Rheumatic Fever Following Streptococcal Vaccination

Pathogenesis of Group A Streptococcal Infections

“…The vaccine was given to siblings in families with rheumatic fever. There were three episodes of rheumatic fever in the vaccinees, but it was not certain if the vaccine was related to the development of rheumatic fever (350). In the study, 3 of 21 vaccinees developed rheumatic fever following group A streptococcal infections occurring during the period of immunization.…”

Rheumatic fever: New ideas in diagnosis and management

“…Initial attempts at developing a vaccine against group A streptococcal infection failed when vaccinated subjects developed acute rheumatic fever after vaccination. (9) Despite a better understanding of vaccine design the authors of a recent paper expressed disappointment that only one vaccine has been studied clinically in the last 3 decades. (10) The accurate identification of the multiple serotypes causing acute rheumatic fever in various parts of the globe has raised concerns regarding the potential effectiveness of the current multivalent vaccine.…”

The prospect of vaccination against group a β-hemolytic streptococci

“…However, when injected with mineral oil adjuvant, partially purified M protein induced bactericidal antibodies in 10 of 16 subjects [41], suggesting that a vaccine based on M protein may be an effective strategy if a safe and reliable delivery system is identified. Unfortunately, progress in clinical vaccine development faltered when investigators conducting a clinical trial involving a partially purified M3 protein reported an apparent increase in the attack rate of ARF among vaccinated children compared with historical controls [42]. Whether these cases were caused by vaccination remains uncertain.…”