal immunization constitutes a global public health priority, to prevent GBS-associated early life invasive disease, stillbirth, premature birth, maternal sepsis, adverse neurodevelopmental consequences, and to reduce perinatal antibiotic use. Sample size requirements for the conduct of a randomized placebo-controlled trial to assess vaccine efficacy against the most relevant clinical endpoints, under conditions of appropriate ethical standards of care, constitute a significant obstacle on the pathway to vaccine availability. Alternatively, indirect evidence of protection based on immunologic data from vaccine and sero-epidemiological studies, complemented by data from opsonophagocytic in vitro assays and animal models, could be considered as pivotal data for licensure, with subsequent confirmation of effectiveness against disease outcomes in post-licensure evaluations. Based on discussions initiated by the World Health Organization we present key considerations about the potential role of correlates of protection towards an accelerated pathway for GBS vaccine licensure and wide scale use. Priority activities to support progress to regulatory and policy decision are outlined.

Original publication

DOI

10.1016/j.vaccine.2019.04.039

Type

Journal article

Journal

Vaccine

Publication Date

05/2019

Volume

37

Pages

3190 - 3198

Addresses

Initiative for Vaccine Research, World Health Organization, 20 Av Appia, 1202 Geneva, Switzerland. Electronic address: vekemansj@who.int.

Keywords

Humans, Streptococcus agalactiae, Streptococcal Infections, Pregnancy Complications, Infectious, Premature Birth, Infant, Newborn, Diseases, Streptococcal Vaccines, Vaccination, Drug Approval, Pregnancy, Infant, Newborn, Cost-Benefit Analysis, World Health Organization, Female, Stillbirth, Maternal Health