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Using vaccine science to get ahead of antimicrobial resistance

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28 April 2022

Alongside antibiotics, vaccines are an important and yet broadly underused tool in reducing the spread of antibiotic resistance globally.[1]

Since their discovery in the early 20th century, antibiotics have revolutionised human health care, saving and extending countless lives around the world. Before Alexander Fleming’s landmark discovery of penicillin in 1928, the average life expectancy was 47 years and the smallest cut had the potential to be fatal if it became infected.[2] But the growing burden of antimicrobial resistance (AMR) now poses a major global threat to individuals, public health, society, and economies worldwide. 

What is AMR?

AMR develops when microorganisms (bacteria, viruses, fungi or parasites) no longer respond to drugs designed to inhibit their replication. This resistance builds over time through mutation and overexposure to antimicrobial drugs especially when administered through sub-optimal treatment courses. Without effective treatments, these infections can remain, grow and continue to spread to other areas of the body.

Overuse and misuse of antibiotics is rising across the world, accelerating the rate at which resistance, including resistance to superbugs (bacteria with accumulated resistance to almost all available antibiotics), is developing. It is estimated that 1.27 million people lost their lives to bacterial AMR in 2019.[3] In a worst-case scenario, AMR could claim up to 10 million lives each year by 2050, more than currently die from cancer and diabetes combined.[4]

Rising AMR compromises our ability to treat common infectious diseases and could reverse the significant advances made in health care over the past century. Cancer therapies could become ineffective, routine surgeries impossible, or childbirth less safe.[5]

Preventing infections to reduce the spread of AMR

Developing new antibiotics is very difficult, both scientifically and financially. But at GSK, we are continuing research in this field. We also believe that vaccinations are an important part of the toolkit in addressing the global threat of AMR.

Vaccinations can help to reduce an individual’s risk of infection, while training the immune system to recognise and develop a rapid and effective immune defence to a pathogen. Many vaccines can also help to protect unvaccinated individuals that cannot be vaccinated (for example people with a compromised immune system) through a process called ‘herd immunity’, which greatly reduces disease in the overall population. By reducing the spread of disease, vaccination subsequently lowers the need and use for antibiotic treatment, further limiting the opportunities for resistance.

New insights and novel technologies

Our current portfolio of vaccines helps to protect tens of millions of people globally against a range of bacterial and non-bacterial infections.

By focusing on new scientific insights and novel technologies – such as adjuvants, bioconjugation and generalised module for membrane antigens (GMMA) – we would be able to target further pathogens that are likely to develop resistance and develop effective vaccines more rapidly compared with traditional approaches.

We currently have several vaccine and medicine projects targeting priority AMR pathogens for the WHO, the European Centre for Disease Prevention and Control (ECDC) and the US Centers of Disease Control and Prevention (CDC).



Leveraging the potential of vaccines

Although vaccines could help protect more people from infectious disease and reduce resistance, they remain a broadly underused tool in getting ahead of AMR. This is due to factors such as lack of access, insufficient data on the impact of vaccines against AMR, and vaccine hesitancy.[6]  

There are at least three policy areas where industry, governments and other stakeholders can help to further the impact of existing and future vaccines as a tool against AMR:

  1. Increasing access and uptake of current AMR-relevant vaccines to prevent disease and reduce demand for antibiotics

  2. Incentivising development of further AMR-relevant vaccines

  3. Using data for impact by expanding the evidence available on the value of vaccines on AMR

As the global community emerges from the COVID-19 pandemic, we have a window of opportunity to get ahead of AMR. Taking these steps to leverage the potential of vaccines, as well as appropriately use and develop other tools to prevent and treat infection, will help us to beat the bugs together.

References 

[1] T. Mark Doherty, William P. Hausdorff & Karl G. Kristinsson (2020) Effect of vaccination on the use of antimicrobial agents: a systematic literature review, Annals of Medicine, 52:6, 283-299, DOI: 10.1080/07853890.2020.1782460 Available at: Effect of vaccination on the use of antimicrobial agents: a systematic literature review (tandfonline.com) Last accessed 20 April 2022

Kathrin U. Jansen & Annaliesa S. Anderson (2018) The role of vaccines in fighting antimicrobial resistance (AMR), Human Vaccines & Immunotherapeutics, 14:9, 2142-2149, DOI: 10.1080/21645515.2018.1476814 Available at: Full article: The role of vaccines in fighting antimicrobial resistance (AMR) (tandfonline.com) Last accessed 20 April 2022

[2] Adedeji, W.A.  The treasure called antibiotics. Ann Ib Postgrad Med. 2016 Dec; 14(2): 56–57.  Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354621/#!po=8.33333 Last accessed 12 June 2020

[3] Antimicrobial Resistance Collaborators, Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis, The Lancet, Volume 399, Issue 10325, 2022, Pages 629-655, ISSN 0140-6736, https://doi.org/10.1016/S0140-6736(21)02724-0. Available at: https://www.sciencedirect.com/science/article/pii/S0140673621027240 Last accessed 20 April 2022

[4] HM Government, ‘Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations’, p.5. Last accessed https://amr-review.org/sites/default/files/AMR%20Review%20Paper%20-%20Tackling%20a%20crisis%20for%20the%20health%20and%20wealth%20of%20nations_1.pdf (PDF - 1.99MB) Last accessed 12 June 2020

[5] World Health Organization, ‘About AMR’. Available at: https://www.euro.who.int/en/health-topics/disease-prevention/antimicrobial-resistance/about-amr Last accessed 17 June 2020

[6] Jansen, K. U., Gruber, W. C., Simon, R., Wassil, J., & Anderson, A. S. (2021). The impact of human vaccines on bacterial antimicrobial resistance. A review. Environmental chemistry letters, 1–32. Advance online publication. https://doi.org/10.1007/s10311-021-01274-z Available at: The impact of human vaccines on bacterial antimicrobial resistance. A review - PMC (nih.gov) Last accessed 20 April 2022

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