Get Your Shots: Vaccines Keep Antibiotic Resistance at Bay
We have entered a post-antibiotic era. That striking statement comes from last week’s landmark report from the U.S. Centers for Disease Control and Prevention (CDC). In the United States today, someone gets an antibiotic-resistant infection every 11 seconds and every 15 minutes someone dies from one.
Since their discovery less than 100 years ago, antibiotics have saved countless millions of lives. But bacteria are always one step ahead, mutating to withstand each new drug we throw at them. Now, medical professionals are grappling with the deadly impact of “superbugs” – microbes that are resistant to most or all antibiotics. Globally, at least 700,000 people die every year from drug-resistant diseases.
In 2016, scientists from Harvard Medical School and Technion-Israel Institute of Technology created a stunning video showing bacteria developing resistance to high doses of antibiotics in only 11 days. In a frightening, real-life demonstration of this phenomenon, a young child in France infected with extremely drug-resistant Pseudomonas Aeruginosa recently developed resistance to a last-resort antibiotic drug in less than a month.
If this soaring trend of antibiotic resistance continues, 10 million people worldwide are expected to die annually from untreatable infections by 2050.
Can we turn this ship around?
Curbing antimicrobial resistance has emerged as a top priority for national and global stakeholders, with agencies like the World Health Organization, the United Nations and the CDC taking the lead. Solutions include creating new antimicrobials to replace older ones and increasing antimicrobial stewardship.
As Dr. Rick Bright, director at the U.S. Biomedical Advanced Research and Development Authority (BARDA), wrote earlier this year in Forbes, “now is the time to build new business models and novel partnerships that foster a robust end-to-end enterprise, making critically needed antimicrobials available to patients.” He described BARDA’s portfolio approach to develop antimicrobial medical countermeasures, called CARB-X, and called for biotech and pharmaceutical industry to “join in pursuing better, sustainable business models for antimicrobials.” Importantly, BARDA’s portfolio includes not only new antibiotics, but novel antimicrobial approaches, diagnostics and vaccines.
An ounce of prevention
Vaccines, one of the best investments in health, save as many as three million lives annually and play an important role in preventing antibiotic resistance. Vaccines reduce the need for antibiotics by preventing bacterial diseases, such as pneumococcal infections or bacterial meningitis, which are usually treated with antibiotics. Vaccines also prevent viral diseases like influenza, which are often mistreated with antibiotics, as well as the secondary bacterial infections they can cause.
Vaccines stave off future bacterial infections, preventing them from taking hold in the body. Compare this to antibiotics, which are given after an infection occurs and once bacteria have had an opportunity to multiply – and potentially become resistant.
No outbreak, no antibiotics
In the 1990s, drug-resistant pneumococcal bacteria were on the rise in the United States, with some strains developing resistance to three or more classes of drugs. Following the introduction of first-generation pneumococcal conjugate vaccines, cases declined sharply, including antibiotic-resistant strains. Two further conjugate vaccines have since been introduced, the most advanced being PCV13, which targets 13 strains of pneumococcal bacteria. Within just three years of introducing this vaccine in the United States, resistance to four classes of antibiotics dropped by more than 50 percent (see chart below). Because this effect was only observed in strains covered by the vaccine, we can safely conclude the decline was caused by the vaccine.
The evidence is clear. Vaccination is a powerful tool for reducing antibiotic resistance.
Herd immunity (or community immunity) resulting from vaccination also plays an integral role in slowing the spread of superbugs. When enough people in a community are immunized against diseases that would be treated with antibiotics, the disease is not able to spread in that community, which protects those who cannot be vaccinated and averts the use of antibiotics to respond to an outbreak.
While researchers continue to work against superbugs, there are many things each of us can do to be antibiotics aware. Apart from staying up to date on your vaccinations (including your flu shot!), talk to your doctor about antimicrobial resistance, take antibiotics exactly as prescribed and follow simple hygiene measures, such as washing hands regularly. This U.S. Antibiotics Awareness Week (November 18-24), spread the word about the dangers of antibiotic resistance.