Background: Group A Streptococcus (Strep A) has an under-appreciated global burden, despite being identified as a World Health Organization priority vaccine target in 2018. Accurate and robust burden of disease data are now needed to guide vaccine development and implementation decisions.
Methods: Through a Working Group formed with the Strep A Vaccine Global Consortium (SAVAC), we developed an innovative systematic framework outlining priorities and requirements of burden of disease data. Requirements were viewed through four different vaccine evaluation objectives: advocacy; regulatory oversight and licensure; policy and post-licensure evaluation; and post-licensure financing.
Results: Key stakeholders vary for each vaccine objective including funding bodies and advocacy groups; national governments, manufacturers and developers; global, regional and national policy makers and multilateral funders. Data purposes vary from quantifying overall and comparative disease burden across jurisdictions; providing the foundation needed to design and plan clinical trials; measuring population-based vaccine preventable disease burden from specific and non-specific endpoints; and enumerating cost of illness and existing control and prevention activities to assess return on investment decisions. We defined data requirements for eight Strep A endpoints including initial vaccine target conditions, pharyngitis and impetigo. Where possible, we differentiated requirements between high- and low-middle-income countries.
Conclusions: This dynamic framework can be used to identify and prioritise research and surveillance activities addressing knowledge gaps for strep A burden of disease and thus accelerate vaccine development. This framework can also be adapted as vaccine candidates progress through clinical trials and to accelerate development of vaccines targeting other diseases.