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Report  Selection Criteria

 

Bacterial pathogens reviewed included: Acinetobacter baumannii, Campylobacter jejuni, Clostridioides difficile, Enterococcus faecium, Enterotoxigenic Escherichia coli (ETEC), Extraintestinal Pathogenic Escherichia coli (ExPEC), Group A Streptococcus (GAS), Haemophilus influenzae type B (Hib), Helicobacter pylori, Klebsiella pneumoniae, Mycobacterium tuberculosis, Neisseria gonorrhoeae, Nontyphoidal Salmonella, Pseudomonas aeruginosa, Salmonella Paratyphi A, Salmonella Typhi, Shigella, Staphylococcus aureus, and Streptococcus pneumoniae.  

Viral pathogens included influenza, norovirus, rotavirus, and respiratory syncytial virus (RSV).

The parasite reviewed was Plasmodium falciparum, responsible for malaria.

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Findings 

The report clearly demonstrated two key points: first, that vaccines are essential in preventing infections, and second, that in doing so, they significantly reduce the costs and burden of these diseases. 

By targeting just 24 key pathogens, vaccines could reduce global antibiotic use by 22%, which equates to 2.5 billion defined daily doses each year, significantly contributing to efforts to curb antimicrobial resistance.

Vaccinated individuals not only experience fewer infections but are also less likely to require antimicrobial treatments or hospitalization due to secondary infections.

For example:

• If Streptococcus pneumoniae vaccination reaches the 90% global coverage target for children and older adults, it could save 33 million antibiotic doses annually.
• Accelerating the introduction of typhoid vaccines in high-burden countries could save 45 million antibiotic doses each year.
•  Plasmodium falciparum vaccines could prevent up to 25 million antibiotic doses that are often misused in malaria treatment.
• The development of TB vaccines could have the most significant impact, potentially saving between 1.2 to 1.9 billion antibiotic doses annually.

In relation to the vaccine pipeline, the report found broadly that:
 

• Prevent up to 106,000 deaths annually
• Reduce 9.1 million disability-adjusted life years (DALYs)
• Save US$ 861 million in hospital costs, and
• Prevent US$ 5.9 billion in productivity losses related to antimicrobial resistance.

Additionally, these vaccines could decrease antibiotic use by 142 million defined daily doses each year.

For example:
Achieving the Immunization Agenda 2030 (IA2030) and the World Health Organisation target of 90% global coverage for Streptococcus pneumoniae vaccines in children and the elderly could prevent an additional 27,100 deaths, avert 1.5 million DALYs and save US$ 507 million in hospital costs and US$ 879 million in productivity losses annually, all linked to AMR.

 

• Prevent up to 135,000 deaths annually
• Avert 5 million DALYs
• Save US$1.2 billion in hospital costs, and
• Prevent US$2.2 billion in productivity losses related to antimicrobial resistance.

These vaccines could also reduce antimicrobial use by 1.9 billion defined daily doses each year.

To illustrate:
A vaccine against Mycobacterium tuberculosis, given to adolescents to prevent the progression from latent infection to active disease, could significantly reduce AMR burdens, preventing 71,000 deaths and 2.6 million DALYs, and reduce antimicrobial use by 1.2 billion DDDs annually.
 

• Avert up to 408,000 deaths annually
• Reduce 23 million DALYs
• Save US$30 billion in hospital costs, and
• Prevent US$17.7 billion in productivity losses associated with AMR

These vaccines could also lower antimicrobial use by 548 million DDDs annually.

For example:
A maternal vaccine targeting Klebsiella pneumoniae to protect neonates from bloodstream infections could prevent an estimated 27,000 deaths,  2.4 million DALYs, save US$ 280 million in hospital costs, and prevent US$ 2.5 billion in productivity losses each year, all linked to AMR.

 

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High-level Recommendations

The report puts forward several key recommendations, including:
 

1. Recognizing the Impact of Vaccines on AMR

Vaccines should be included in global, regional, and national AMR and immunization strategies. Broader advocacy for vaccine integration is essential.

2. Accelerating the Use of Existing Vaccines

Increasing vaccine coverage to meet the Immunization Agenda 2030 targets is crucial, particularly for paediatric vaccines and older adults. Monitoring the impact of vaccines on AMR is vital for guiding policy.
 

3. Preparing for New Vaccines

Evaluating the impact of new vaccines on AMR should be systematically integrated into decision frameworks, including regulatory policies, cost-effectiveness studies, and immunization strategies.

4. Supporting Vaccine Development and Implementation

Clinical trials should include AMR endpoints, and PPCs should be developed for vaccines with the highest impact. Prioritizing access for high-risk populations, research roadmaps, and One Health approaches are key to combating AMR.
 

5. Implementing Comprehensive AMR Containment Strategies

Surveillance, data collection, and awareness-raising about resistant pathogens are essential. Vaccine value assessments must also consider broader equity and healthcare impacts.

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 In Conclusion

This report is a clear call to action. 

Vaccines should be seen as part of a comprehensive approach to AMR, complementing other strategies such as infection prevention, enhanced healthcare access, accurate diagnosis, and appropriate treatment. Enhanced surveillance platforms are vital for tracking resistant pathogens, enabling the informed development of effective vaccination strategies.

Furthermore, developing Preferred Product Characteristics from the early stages to mid-clinical development can guide the creation of impactful vaccines. Additionally, research roadmaps can help overcome significant development barriers, particularly in low- and middle-income countries. 

The report concludes that the implementation of its key recommendations would accelerate the integration of vaccines into AMR strategies, enabling significant strides in addressing this fast-emerging global health threat.

 

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