The role of vaccination in the fight against antimicrobial resistance

AMR represents a major challenge, being considered both a global public health and societal threat. In 2019, nearly 5 million deaths were associated with AMR worldwide, with this number projected to rise to 10 million deaths per year globally by 2050.  

In the EU/EEA region, the health burden of infections due to AMR is comparable to that of influenza, tuberculosis and HIV/AIDS combined, with the health threat expected to result in over 569 million extra hospital days annually. 

In a new white paper published by Vaccines Europe, the research shows that vaccination is a valuable tool to address this threat, preserving the value of antibiotics by increasing their longevity and ensuring continued effectiveness. We must recognize and support the synergistic relationship between these tools to effectively manage AMR and protect public health. As such, Vaccines Europe outlines several strategies to enhance the coverage of existing vaccines and support the development of vaccines in the pipeline.

The proposed strategies are:    

Strategies for existing vaccines 

• Awareness raising on the importance of vaccination to improve uptake and coverage and encourage investment in vaccine development. 
• Immunisation uptake to improve vaccination coverage in all age groups across EU member states by prioritising a life course immunisation approach.  
• Develop policies that integrate and support prevention in the fight against AMR. 
• Improve generation and utilisation of real-world healthcare data and develop surveillance systems to monitor the impact of both new and established vaccines on AMR. 

Strategies for future vaccines 

• Ensure availability of surveillance platforms assessing the use and misuse of antibiotics for vaccine-preventable infections 
• Increasing awareness of global and regional priority pathogen lists. 
• Developing innovative financing mechanisms and incentives for early and late-stage vaccine research. 
• Increased public funding and support for public-private partnerships to drive R&D and improve access in priority disease areas. 
• A regulatory framework that provides guidelines and supports streamlined development and authorisation of vaccines against AMR. 
• Development of vaccine specific HTA methodologies that recognise the value of vaccination against AMR. 

AMR cannot be solved by one actor alone but must be confronted using every available tool, starting with vaccination, which must be integrated into any AMR response at the national, EU and global level. To make this vision a reality, an attractive innovation ecosystem in the EU is required that encourages the uptake of existing vaccines and supports the development of next generation vaccines that address AMR.     

Harnessing the value of vaccination

In June of this year, the Council of the EU adopted a recommendation aimed at stepping up EU actions to combat AMR with a One Health approach. The recommendation recognises vaccination as a powerful, cost-effective tool to prevent communicable diseases, with the potential to curb the spread of AMR infections and reduce the use of antimicrobials. As such, Vaccines Europe calls for the implementation of the Council recommendation.  

To continue to unlock the full potential of vaccination, the revision of the European General Pharmaceutical Legislation represents another important opportunity to foster an innovative ecosystem that recognises the value of vaccines against AMR. This support would further advance the development and uptake of countermeasures to tackle this threat. 

Despite this, developing vaccines that address resistant pathogens remains a challenge due to scientific hurdles, long development times, high failure rates, high costs, inability to account for market failures, prolonged licensure review process and lack of recommendations regarding use. These challenges must be addressed as vaccination has the capacity to prevent AMR-related health consequences of infectious diseases by: 

• Preventing deaths and complications 
• Decreasing the prevalence and transmission of resistant pathogens 
• Reducing the misuse and overuse of antimicrobials  
• Diminish healthcare costs, including costly hospitalisations and care related to long-term health complications.  

“In the face of the global threat of AMR, vaccines play a pivotal role in safeguarding public health. Vaccination is not just a vital tool but also a prerequisite to treating resistant pathogens, preserving the value of antibiotics and prolonging their efficacy. To combat AMR, all stakeholders must work together by investing in and expanding awareness and coverage of existing and next generation vaccines.”
Sibilia Quilici, Executive Director, Vaccines Europe