There is an urgent global health need for a vaccine that could protect pregnant women and their infants against GBS, particularly in developing countries where prophylactic administration of antibiotics is not routine. A pregnant woman has the ability to transfer protective antibodies to her unborn child through the placenta; if successful, the vaccine could help augment this protective effect for the newborn baby.
"The first few days and weeks of a baby's life are the most dangerous by far," said Keith Klugman, Director for Pneumonia at the Bill & Melinda Gates Foundation. "The clinical development of a group B streptococcal vaccine would be an important landmark in the story of vaccine development to protect newborns from this disease through the immunization of their mothers."
Neonatal GBS infection is a debilitating and often fatal disease with mortality rates of around 6% to 14% of those infected in industrialized countries(2) and approximately 14% to 38% of those infected in parts of the developing world.(3) The estimated incidence of invasive GBS disease is among the highest in South Africa, with 2.38 cases per 1,000 live births.(4)
"The health benefits of maternal immunization to protect pregnant mothers and their babies against flu, tetanus and pertussis are well-documented," said Kathrin U. Jansen, Ph.D., Senior Vice President and Head of Vaccine Research & Development, Pfizer. "We are looking to determine whether our investigational vaccine could generate levels of protective antibodies in the mother that, when passed to her unborn baby, will protect the baby against deadly GBS infection during a time when the infant is most vulnerable to infection."
GBS bacteria have the potential to cause severe disease, particularly in newborn infants who have an immature immune system that is still adapting to the environment outside the womb. Some of the most common complications caused by GBS impact the blood, lungs, lining of the brain, and spinal cord in the form of sepsis, pneumonia or meningitis. It is estimated that more than 40% of survivors remain impaired during childhood.(5) Current preventative care in the developed world consists of prophylactic treatment with intravenous antibiotics before delivery of the baby, which is an uncommon practice in the developing world as it presents multiple challenges to implementation in countries lacking a robust health care infrastructure.
Research has shown that a potential conjugate vaccine that incorporates at least five serotypes of GBS could prevent approximately 95% of group B streptococcal disease in infants younger than three months.(6)
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1. Thigpen MC, et al. Bacterial Meningitis in the United States, 1998–2007. N Engl J Med. 2011: 364:2016-2025.
2. Edwards MS, Gonik B, "Preventing the broad spectrum of perinatal morbidity and mortality through group B streptococcal vaccination." Accessed 24 June 2016. Available at http://www.ncbi.nlm.nih.gov/pubmed/23200934
3. Johri AK, Lata H, et al., "Epidemiology of Group B Streptococcus in developing countries." Accessed 24 June 2016. Available athttp://www.ncbi.nlm.nih.gov/pubmed/23973346
4. Dangor Z, Lala SG, et al., "Burden of Invasive Group B Streptococcus Disease and Early Neurological Sequelae in South African Infants." Accessed 13 October 2016. Available at http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0123014#sec014
5. Libster R, Edwards KM, et al., "Long-term outcomes of group B streptococcal meningitis." Accessed 24 June 2016. Available athttp://www.ncbi.nlm.nih.gov/pubmed/22689869
6. Le Doare K, Heath PT, "An overview of global GBS epidemiology." Vaccine. 2013; D7– D12. Accessed October 10 2016. Available athttp://www.sciencedirect.com/science/article/pii/S0264410X13000285