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Rheumatic Fever Vaccine On The Cards – Expert Reaction


Preventing rheumatic fever may become within reach, as $10 million is secured to support design of a vaccine.

University of Auckland researchers will lead studies into the strep-throat vaccine’s development next year. Rheumatic fever is a devastating but preventable illness, mainly affecting Māori and Pacific kids and teens. If rheumatic fever develops into rheumatic heart disease, it can cause serious lifelong heart problems and even death.

The SMC asked experts to comment.

Dr Dianne Sika-Paotonu, Immunologist, Associate Dean (Pacific), Head of University of Otago Wellington Pacific Office, and Senior Lecturer, Pathology & Molecular Medicine, University of Otago Wellington, comments:

“It was announced today by the Associate Minister of Health Dr Ayesha Verrall that the Government will be investing $10 million to support further development efforts for a vaccine targeting Group A Streptococcal bacteria (GAS). A GAS vaccine will help prevent acute rheumatic fever (ARF) and rheumatic heart disease (RHD) and is welcome news at this time.

“There are extraordinarily high rates of ARF in Aotearoa New Zealand predominantly affecting our Māori and Pacific children and young people. An equity focus as a basis for the scientific research work supported by this investment will be important given the significant impact of ARF/RHD particularly for Māori and Pacific children and young people and their whānau and aiga.

“It was also announced that the Prime Minister’s Chief Science Advisor has published a report on ARF which found that preventing GAS infections through vaccination could make a significant difference to infection rates, and subsequent complications of ARF and RHD.

“ARF is the body’s autoimmune reaction to untreated bacterial infections of the throat or skin caused by GAS bacteria. If very severe or repeated episodes of ARF occur and are left untreated, this can lead to RHD which is the permanent heart damage that can occur.

“RHD remains a major cause of morbidity and mortality worldwide.

“In the absence of a GAS vaccine, painful monthly injections of Benzathine Penicillin G (BPG) are given to prevent any further GAS infections that could trigger ARF and lead to RHD. These injections are given for 10 years or more.

“Work is being undertaken to develop a more appropriate form of Penicillin that is longer lasting and hurts less upon delivery – for ARF/RHD prevention.”

Conflict of interest statement: Dr Dianne Sika-Paotonu is a member of the Prime Minister’s Chief Science Advisory Committee for Infectious Diseases and Antimicrobial Resistance Expert Panel, New Zealand. She is also the Scientific Lead for the Penicillin reformulation research work that seeking to develop a new Penicillin for ARF and RHD prevention.

Associate Professor Collin Tukuitonga, Associate Dean Pacific, Faculty of Medical and Health Sciences, University of Auckland, comments:

“This is welcome news for Pacific and Māori families who continue to suffer from very high rates of Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD). ARF/RHD seriously affects the health and wellbeing of Pacific and Māori children and young people, robbing them of opportunities for a successful personal and professional life.

“Investment in the development of a vaccine will enhance our efforts to improve housing and other public health interventions. It is clear that our previous attempts at preventing and controlling ARF/RHD has not had the impact that we desire. This investment will strengthen our prospects for eliminating ARF/RHD. This Government investment supports past investment by the National Heart Foundation.

“If successful, this move will reduce ethnic inequities in health in Aotearoa/New Zealand”

No conflict of interest declared.

Dr Emma Best, Medical Advisor and Paediatrician specialist, Immunisation Advisory Centre, University of Auckland, comments:

“IMAC welcomes this targeted research funding for prevention of such an important disease of inequity for Aotearoa/NZ.

“Māori tamariki and rangatahi suffer from rheumatic fever, and the consequent heart disease is a leading cause of premature mortality for indigenous peoples of Australia, Aotearoa/New Zealand and the Pacific.

“Progress towards a vaccine against this bacteria is urgently needed. Our rates of rheumatic fever and other consequences of infections with Group A streptococcus in children are shameful for a developed country and reflect continuing inequitable healthcare access, and the effects of poverty and crowding.”

“This funding also gives foundational support for laboratory testing, pathogen surveillance and vaccine clinical trials which benefits Aotearoa.”

Conflict of interest statement: “I work as a medical advisor to the Immunisation Advisory Centre in addition to my specialist clinical/hospital work and as a senior Lecturer, University of Auckland Department of Paediatrics; Child and Youth Health. I am a member of the PHARMAC anti-infectives subcommittee.”

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