The World Health Organization released a report, “Assessing the Impact of Vaccines on Reducing Antibiotic Resistance and Antibiotic Prescriptions,” and outlined its key findings in a press release. According to the report, a global vaccination campaign against 24 major pathogens could reduce the need for antibiotics by 22 percent, or 2.5 billion daily doses annually.
Antimicrobial resistance is one of the major threats to public health and development, discussed at the UN General Assembly. According to WHO estimates, it caused 4.9 million deaths worldwide in 2019. The key driver of resistance is the overuse of antibiotics in human, veterinary and agricultural settings. In 2019, the use of these drugs in animals decreased by 13 percent compared to 2017, but still amounted to 84.5 thousand tons. At the same time, their use in humans increased by 65 percent from 2000 to 2015 and is projected to triple by 2030. One of the most important methods for combating antibiotic resistance is to increase vaccination coverage.
A new WHO report looks at the potential effects of 44 vaccines against 24 major pathogens: 19 bacteria, one protist and four viruses. These include Acinetobacter baumannii, Campylobacter jejuni, Clostridioides difficile, Enterococcus faecium, enterotoxigenic Escherichia coli, extraintestinal pathogenic Escherichia coli, group A Streptococcus, Haemophilus influenzae type B, Helicobacter pylori, Klebsiella pneumoniae, Mycobacterium tuberculosis, Neisseria gonorrhoeae, Pseudomonas aeruginosa, nontyphoidal Salmonella species, Salmonella paratyphoid A, Salmonella typhi, Shigella, Staphylococcus aureus, Streptococcus pneumoniae, Plasmodium falciparum (the causative agent of malaria), influenza viruses, noroviruses, rotaviruses, and respiratory syncytial virus.
Vaccines against most of these pathogens are commercially available but underused, and vaccines against several others are in various stages of development. According to the WHO, adequate coverage with existing vaccinations against three infections—pneumococcal pneumonia, Haemophilus influenzae type B, and typhoid—could prevent 106,000 antibiotic-resistant deaths per year. Completion and widespread introduction of new vaccines against tuberculosis (already in clinical trials) and Klebsiella (in early preclinical testing) could increase that number by 543,000. Together, these could save more than 37 million disability-adjusted life years annually, reduce health care costs by about $32 billion, and prevent nearly $26 billion in lost productivity.
Every year, 11.3 billion daily doses of antibiotics are used to treat the listed infections. With adequate vaccination coverage, this amount can be reduced by 22 percent, which corresponds to 2.5 billion doses per year. The development and introduction of tuberculosis vaccines is of the greatest importance - they can reduce the use of drugs by 1.2-1.9 billion doses. Vaccination against typhoid fever can save 45 million doses, against streptococcal pneumonia 33 million, and against malaria 25 million.
Thus, to combat antibiotic resistance, measures are needed to ensure global vaccination coverage, including for older age groups; accelerated development and introduction of new vaccines; inclusion of resistance-related endpoints in clinical trials; and timely collection and analysis of data on the impact of vaccination on the spread of resistance and use of antibiotics, WHO experts conclude.
The article “The End of a Beautiful Era” tells about how bacteria first discovered a gene for resistance to an antibiotic of last resort, as well as about the nature of antibiotic resistance in general.