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August 11, 2004

Group A Streptococcal Vaccines

JAMA. 2004;292(6):738-739. doi:10.1001/jama.292.6.738

In this issue of JAMA, Kotloff and colleagues1 report on the safety and immunogenicity of a recombinant multivalent M protein group A streptococcal (GAS) vaccine evaluated in 28 healthy adult volunteers. This preliminary report is a positive step in a long journey ahead to develop a GAS vaccine.

Numerous attempts to immunize humans against GAS infections date back to the 1930s, when dead GAS intravenously administered to children who had rheumatic fever reportedly decreased recurrence rates.2,3 There was no evidence that these immunizations caused or reactivated rheumatic fever. In the 1940s, heat-killed and ultraviolet-killed GAS was administered subcutaneously, repetitively, and in high inocula to hundreds of military recruits with evidence of toxicity but not efficacy.4

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