During the ongoing World Antimicrobial Awareness Week (WAAW), World Health Organization (WHO) launched its new report “Estimating the impact of vaccines in reducing antimicrobial resistance and antibiotic use: technical report” during a webinar.
The event delved into the critical role vaccines can play in mitigating the growing threat of antimicrobial resistance (AMR).
The webinar was hosted and moderated by the WHO. It brought together experts from leading organisations, including Bill & Melinda Gates Foundation, Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X), The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), Gavi, the Vaccine Alliance and National Institute of Health.
Experts discussed the report’s implications and strategies to integrate vaccines into AMR containment plans.
The report provides a detailed, systematic evaluation of how vaccines can help reduce AMR by examining their role in mitigating AMR health burden, curbing antibiotic use and alleviating associated economic burden.
The report focuses on 24 pathogens and 44 vaccines, including licensed vaccines, vaccines in late clinical development and vaccines in early development, and quantifies their potential in reducing AMR. The findings emphasise that vaccines can reduce AMR through preventing infections (both drug sensitive and drug resistant), decreasing antibiotic use and suppressing evolution of resistant genes.
One notable finding is that vaccines, if developed and used optimally, could potentially avert up to 2.5 billion of defined daily doses (DDDs) of antibiotics annually which is equivalent of 22 per cent of the global estimated antibiotic use in humans associated with treating the evaluated pathogens in the report.
The highest impact would be seen in the WHO South-East Asia Region (40 per cent of global averted burden) with 1 billion DDDs potentially averted.
Among these, existing vaccines, vaccines in late clinical development and vaccines in early development could avert up to 142 million, 1.9 billion and 548 million DDDs annually respectively.
In the webinar, speakers noted how discussions around vaccines and their potential have significantly advanced in recent years. Notably, there has been a significant reduction in AMR rates among children over the last three decades. However, AMR rates among elderly populations are increasing, indicating the need for more adult life-course immunisation strategies.
On the R&D side, the discussion highlighted that several high-priority pathogens have thin vaccine pipelines, primarily in early stages of development. There are many challenges in the vaccine development space including the lack of robust preclinical models, lack of clarity on regulatory pathways, undefined biomarkers, and limited capacity for translational and clinical work.
The need for fostering collaboration across sectors, strengthening preclinical and translational research capabilities, regulatory incentives and targeted funding support was stressed in order to overcome these challenges.
Experts also emphasised that the impact of vaccines on AMR is often overlooked in policy-making processes. There is a need for greater recognition and integration of vaccines into AMR containment strategies, such as infection prevention, access to essential health services, diagnostics, and treatment and in national action plans.
This requires greater communication, information sharing and collaboration between AMR stakeholders as well as the vaccine and immunisation community.
The WHO report also provides key recommendations to include vaccines in global, regional and national AMR and immunisation strategies and implementation frameworks. The coverage for existing vaccines should be increased.
The impact of existing vaccines on AMR should be monitored and inform regulatory and policy frameworks.
To enable vaccine development, delivery and implementation, it is important to include AMR endpoints in clinical trials, focus research on challenging vaccines and also on synergistic vaccine approaches. In addition, access to vaccines must be prioritised for high-risk populations.
Overall, to implement effective AMR containment strategies, alternative interventions, enhanced surveillance, collection of data and increased awareness are essential.