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Strep A kills half a million per year; why don't we have a vaccine?

Strep A is among the deadliest pathogens in the world – yet we’ve never prioritised making a vaccine. Emily Sohn uncovers the cost of ignoring this problem, and meets those taking the fight to this silent killer.

As rhythmic sounds of drums and xylophones waft through the schoolyard, three or four students at a time lie on their left sides, heads on elbows, while screeners squirt gel onto their chests, press the wands over their hearts and pull up grainy grey images that show their valves opening and shutting. About 15 minutes into the session, a lean and muscular 16-year-old boy in maroon shorts and brown boots stretches out on a table in front of Marco Costa, a gregarious cardiologist based at Case Western Reserve University in Cleveland, Ohio. If it could simultaneously prevent rampant skin infections in Fiji, sore throats in American schoolchildren and the cascade to rheumatic heart disease across low-income countries, it might be put on the list of recommended childhood vaccines – offering drug companies a reason to dole out the money needed.

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