Microbes and the Rising Threat of Antimicrobial Resistance
Microbes, including bacteria, viruses, parasites, and fungi, are increasingly developing resistance to the drugs used to treat them. This growing threat is poised to become one of the greatest dangers to public health in the coming years. Vaccines have already prevented millions of deaths in recent decades. In this new era where many pathogens evolve to evade treatment, vaccines will be more important than ever to protect us. A new report from Gavi released this week details how crucial vaccines will be in the fight against antimicrobial resistance (AMR).
1. Vaccines Slow or Suppress the Evolution of Resistance
Drug resistance develops as treatments are used. The more a disease is exposed to a drug, the more likely it is that strains resistant to that treatment will survive and multiply, which encourages the development of resistance.
The higher the usage of treatments like antibiotics, the greater the likelihood that a pathogen will evolve resistance. On the other hand, vaccinated individuals require fewer treatments, which reduces the risk of developing resistance.
Bringing new treatments to market is often a lengthy and complex process. Even with substantial investments in research, many obstacles can arise before a new drug becomes available to the public.
2. Vaccines Prevent Infections and Promote Herd Immunity
Vaccines can prevent a wide range of infections, particularly bacterial infections that can be contracted from the general population or hospitals. Such infections tend to be more severe, affecting individuals who already have compromised immune systems.
When a significant portion of the population is vaccinated, it leads to herd immunity—an indirect protection that lowers the overall risk of infection and the development of resistance.
3. Vaccines Can Reduce Misdiagnosis and Misuse of Antibiotics Against Viral Infections
Vaccination can prevent viral infections, which is critical as antibiotics are frequently misprescribed for these conditions. This wrongful prescribing often occurs due to limited diagnostic tools, pushing doctors to prescribe antibiotics “as a precaution.”
4. The Evidence is Strong: Vaccines Help Mitigate Antimicrobial Resistance
Research by the One Health Trust has shown compelling evidence highlighting the impact of vaccinations on antimicrobial resistance:
- In Indonesia, achieving 85% coverage of the pneumococcal conjugate vaccine (PCV) in two years, subsequently increasing to 99%, could prevent up to 13.8% of antibiotic treatment failures.
- Increasing PCV vaccination coverage led to approximately 718,100 prevented treatment failures, contributing to a 27.8% reduction in AMR-related deaths between 2011 and 2017.
- Rotavirus vaccines, with a 77% coverage rate in children under two in 18 low- and middle-income countries, could avert 13.6 million (31%) episodes of antibiotic-treated diarrhea annually.
- At 70% coverage, PCV vaccination in children under two in 18 low- and middle-income countries could prevent 23.8 million antibiotic-treated cases of acute respiratory infections.
5. To Maximize the Impact of Vaccination, It is Crucial to Relaunch Systematic Immunization
The importance of vaccination is evident, but further efforts are needed to extend routine vaccines to the world’s most vulnerable children.
- The number of “zero-dose children” who missed routine immunization services decreased from 18.1 million in 2021 to 14.3 million in 2022. However, this remains above the pre-pandemic level of 12.9 million in 2019.
- Although coverage of the diphtheria, tetanus, and pertussis (DTP3) vaccine returned to 84% in 2022, 205 million children remain susceptible to vaccine-preventable diseases.
6. Gavi Recommends Integrating Immunization into AMR Strategies
The Gavi report recommends incorporating vaccines into national AMR strategies and ensuring that implementation plans for vaccines and AMR are aligned. Additionally, it advocates for strengthening AMR surveillance systems to gather more accurate data on resistance and its contributing factors, including the preventive role of vaccination.
Practical Tips for Individuals to Support Vaccination Efforts
- Stay informed about recommended vaccines for you and your family.
- Pursue regular check-ups that include discussions about vaccination status and any catch-up needs.
- Advocate for community vaccination programs and educate others on the importance of vaccines in preventing diseases and resistance.
- Support policies that promote equitable access to vaccines globally, especially in low- and middle-income countries.
Case Study: The Impact of Meningococcal Vaccination
In 2019, a comprehensive vaccination campaign against meningococcal disease was rolled out across multiple regions in sub-Saharan Africa. Post-vaccination data indicated a sharp decline in both incidents of the disease and subsequent antibiotic treatment, demonstrating the effectiveness of vaccinations in reducing antimicrobial resistance.
Conclusion
Vaccines are a critical tool in the ongoing battle against antimicrobial resistance. By preventing infections, reducing the need for antibiotics, and promoting herd immunity, vaccinations not only save lives now but also safeguard the efficacy of existing treatments for future generations.
