Group A Streptococcus (GAS)
infections result in a considerable underappreciated burden of acute and
chronic disease globally. A 2018 World Health Assembly resolution calls for better control and prevention. Providing guidance on global health research needs is an important World Health Organization (WHO) activity, influencing prioritization of investments. Here, the role, status, and directions in GAS
vaccines research are discussed. WHO preferred product characteristics and a research and development technology roadmap, briefly presented, offer an actionable framework for
vaccine development to regulatory and policy decision making, availability, and use. GAS
vaccines should be considered for global prevention of the range of clinical manifestations and associated
antibiotic use. Impediments related to
antigen diversity, safety concerns, and the difficulty to establish
vaccine efficacy against
rheumatic heart disease are discussed. Demonstration of
vaccine efficacy against
pharyngitis and skin
infections constitutes a key near-term strategic goal. Investments and collaborative partnerships to diversify and advance
vaccine candidates are needed.