Vaginal Microbiome Consortium (2007– )

The Vaginal Microbiome Consortium, or the VMC, established in 2007, consists of a group of researchers, clinicians, statisticians, and geneticists who study the impact of the vaginal microbiome on women’s health. Virginia Commonwealth University in Richmond, Virginia, operates the VMC. The United States National Institutes of Health, or the NIH, funds the VMC’s ongoing project called the Vaginal Microbiome Project. Thousands of women have contributed samples for use in research studies by the VMC, which its members have used to research the communities of microorganisms that live in the vagina. A balanced vaginal microbiome can decrease the risk of preterm birth and sexually transmitted infections, or STIs, and pelvic diseases, which helps support women’s health. Researchers can use the VMC’s findings to develop genetic sequence testing for pregnant women to predict preterm birth, which accounted for 10.4 percent of live births in the United States in 2023. The VMC’s research in reproductive health has allowed physicians to prepare birth and treatment plans that improve maternal and infant health and survival.

Before the establishment of the VMC, researchers had yet to describe the correlation between the vaginal microbiome and hormonal and lifestyle changes. During that time, researchers had begun to explore the microbiome in other body parts through the Human Microbiome Project, or the HMP. In 2001, Joshua Lederberg, a molecular biology researcher, coined the term microbiome to refer to the community of microbes in and on the human body. Lederberg conducted research to understand the microbiome. In November 2005, the French National Institute for Agricultural Research held an international meeting in Paris, France, to discuss researching the human intestinal microbiome. After that meeting, the NIH initiated the Human Microbiome Project, or HMP, in 2008 to examine the microbes found in and on the intestines, mouth, vagina, and skin of humans. The VMC has similar goals to the HMP, but it focuses on the vaginal microbiome instead of other parts of the human body. 

Researchers established the VMC as a means of contributing to the HMP while focusing on the vaginal microbiome. Before 2007, researchers understood the human microbiome underwent alterations throughout a woman’s life. The VMC sought to understand how environmental, genetic, hormonal, and lifestyle factors affect the vaginal microbiome. The VMC uses its research and applies it to the prevention of urogenital conditions, which affect the reproductive organs. Common urogenital conditions include urinary tract infections, or UTIs, infertility, and STIs. Before the VMC, there was also no well-known way to use microbiome samples to predict and prevent preterm birth. Preterm birth increases the risk of infant death and future health concerns. The VMC aimed to understand the vaginal microbiome in women who had full-term births compared to preterm births.

The VMC team comprises multiple researchers, including professors, engineers, graduate students, analysts, and clinical coordinators who study topics like the female reproductive tract and microbiology. Its executive members are all affiliated with Virginia Commonwealth University. As of 2025, the lead investigators of the VMC at Virginia Commonwealth University are Gregory Buck and Kimberly Jefferson, who are professors of microbiology and immunology. The co-lead investigators are Jerome Strauss, who is the dean of the school of medicine, Jefferson, and professors Timothy York and Lindon Eaves. Jennifer Fettles, a postdoctoral fellow at the university, serves as the project director, which means she manages the several projects the VMC conducts. The VMC also has four clinical coordinators who coordinate the clinical trials with participants and sequencing engineers who specialize in microbiology and immunology sequencing and perform DNA extractions.

The VMC’s main study is the Vaginal Microbiome Project, which started in 2007 and continues as of 2025. The project contains two parts that focus on how women’s conditions, physiology, and environment contribute to their vaginal microbiome. Researchers hypothesized that genetics impact the vaginal microbiome. Physiological states, such as pregnancy, disease, and environmental factors, alter the vaginal microbiome. Researchers also hypothesized that a woman’s genetic composition affects the ability of microbes to infect the genital tract. The two parts of the Vaginal Microbiome Project aim to test the hypotheses.

The first part of the VMC’s Vaginal Microbiome Project focuses on understanding if genes affect the vaginal microbiome composition, how the vaginal microbiome alters health conditions, and what changes are associated with health and disease. Researchers began the first part of the study by collecting vaginal samples from three sites of a woman’s vagina. They also collected buccal samples, which are from the inside of the mouth, and perianal samples, which are from the skin that surrounds the anus. Each of the samples provided information on the microbes of the region. 6,000 healthy women visited participating women’s clinics in Central Virginia and agreed to provide samples to the VMC. The study also used existing samples from 250 healthy monozygotic, or identical, and dizygotic, or fraternal, twins from the Virginia Commonwealth University's Mid-Atlantic Twin Registry. Twins have strong genetic relationships and typically share childhood environments, which makes them ideal for research since disease expression is largely due to genetic factors. Researchers could better determine relationships between the vaginal microbiome and health by studying differences between twins. After collecting their samples, the VMC team used gene sequencing to analyze and classify the microbes. Researchers found about thirty million microbes in the vaginal samples and published data in a public online database to serve as a model for the healthy vaginal microbiome.

