Leveraging Vaccines to Reduce Antibiotic Use and Prevent Antimicrobial Resistance: A World Health Organization Action Framework

Abstract

The growing burden of antimicrobial-resistant (AMR) microbes constitutes a significant global threat. Vaccines are effective tools to prevent infections could help to control and prevent AMR. In this Viewpoint we present an Action Framework for vaccines to contribute fully, sustainably and equitably to the prevention and control of AMR by preventing infections and reducing antimicrobial use. The document identifies a series of priority actions in three areas: expanding the use of licensed vaccines to maximize impact on AMR, developing new vaccines that contribute to the prevention and control of AMR, and expanding and sharing knowledge about the impact of vaccines on AMR. The objective of this document is to support an alignment of activities among international vaccine and AMR partners, and structure and articulate key priority actions.

Survey among Italian experts on existing vaccines’ role in limiting antibiotic resistance

“…The present survey was aligned to the WHO Action Framework, which has, among others, the objective to improve "awareness and understanding of the role of vaccines in limiting AMR" by sharing knowledge of vaccine impact on AMR. 2 Moreover, the high level of participation, uncommon for surveys, reflects a high interest in the topic by the experts on the field. The experts' opinions expressed in the present survey as derived from their informed daily clinical practice may already constitute preliminary evidence that vaccines contribution has been acknowledged in practice by the specialists in Italy.…”

“…Antimicrobial resistance (AMR) is a major public health problem that threatens to undermine the effectiveness and sustainability of modern medicine. 1,2 Globally the increasing AMR raises the risk of a near future dominated by an ominous shortage of effective antibiotics against several bacteria. 3,4 AMR develops in response to the "selective pressure" imposed to pathogens by the antimicrobials, for instance, antibiotics, antivirals, antifungals, and antiparasitics.…”

“…14 In a recent publication, WHO further details the contribution of vaccines as a weapon against AMR by preventing infections and reducing the need for antibiotics. 2 Vaccination can decrease AMR prevalence by various pathways. Primarily, vaccination reduces the number of infected cases in need of antibiotic treatment.…”

What Drives the Value of a Shigella Vaccine?

“…It would target a pathogen whose increasingly high levels of resistance to a variety of antibiotics make it a "serious threat" (according to the US Centers for Disease Control and Prevention) [25], and for which WHO deems a vaccine is "critically needed" [26].…”

Resetting the agenda for antibiotic resistance through a health systems perspective

“…There is also an urgent need to make existing bacterial vaccines available, and develop new ones for the prevention and control of antibiotic resistance. 38,39 COVID19 proves that urgency enables science to be rapidly translated into action on the ground. The quick development of diagnostic tests allowed for the tracing of individual cases and an unprecedented generation and dissemination of global data.…”