Effective use of vaccines can reduce antibiotic use by 2.5 billion doses annually, WHO report says

M. Waqar Bhatti:

Effective use of vaccines against 24 pathogens (infectious disease agents) could reduce the number of antibiotics needed by 22% or 2.5 billion defined daily doses globally every year, supporting worldwide efforts to address antimicrobial resistance (AMR), a new report by the World Health Organization (WHO) said.Healthcare in Crisis: Male Doctors Flee, Women Opt-Out, Warns PIMA

While some of these vaccines are already available but underutilized, others still need to be developed and brought to market as soon as possible, the report states.

AMR occurs when bacteria, viruses, fungi, and parasites no longer respond to antimicrobial medicines, making infections harder to treat and increasing the risk of illness, death, and the spread of drug-resistant pathogens. AMR is largely driven by the misuse and overuse of antimicrobials, while many people worldwide still lack access to essential antimicrobial medicines. Nearly 5 million deaths globally each year are associated with AMR.

Vaccines are a crucial tool in the fight against AMR, as they prevent infections, reduce the overuse of antimicrobials, and slow the emergence and spread of drug-resistant pathogens.

The new report expands on a 2023 WHO study published in BMJ Global Health. It estimates that vaccines already in use, such as those against pneumococcus pneumonia, Haemophilus influenzae type B (Hib, a bacterium causing pneumonia and meningitis), and typhoid, could prevent up to 106,000 AMR-associated deaths each year.

An additional 543,000 deaths related to AMR could be prevented annually when new vaccines for tuberculosis (TB) and Klebsiella pneumoniae are developed and rolled out globally. While new TB vaccines are currently in clinical trials, a vaccine for Klebsiella pneumoniae is still in the early stages of development.

“Addressing antimicrobial resistance starts with preventing infections, and vaccines are among the most powerful tools for doing that,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. “Prevention is better than cure, and increasing access to existing vaccines while developing new ones for critical diseases, like tuberculosis, is crucial to saving lives and reversing the tide on AMR.”

Vaccinated individuals experience fewer infections and are protected against complications from secondary infections that may require antimicrobial treatment or hospitalization. The report analyzed the impact of licensed vaccines, as well as those still in various stages of development.

The report estimates that vaccines against Streptococcus pneumoniae could save 33 million antibiotic doses annually if the Immunization Agenda 2030 target of vaccinating 90% of the world’s children and older adults is achieved. Similarly, a vaccine for typhoid could save 45 million antibiotic doses if its introduction is accelerated in high-burden countries.

In addition, a vaccine for malaria caused by Plasmodium falciparum could save up to 25 million antibiotic doses, which are often misused in attempts to treat malaria. A TB vaccine could have the most significant impact, potentially saving between 1.2 and 1.9 billion antibiotic doses—a substantial portion of the 11.3 billion doses used annually to treat the diseases covered in this report.

Globally, the hospital costs of treating resistant infections evaluated in the report are estimated at US$ 730 billion annually. If vaccines against all the evaluated pathogens could be rolled out, they could save one-third of the hospital costs associated with AMR.

A comprehensive, people-centered approach across health systems is needed to prevent, diagnose, and treat infections. This approach recognizes vaccination as central to preventing AMR and is especially effective when combined with other interventions.

At the 79th United Nations General Assembly High-Level Meeting on AMR, held on September 26, world leaders endorsed a political declaration that set clear targets and actions, including a commitment to reduce the 4.95 million deaths associated with bacterial AMR annually by 10% by 2030.

The declaration emphasizes the importance of access to vaccines, medicines, treatments, and diagnostics, while calling for incentives and financing mechanisms to drive multisectoral health research, innovation, and development in addressing AMR.