The second part of the Vaginal Microbiome Project aims to understand the microbiomes of pregnant women and infants and determine a link between the vaginal microbiome and preterm birth risk through a separate study. That part of the study also contributed to the work of the HMP in the Multi-Omic Microbiome Study Pregnancy Initiative. The VMC conducted the study in collaboration with the Global Alliance to Prevent Prematurity and Stillbirth, or GAPPS. GAPPS is an organization that works to decrease preterm births and stillbirths. Researchers collected samples from 12,000 pregnant women and their infants. The pregnant women’s samples came from prenatal visits during pregnancy, at delivery, and postnatal visits. Researchers collected vaginal, buccal, perianal, and skin samples from pregnant or postpartum women each time and buccal, rectal, stool, and skin samples from infants shortly after birth. Researchers sequenced the complete microbiomes of the samples from two sub-groups of the sample that consisted of forty-five women who had a preterm birth and ninety women who had a full-term birth to find differences.

Findings from the second part of the Vaginal Microbiome Project revealed microbiome differences between women who had preterm and full-term births. That finding indicated that the microbes present in women’s vaginal samples early in pregnancy can predict preterm birth risk. The women who had preterm births had higher levels of microbes than those with full-term births. Women who had preterm births also had lower levels of a specific bacterium called Lactobacillus crispatus, which is a beneficial bacterium in the female reproductive tract. Women with preterm births also had more inflammatory molecules, which induce immune responses in labor. Higher levels of those inflammatory molecules indicate preterm birth risk because inflammation is a sign of oncoming labor. The findings from the Multi-Omic Microbiome Study Pregnancy Initiative allowed researchers to conclude the vaginal microbiome can predict the likelihood of preterm birth. They concluded that physicians could take samples of a woman’s microbiome and test for overall levels of microbes, L. crispatus, and inflammatory molecules to determine preterm birth risk.

As of 2025, the VMC studies the impact of women’s urogenital conditions, physiological states, and environmental factors on the vaginal microbiome. The organization has published more than twenty papers on its findings. The VMC examines the characteristics of a healthy vaginal microbiome to prevent urogenital conditions and improve reproductive health. Researchers work on the development of treatments for STIs, yeast infections, UTIs, and bacterial vaginosis, or BV, based on an understanding of the healthy vaginal microbiome. Preterm birth affects ten percent of women worldwide. As of 2025, the VMC produces community resources in public databases, including the characterization of microbes associated with preterm birth. The findings allow researchers new ways to assess the risk of preterm birth.

The VMC’s research and contributions have increased technologies for reproductive health care and further research. Its work has led to physicians having microbiome testing capabilities. In 2023, a survey showed that some physicians used microbiome testing to determine preterm birth risk, and there had been an increase in home microbiome test kits for the same purpose. Research from the VMC has also contributed to the researcher’s understanding of how delivery methods can alter the microbiome. Researchers have discovered that cesarean sections, or C-sections, cause a greater change in the vaginal microbiome than a vaginal delivery. Infants delivered via C-section do not come into contact with the mother’s vaginal microbiome and show slower development of the gut microbiome compared to those delivered vaginally.

The VMC investigates the roles of the vaginal microbiome in women’s urogenital health to improve reproductive health. Its studies on the healthy human microbiome and pregnant women’s and infants’ microbiomes have allowed new ways to predict disease and adverse events. By having a model of a healthy vaginal human microbiome, researchers can compare an unhealthy microbiome to the model. Researchers can use the model for comparative purposes to detect microbes present in disease but not in the healthy model. The model can also help researchers identify new microbes. The VMC’s understanding of the vaginal microbiome progresses the HMP’s and researchers’ understanding of how the microbiome can determine health risks to improve maternal and infant health.

