Vaccination: A Strategic Weapon in Combating Antimicrobial Resistance

This informal CPD article ‘Vaccination: A Strategic Weapon in Combating Antimicrobial Resistance’ was provided by Cima Care, who offer extensive training in vaccination and public health, advancing global health initiatives.

The global healthcare community is facing an escalating challenge: antimicrobial resistance (AMR). While much awareness concentrates on designing new antibiotics, a strong tool in our arsenal often goes underrecognized: vaccines. Recent findings from the World Health Organisation ¹ show a clear connection between immunisation programs and the fight against drug-resistant pathogens.

Breaking the Chain: How Vaccines Reduce Antibiotic Dependency

By implementing comprehensive vaccination programs targeting just 24 specific pathogens, we could cut global antibiotic consumption by 22%. This means 2.5 billion fewer daily doses of antibiotics will be used in one year. ¹ For healthcare professionals working on the frontlines, this decline represents a significant step toward maintaining the efficacy of our existing antimicrobial medicines.

The relationship between vaccination and AMR works in numerous ways. When we prevent infections through immunisation, we stop the need for antibiotic treatment from the beginning. This preventative approach not only protects individual patients but also reduces the environmental pressure that drives the growth of resistant strains. Resistance makes infections more difficult to treat, potentially worsening patients' conditions and allowing these difficult-to-treat infections to circulate more quickly.

The Economic Dimension

The economic burden of treating resistant infections weighs heavily on healthcare systems worldwide. Recent estimations place hospital fees at approximately US$730 billion per year¹. However, widespread vaccine undertaking could reduce these costs by one-third, resources that could be spent on other critical healthcare needs.

Particularly disturbing is how AMR disproportionately impacts vulnerable populations. Communities in sub-Saharan Africa bear an excessive burden, while factors like climate change and inhabitants' displacement further problematise the picture.⁷

Quantifying Success: Lives Saved and Quality of Life Preserved

Recent studies provide clear evidence of vaccines' impact. Investigation shows that targeting 15 key pathogens could prevent 510,000 deaths and 28 million disability-adjusted life years (DALYs) yearly. More potentially impactful vaccination strategies focusing on seven distinctive pathogens could save an additional 1.2 million lives and prevent 37 million DALYs. ⁵

Global Response and Future Directions

The international community is mobilising. A recent United Nations General Assembly meeting on AMR resulted in substantial commitments, including a target to reduce AMR-related deaths by 10% by 2030. This initiative includes allocating US$100 million to help national action plans. ^{2 &3}

The WHO's strategic framework for 2025-2035 emphasises four key areas:

• Infection prevention
• Universal access to quality diagnostics and proper treatment
• Evidence-based innovation
• Effective government approaches ⁶

Technological Innovation in Vaccine Implementation

Digital technology plays an increasingly important role in maximising vaccine impact. Mobile and geospatial tools improve vaccination coverage and data collection efficiency. As WHO Director-General Dr. Tedros notes, "Digital technologies are critical for building resilient health systems capable of addressing considerable challenges, from outbreaks to climate change."⁴

Research Challenges and Opportunities

Developing vaccines against resistant pathogens delivers notable challenges, including

• Recognising protecting correlates
• Addressing antigenic variation
• Opposing immune evasion mechanisms

Researchers are examining innovative solutions through reverse vaccinology for antigen discovery and novel adjuvant development while deepening their understanding of host-pathogen interactions. ⁸

Moving Forward

Despite substantial strides in fighting antimicrobial resistance, significant challenges remain ahead. The healthcare community faces the complex task of ensuring precise vaccine timing and developing effective immunisation strategies for diverse populations. ⁵ The development of vaccines targeting antimicrobial-resistant pathogens offers outstanding scientific burdens, such as lack of correlates of protection, antigenic variability, and immune evasion mechanisms. Scientists are tackling these barriers through cutting-edge approaches, including reverse vaccinology techniques for identifying antigens and developing advanced adjuvant technologies while deepening their knowledge of the complex relationships between pathogens and host immune responses^.8

Additional challenges include providing a balance between vaccine supply and demand, ensuring sustainable funding, and expanding vaccination coverage in regions experiencing high AMR. The WHO continues to emphasise the crucial need for innovative vaccine development, mainly focusing on formulations that could significantly impact AMR reduction. Success in our ongoing action against antimicrobial resistance depends on our ability to overcome these multifaceted challenges. ⁵

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References:

1-     Better use of vaccines could reduce antibiotic use by 2.5 billion doses annually, says WHO [Internet]. Who.int. 2024. Available from: https://www.who.int/news/item/10-10-2024-better-use-of-vaccines-could-reduce-antibiotic-use-by-2.5-billion-doses-annually--says-who

2-     UN General Assembly High-Level Meeting on antimicrobial resistance 2024 [Internet]. www.who.int. Available from: https://www.who.int/news-room/events/detail/2024/09/26/default-calendar/un-general-assembly-high-level-meeting-on-antimicrobial-resistance-2024

3-     ‌World. World leaders commit to decisive action on antimicrobial resistance [Internet]. Who.int. World Health Organization: WHO; 2024. Available from: https://www.who.int/news/item/26-09-2024-world-leaders-commit-to-decisive-action-on-antimicrobial-resistance

4-     World. WHO at UNGA: Call for urgent, high-level action to address global scourge of antimicrobial resistance [Internet]. Who.int. World Health Organization: WHO; 2024. Available from: https://www.who.int/news/item/19-09-2024-who-at-unga-call-for-urgent--high-level-action-to-address-global-scourge-of-antimicrobial-resistance

5-     ‌Kim C, Holm M, Frost I, Mateusz Hasso-Agopsowicz, Abbas K. Global and regional burden of attributable and associated bacterial antimicrobial resistance avertable by vaccination: modelling study. BMJ Global Health. 2023 Jul 1;8(7):e011341–1.

6-     ‌ World Health Organization. WHO strategic and operational priorities to address drug-resistant bacterial infections, 2025-2035: Consultation document [Internet]. Geneva: WHO; 2023 Nov [cited 2024 Oct 22]. Available from: https://cdn.who.int/media/docs/default-source/antimicrobial-resistance/amr-spc-npm/people-centred-framework/amr-strategic-and-operational-priorities-consultation-document.pdf?sfvrsn=e259fd22_6

7-     ‌‌HAPC Building Resilience and Trust [Internet]. Pagesuite-professional.co.uk. 2024. Available from: https://edition.pagesuite-professional.co.uk/html5/reader/production/default.aspx?pubname=&edid=4739a6bd-3618-4bc2-ad39-950773db138e

8-     ‌ Brazzoli M, Piccioli D, Marchetti F. Challenges in development of vaccines directed toward antimicrobial resistant bacterial species. Human Vaccines & Immunotherapeutics. 2023 Aug 1;19(2):2228669