 Staphylococcus aureus, S aureus, is a challenging bacterial pathogen that causes a range of diseases, including deep or organ-space surgical site infections and life-threatening bacteremia. Despite current infection control measures, the burden of disease remains high. A four-antigen S aureus vaccine, SA4-AG, candidate is being evaluated in a phase 2B3 efficacy study in patients undergoing elective spinal fusion surgery. SA4-AG has been shown to be generally safe and well tolerated, and to induce high levels of bactericidal antibodies in healthy adults. The results of the Strive efficacy study are likely generalizable to a broad elective orthopedic surgery population due to the common pathophysiology of invasive S aureus disease and patient and procedural risk factors for developing post-operative S aureus surgical site infections. This article was authored by a Gertman, Ibagaya, N-Mohammed, and others.