Vaccines in combat
A few days ago, my pediatric colleagues and I were invited to a roundtable discussion with other stakeholders to discuss how vaccines can play a role in reducing antimicrobial resistance. Among the invited participants were clinicians, public health experts, government agencies, and medical societies. The project is an initiative of the International Center for Antimicrobial Solutions and the International Vaccine Institute—whose aim, with the help of different sectors, is to develop a comprehensive, detailed, and strategic action plan to utilize immunization as a tool in the fight against AMR.
Listening to the comprehensive scoping review, the people seated at our table could only nod and at times, silently exchange glances in agreement with the complexities of the link and the gaps that were identified. Prior to the meeting, I had reached out to one of the organizers to ask for particulars so we could do our homework. It was such a valued reconnection. I had met him early on, when he was starting his career in public health, and had invited him to be a plenary speaker at our pediatric infectious disease annual convention. His enthusiasm has not waned, and his energy remains contagious.
In response to my query, their group immediately sent out a framework for the panel discussion. This was such a welcome and much-appreciated briefer to assist in keeping our conversations focused. I use the word “welcome” because this is not the norm. More often than not, from experience, in an effort to gather multisectoral perspectives, there is a tendency to deviate by virtue of the enormity of the scope of the concern to be tackled. We were also instructed to keep to the time. Analyzing how the day went, a lot of us can probably learn from them on how to conduct high-yield meetings. While there was an urgency to the matter, it didn’t feel like we were pressured to come up with quick solutions. It helped that one panelist managed to ground us right from the beginning by saying that if we have realized that not everyone understands the relationship between how vaccines can combat resistance. On that note, I decided that it might be worth writing about to help raise awareness. For now, this is the most doable. Hopefully, this can get somewhere, and for some of you, serve to give a clearer picture of the real and promised link.
For starters, let us do a quick review with basic facts. Vaccines are an excellent tool to be used for primary prevention. The general principle is that for vaccines that are live in nature, immunity is expected to be long-lasting. For those which are classified as inactivated, periodic boosting is needed throughout one’s lifetime. This, in part, explains why your physician gives you a required number of doses.
No vaccine is 100 percent effective, and there is no claim that it is so. Real-world evidence and history itself have proven that the benefits are substantial. The simple explanation for the whole process is: getting immunized provides you with a form of protection through preformed antibodies, so that in the event that you meet the offending pathogen, infection may be averted or less severe. Furthermore, you are at a lower risk of experiencing sequelae from complications of coming down with a natural infection, which may, in some instances, be permanent and irreversible.
Having laid out its benefits, it is clear that with the protection that it provides, there is a decreased incidence of infection, which in turn can help in reducing the use of antibiotics and the associated risk of inviting antibiotic resistance. One of the most compelling evidence that lends strength to this statement has been through the pneumococcal vaccine, which has been shown to directly prevent infections with certain bacterial serotypes. This is the promise that vaccination holds for the control of antimicrobial resistance.
In the past years, as doctors, we have been faced with situations wherein we are left with no antibiotics to combat severe and debilitating infections. The enormity of the problem can either paralyze or provide that needed push to call for commitment. In that room, we exchanged experiences and ideas, opinions, and frustrations that were warmly embraced by everyone.
We were all on the same page and cognizant of what we could do, but we also knew that we had a long way to go.
We said our goodbyes and promised to be in touch. Reinvigorated, we agreed that the best thing to do would be to create awareness as an initial step with a focus on the right health messaging. The importance of vaccination and the problem of antimicrobial resistance need to be further made clear before we can even begin talking about the link.
The work begins.
