A US case-control study to estimate infant group B streptococcal disease serological thresholds of risk-reduction

J Julia C. Rhodes R Rebecca Kahn S Shanna Bolcen N Nong Shang Y Yunmi Chung M Monica M. Farley A Amber N. Britton A Ashley E. Moore S Stepy Thomas J Joelle Nadle (California Emerging Infections Program, Oakland) L Laura B. Amsden J Jacek Skarbinski K Kristi R. VanWinden M Meghan Barnes K Kerianne Engesser P Patricia Ferrieri A AmberJean P. Hansen L Lee H. Harrison L Laura Jeffrey J Jessica L. Nyholm S Sean T. O’Leary (Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine, Children’s Hospital Colorado, Aurora) C Courtney Olson-Chen J Jemma V. Rowlands S Shannon A. Seopaul A Ann R. Thomas H Htet Htet N. Wrigley L Lesley McGee S Sundaram Ajay Vishwanathan F Fahmina Akhter B Bailey Alston L Lily Tao Jia Y Yikun Li P Palak Y. Patel J Joy Rivers J Jessica E. Southwell T Theresa Tran P Panagiotis Maniatis S Stephanie J. Schrag

Abstract

Abstract Maternal vaccines to prevent infant Group B Streptococcus (GBS) disease have progressed through phase II development and may be licensed based on immunologic endpoints, which have yet to be approved by regulatory authorities. Here we present a multistate case control study to characterize the relationship between serotype-specific anti-capsular polysaccharide (CPS) immunoglobulin G concentrations near birth and infant GBS disease risk reduction. Antibody concentration distributions are significantly lower for cases (n = 643) than controls (n = 2801) and serologic thresholds varied by serotype and age at onset, with 80% serotype-specific protective thresholds ranging from 0.52 to 2.49 mcg/mL for early-onset disease (EOD; <7 days old) and 0.02 to 0.14 mcg/mL for late-onset disease (LOD; 7-89 days old). Our study provides the most robust data to date that protection thresholds vary by serotype and are notably lower for LOD than EOD, thereby informing potential serological endpoints for phase III trials evaluating CPS-based maternal GBS vaccine candidates.

Article Details

Volume / Issue Vol. 16, Issue 1
Published October 23, 2025
ISSN 2041-1723
Publisher Nature Portfolio

Journal Info

Nature Communications

Nature Portfolio

ISSN: 2041-1723 Open Access Life Sciences

Authors (38)

J

Julia C. Rhodes

R

Rebecca Kahn

S

Shanna Bolcen

N

Nong Shang

Y

Yunmi Chung

M

Monica M. Farley

A

Amber N. Britton

A

Ashley E. Moore

S

Stepy Thomas

J

Joelle Nadle

California Emerging Infections Program, Oakland

L

Laura B. Amsden

J

Jacek Skarbinski

K

Kristi R. VanWinden

M

Meghan Barnes

K

Kerianne Engesser

P

Patricia Ferrieri

A

AmberJean P. Hansen

L

Lee H. Harrison

L

Laura Jeffrey

J

Jessica L. Nyholm

S

Sean T. O’Leary

Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine, Children’s Hospital Colorado, Aurora

C

Courtney Olson-Chen

J

Jemma V. Rowlands

S

Shannon A. Seopaul

A

Ann R. Thomas

H

Htet Htet N. Wrigley

L

Lesley McGee

S

Sundaram Ajay Vishwanathan

F

Fahmina Akhter

B

Bailey Alston

L

Lily Tao Jia

Y

Yikun Li

P

Palak Y. Patel

J

Joy Rivers

J

Jessica E. Southwell

T

Theresa Tran

P

Panagiotis Maniatis

S

Stephanie J. Schrag