Sources

1. Collins, Francis. “Fundamental Knowledge of Microbes Shedding New Light on Human Health.” NIH Director’s Blog. https://directorsblog.nih.gov/tag/the-vaginal-microbiome-consortium/ (Accessed May 26, 2025).
2. Dennett, Carrie. “Do Home Microbiome Tests Really Help You Be Healthier?” The Seattle Times, August 14, 2023. https://www.seattletimes.com/life/wellness/do-home-microbiome-tests-really-help-you-be-healthier/ (Accessed May 26, 2025).
3. Fettweis, Jennifer M., Myrna G Serrano, Nihar U Sheth, Carly M Mayer, Abigail L Glascock, J Paul Brooks, Kimberly K Jefferson, Vaginal Microbiome Consortium (additional members) and Gregory A Buck. “Species-Level Classification of the Vaginal Microbiome.” BMC Genomics, 13 (2012): S17. https://pmc.ncbi.nlm.nih.gov/articles/pmid/23282177/ (Accessed May 26, 2025).
4. Gao, Xi, Vladimir Lee, Elizabeth Prom-Wormley, Philippe Girerd, Huan Mo, Bin Xie, Michael Harwich, Michael Neale, Timothy York, Stephanie Hendricks, Federico Puma, Cynthia Cornelissen, Mark Reimers, Jerome Strauss III, Jennifer Fettweis, Maria Rivera, Lindon Eaves, Joao Alves, Seth Roberts, Gregory Buck, Joseph Borzelleca, Myrna Serrano, James Brooks, Nihar Sheth, Judy Silberg, Christopher Friedline, Kimberly Jefferson, Logan Voegtly and Yuan Gao “The Vaginal Microbiome: Disease, Genetics and the Environment.” Nature Precedings, (2011). https://www.nature.com/articles/npre.2011.5150.2 (Accessed May 26, 2025).
5. Holdcroft, Alexandra M., Demelza J. Ireland, and Matthew S. Payne. “The Vaginal Microbiome in Health and Disease-What Role Do Common Intimate Hygiene Practices Play?” Microorganisms, 11 (2023): 298. https://pmc.ncbi.nlm.nih.gov/articles/pmid/36838262/ (Accessed May 26, 2025).
6. Huang, Bernice, Jennifer M. Fettweis, J. Paul Brooks, Kimberly K. Jefferson, and Gregory A. Buck. “The Changing Landscape of the Vaginal Microbiome.” Clinicals in Laboratory Medicine 34 (2014): 747–761. https://pmc.ncbi.nlm.nih.gov/articles/PMC4254509/ (Accessed May 26, 2025).
7. Liu, Xiaoni. “Microbiome.” The Yale Journal of Biology and Medicine, 89 (2016): 275–276. https://pmc.ncbi.nlm.nih.gov/articles/PMC5045136/ (Accessed May 26, 2025).
8. March of Dimes. “A Profile of Prematurity of United States.” March of Dimes. https://www.marchofdimes.org/peristats/reports/united-states/prematurity-profile
9. March of Dimes. “Long-Term Health Effects of Preterm Birth.” March of Dimes. https://www.marchofdimes.org/find-support/topics/birth/long-term-health-effects-preterm-birth (Accessed May 26, 2025).
10. Methé, Barbara, et al. “A Framework for Human Microbiome Research.” Nature, 486 (2012): 215–221. https://pmc.ncbi.nlm.nih.gov/articles/pmid/22699610/ (Accessed May 26, 2025).
11. The NIH HMP Working Group, Jane Peterson, Susan Garges, Maria Giovanni, Pamela McInnes, Lu Wang, Jeffery A. Schloss, Vivie, Jean E. McEwen, Kris A. Wetterstrand, Carolyn Deal, Carl C. Baker, Valentina Di Francesco, T Kevin Howcroft, Robert W. Karp, R. Dwayne Lunsford, Christopher R. Wellington, Tsegahiwot Belachew, Michael Wright, Christina Giblin, Hagit David, Melody Mills, Rachelle Salomon, Christopher Mullins, Beena Akolkar, Lisa Begg, Cindy Davis, Lindsey Grandison, Michael Humble, Jag Khalsa, A. Roger Little, Hannah Peavy, Carol Pontzer, Matthew Portnoy, Michael H. Sayre, Pamela Starke-Reed, Samir Zakhari, Jennifer Read, Bracie Watson, Mark Guyer. “The NIH Human Microbiome Project.” Genome Research, 19 (2009): 2317–2323. https://pmc.ncbi.nlm.nih.gov/articles/PMC2792171/ (Accessed May 26, 2025).

12. Ríos-Covian, David, Philippe Langella, Rebeca Martín 1. “From Short- to Long-Term Effects of C-Section Delivery on Microbiome Establishment and Host Health.” Microorganisms, 9 (2021): 2122. https://pmc.ncbi.nlm.nih.gov/articles/PMC8537978/ (Accessed May 26, 2025).

     

13. Tiano, Joseph P. “The Human Microbiome Project.” NIH Intramural Research Program. https://irp.nih.gov/catalyst/21/6/the-human-microbiome-project (Accessed May 26, 2025).
14. Vaginal Microbiome Consortium. “Vaginal Microbiome Consortium.” Vaginal Microbiome Consortium. https://www.vmc.vcu.edu (Accessed May 26, 2025).