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ECOO18A is a bacterial bioconjugate vaccine component developed by Janssen Vaccines & Prevention B.V. (a subsidiary of Johnson & Johnson). It consists of the O-specific polysaccharide (O-antigen) from the *Escherichia coli* serotype O18A, which is enzymatically linked to a detoxified carrier protein, *Pseudomonas aeruginosa* Exoprotein A (EPA), using site-specific glycoengineering technology. ECOO18A is one of the nine monovalent drug substances that comprise the 9-valent ExPEC vaccine (ExPEC9V; VAC52416), currently in Phase 3 clinical development. The vaccine is designed to prevent invasive extraintestinal pathogenic *Escherichia coli* (ExPEC) disease (IED) and associated conditions such as complicated urinary tract infections, pyelonephritis, and acute bacterial prostatitis in older adults. By targeting the O18A serotype, one of the most prevalent serotypes associated with IED, ECOO18A induces O-antigen-specific IgG antibodies that facilitate opsonophagocytic killing of the bacteria.
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