Accordingly, the aims of this study were to: (i) describe the GAS emm types, emm clusters and patterns from children at high risk of ARF with presumptive GAS pharyngitis or skin disease in a New Zealand setting, (ii) compare the emm types of GAS strains from children at high risk of ARF with those at low risk, and (iii) determine the theoretical coverage of the 30-valent M-protein vaccine candidate against contemporary GAS strains associated with pharyngitis or skin disease. This evidence concerns the gene MYOM2 and rheumatic fever.