Maternal Group B Streptococcus Vaccination: A Three-Country European Consortium to Improve Surveillance and Data Readiness

Erzsébet Horváth-Puhó,1 Theresa Lamagni,2 Paul T Heath,3 Merijn W Bijlsma,4,5 Malene Risager Lykke,1 Kirsty Le Doare,3 Brechje De Gier,6 Simon R Procter,7 Asma Khalil,3,8 Proma Paul,7 Andrew Norman Young,3 Henrik T Sørensen,1 Joy E Lawn1,7 1Department of Clinical Epidemiology and Center for Population Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark; 2Antimicrobial Resistance & Healthcare Associated Infection Division, UK Health Security Agency, London, UK; 3Centre for Neonatal and Paediatric Infection & Vaccine Institute, City St George’s, University of London, London, UK; 4Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands; 5Department of Paediatrics, Emma Children’s Hospital, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, the Netherlands; 6Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Amsterdam, the Netherlands; 7London School of Hygiene & Tropical Medicine, London, UK; 8Department of Obstetrics and Gynecology, Fetal Medicine Unit, St. George’s University Hospitals NHS Foundation Trust, London, UKCorrespondence: Erzsébet Horváth-Puhó, Department of Clinical Epidemiology and Center for Population Medicine, Aarhus University Hospital and Aarhus University, Olof Palmes Allé 43– 45, Aarhus N, 8200, Denmark, Email [email protected]: Group B Streptococcus (GBS) is a common gut coloniser, yet it can cause serious disease in pregnant women, newborns, and in adults with predisposing conditions. Estimates suggest that approximately 20 million pregnant women are colonised with GBS, and 394,000 cases of invasive disease occur in infants every year, but there are many data gaps. Several countries lack robust data, leading to likely underestimation of the true disease burden, notably for GBS-associated stillbirths and preterm births.Objective: Recent progress in the development of maternal GBS vaccines adds urgency to the need for comprehensive surveillance data. The aim of this study is to describe advances in routine health information systems and record linkage offer new opportunities for robust monitoring and research on GBS outcomes, both before and after vaccine roll-out.Approach: This review article identifies crucial research gaps, proposes priority outcomes that should be monitored, and highlights opportunities to use routine data from three European countries (Denmark, the Netherlands, the United Kingdom) to harmonise data and strengthen the evidence base to inform national GBS vaccine policy decisions.Conclusion: Strengthening and harmonising routine data collection across Europe and globally will be essential to maximize and measure the benefits of a maternal GBS vaccination.Keywords: Group B Streptococcus, maternal vaccines, health registries