AMR: the central role played by vaccines and immunisation
May 3, 2022
Anti-microbial resistance (AMR) is a silent pandemic that is estimated to cause approximately 33,000 deaths each year in Europe. The emergence and spread of drug-resistant pathogens that have acquired new resistance mechanisms, leading to antimicrobial resistance, continues to threaten our ability to treat common infections.
We do have, however, at hand, a very efficient, cost-effective weapon to help in the fight against AMR: I am talking of course about the vaccines.
An abundance of evidence demonstrates that vaccines are critical in helping to combat the growing AMR crisis, by helping prevent both bacterial and viral diseases, as well as commonly-acquired bacterial infections, including hospital-acquired infections (HAIs).
As stated in our response to the European Commission Call for Evidence on AMR, Vaccines Europe believe a true ‘One Health’ approach should give a more central place to vaccines in this important fight.
Indeed, Pneumococcal conjugate vaccines (PCV) bear great potential to affect infections; either by reducing resistant, invasive pneumococcal disease, or by reducing antibiotic use, or both. In the USA, the introduction of the seven-valent PCV was associated with an 84% reduction in multidrug-resistant invasive pneumococcal disease[1]. Sadly, we do not have such data available for EU countries, creating a distortion in the value assessment of the benefits of vaccines against AMR in Europe.
Vaccines can also help prevent HAIs, via bacterial vaccines that could be administered on a targeted basis among high-risk populations, to protect against infections such as Clostridioides difficile (C. difficile) and infections from the ‘ESKAPEE’ group[2].
Finally, vaccines prevent viral infections, which are often treated inappropriately with antibiotics, and can also give rise to secondary infections that require antibiotic treatment. For instance, influenza vaccines decrease the likelihood of secondary bacterial infections, such as pneumonia and otitis media.
We need to optimise the impact of vaccination on AMR, by increasing the uptake of existing vaccines, notably in adult population, and bring to market new vaccines for dangerous pathogens, especially for those resistant to antimicrobial medicines.
National AMR action plans and immunisation programmes of all EU Member States should recognise the unique potential of vaccines to prevent antibiotic use for viral and bacterial vaccine-preventable infections, as well as supporting the uptake across the life course. In addition, the value of AMR-relevant vaccines should be clearly acknowledged in the assessment procedures by HTAs or NITAGs, incorporating the health and economic benefits of such products.
Only a coordinated action can maximize the impact of vaccination on combatting AMR.
Vaccines Europe remains committed to EU and global efforts to fight AMR and looks forward to further dialogue with the European Commission, Member States and all stakeholders.
[1] https://apps.who.int/iris/bitstream/handle/10665/332480/Eurohealth-26-1-16-19-eng.pdf?sequence=1&isAllowed=y
[2] Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter species and E. coli