Journey towards a ‘holy grail’ vaccine

Published: 25 June 2026

New Zealand is leading efforts to tackle rheumatic heart disease, a preventable illness still causing harm here. Decades of research into rheumatic fever are now driving advances, bringing the world’s first effective vaccine within reach.

For decades, researchers in New Zealand, including those who have been funded by the Heart Foundation, have been at the forefront of efforts to understand, treat and one day prevent rheumatic fever, a disease that starts with a simple sore throat and can end in lifelong heart damage or premature death.  

Now, after years of research, the world’s first effective vaccine may finally be within reach, described as the “holy grail” to eradicating the disease. 

Rheumatic heart disease remains one of New Zealand’s most serious public health challenges, causing around 140 deaths each year. While it has largely disappeared in developed countries overseas, it continues to devastate families in New Zealand. 

At the centre of New Zealand’s rheumatic fever research is a long‑standing partnership between the Heart Foundation, the University of Auckland and government, all backing science focused on prevention rather than lifelong treatment.

From sore throats to damaged hearts

Rheumatic fever is triggered by infection with Group A Streptococcus, often called Strep A. This common bacterium causes sore throats and skin infections. 

In some children, repeated or untreated infection causes the immune system to attack the body’s own tissues while reacting to the infection. The heart valves are often affected, causing permanent damage known as rheumatic heart disease. 

For families, the impact can last a lifetime. Some children need painful monthly antibiotic injections for years to prevent repeat infections, while others may face heart surgery or valve replacement procedures. Despite being preventable, rheumatic heart disease continues to claim lives. 

While early diagnosis and antibiotics can prevent some cases, a vaccine offers the possibility of eliminating the disease altogether. 

A homegrown breakthrough

With support from a number of partners, University of Auckland scientist Dr Jacelyn Loh, a former Heart Foundation senior fellowship recipient, has spent more than a decade developing a rheumatic fever vaccine. 

Instead of targeting just one type of Strep A, the vaccine is designed to protect against many strains. It uses small pieces of the bacteria to train the immune system to recognise and fight infection quickly, before it can cause harm. 

“If someone who’s been vaccinated later comes into contact with the bacteria, their immune system is already prepared,” Dr Loh explains. “The antibodies can tag the bacteria and help the body clear it.” 

What makes the vaccine, known as TeeVax, especially important is its potential to work both in New Zealand and overseas.  

Crucially, the research is based on New Zealand data. 

“We’re getting New Zealand information about New Zealand strains,” Dr Loh says. “That helps us design a vaccine that works for our communities.” 

Rethinking how vaccines are delivered

Alongside this research, another Heart Foundation‑funded research programme is exploring how a vaccine could be delivered in a way that’s easier for children. 

Dr Catherine Tsai, also at the University of Auckland, and a Heart Foundation research grant recipient in 2025, is leading work on an oral or nasal vaccine that would avoid injections altogether. 

Her approach uses a safe, food‑grade probiotic – similar to the “good bacteria” found in yoghurt – to carry tiny pieces of Strep A into the body. Because the bacteria usually enter through the throat or nose, delivering the vaccine to those same areas could build immunity at these entry points and help stop infection early. 

“If successful, this could be like taking a regular medicine or using a nasal spray,” Dr Tsai says. “It avoids needles and doesn’t need trained medical staff, providing ease and convenience for the families.” 

How close are we?

While both vaccines are still being tested, there is hope that a solution to eradicating rheumatic fever and rheumatic heart disease is near. 

“I believe we are not far from an effective Strep A vaccine,” Dr Tsai says. 

A successful vaccine would mean a generation of children growing up free from monthly injections, hospital stays and the fear of developing rheumatic heart disease. 

“A vaccine is the holy grail in eliminating this serious disease,” says Heart Foundation Medical Director Dr Gerry Devlin.  

“It affects some of New Zealand’s most vulnerable communities, and we need to eradicate it. Backing research like this is key to delivering lasting change for future generations.”