Better use of vaccines could reduce antibiotic use by 2.5 billion doses per year, says the WHO

A new World Health Organization (WHO) report reveals that vaccines against 24 pathogens could reduce the number of antibiotics needed by 22% or 2.5 billion defined daily doses globally each year, supporting global efforts to tackle antimicrobial resistance (AMR). While some of these vaccines are already available but underutilized, others should be developed and brought to market as soon as possible.

AMR occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial drugs, making people sicker and increasing the risk of illness, death and the spread of hard-to-treat infections. AMR is mainly caused by the misuse and overuse of antimicrobials, but at the same time, many people around the world do not have access to essential antimicrobials. Each year, nearly 5 million deaths are linked to AMR worldwide.

Vaccines are an essential part of the response to reducing AMR because they prevent infections, reduce the use and overuse of antimicrobials, and slow the emergence and spread of drug-resistant pathogens.

The new report expands on a WHO study published in BMJ Global Health last year. It is estimated that the vaccines already used against pneumococcal pneumonia, Haemophilus influenzae type B (Hib, the bacteria that causes pneumonia and meningitis) and typhoid could prevent up to 106,000 AMR-related deaths each year. An additional 543,000 AMR-related deaths could be avoided annually when new tuberculosis (TB) vaccines are introduced and Klebsiella pneumoniae, are developed and introduced globally. While new vaccines against tuberculosis are in clinical trials, one against Klebsiella pneumoniae is in the early stages of development.

“Tackling antimicrobial resistance starts with preventing infection, and vaccines are among the most powerful tools for doing so,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Prevention is better than cure, and increasing access to existing vaccines and developing new ones for critical diseases, such as tuberculosis, is critical to saving lives and turning the tide in the fight against AMR.”

Vaccines are key to preventing infection

Vaccinated people have fewer infections and are protected from possible complications from secondary infections that may require antimicrobial drugs or hospital admission. The report analyzed the performance of already licensed vaccines, as well as vaccines in different stages of development.

Every year, vaccines against:

• Streptococcus pneumoniae could save 33 million doses of antibiotics if the 2030 Immunization Plan target were to have 90% of the world's children vaccinated, as well as older adults;
• Typhoid could save 45 million doses of antibiotics if their introduction is accelerated in high-burden countries;
• Malaria caused Plasmodium falciparum could save up to 25 million doses of antibiotics, which are often misused in an attempt to treat malaria;
• Tuberculosis could have the greatest impact once it develops, saving between 1.2 and 1.9 billion doses of antibiotics – a significant portion of the 11.3 billion doses used annually against the diseases covered in this report.

Vaccines could significantly reduce the substantial economic costs of antirheumatic resistance

Globally, the hospital costs of treating resistant pathogens estimated in the report are estimated at US$730 billion each year. If vaccines could be launched against all the pathogens evaluated, they could save a third of the hospital costs associated with AMR.

comprehensive, people-oriented a health system-wide approach to the prevention, diagnosis and treatment of infections is needed. This approach recognizes vaccination as the core of AMR prevention and is particularly effective when combined with other interventions.

At the 79th United Nations General Assembly high-level meeting on AMR on September 26, world leaders approved political declaration committing to a clear set of goals and actions, including reducing the estimated 4.95 million human deaths associated with bacterial AMR per year by 10% by 2030. The Declaration highlights key aspects, including the importance of access to vaccines, medicines, treatments and diagnostics, while calling for incentives and funding mechanisms to encourage multisectoral health research, innovation and development to address AMR.

Notes for editors:

The report, “Assessing the Impact of Vaccines on Reducing Antimicrobial Resistance and Antibiotic Use,” assesses the role of vaccines in reducing antimicrobial resistance and provides key stakeholders with recommendations for increasing the impact of vaccines on antimicrobial resistance. It is evaluating 44 vaccines targeting 24 pathogens: 19 bacteria, four viruses and one parasite. Infections can result in multiple syndromes and vary among age groups; therefore, the effect of more than one pathogen vaccine on AMR has been evaluated in several cases.

Pathogens include: Acinetobacter baumannii, Campylobacter jejuni, Clostridioides difficile, Enterococcus faeciumEnterotoxigenic Escherichia coli (ETEC), Extraintestinal pathogens Escherichia coli (ExPEC), Group A Streptococcus (GAS), Haemophilus influenzae type B (Hib), Helicobacter pylori, Klebsiella pneumoniae, Mycobacterium tuberculosis, Neisseria gonorrhoeaeNon-typhoidal Salmonella, Pseudomonas aeruginosa, Salmonella Paratyphi A, Salmonella typhus, shigella, Staphylococcus aureus, Streptococcus pneumoniae, Plasmodium falciparum (malaria), influenza, norovirus, rotavirus, respiratory syncytial virus (RSV).

The defined daily dose is the assumed average daily maintenance dose for an antibiotic used for its main indication in adults.