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As Antibiotics Fail, We Need More Vaccines

The global problem of antibiotic misuse that allows bacteria to become resistant can be solved in part by more use—not of antibiotics, but of vaccines and other compounds, which could reduce the occurrence of diseases that antibiotics are otherwise used to treat.

A patient receives a vaccination injection at Gorkha district hospital in Nepal. Photograph by Alex Treadway, National Geographic Creative
A patient receives a vaccination injection at Gorkha district hospital in Nepal. Photograph by Alex Treadway, National Geographic Creative

That is the latest piece of analysis of the worldwide resistance problem from the Review on AMR, the British project that is conducting a two-year examination of antibiotic resistance at the request of UK Prime Minister David Cameron. The group, which is supported by the Wellcome Trust, is closing in on its deadline of May 2016 for presenting comprehensive recommendations to ameliorate resistance. On the way, it has examined reducing agricultural use of antibiotics, funding drug development, promoting increased use of diagnostic devices, combatting over-the-counter sales and counterfeits, and achieving better data on the occurrence and cost of resistance.

“This year, 2016, is a critical year for action on the wider issue of drug-resistant infections, and both vaccines and alternative therapies have a crucial role to play as part of the strategy to tackle this threat. Internationally there will be focus on this issue at the World Health Assembly, the G7, G20 and UN General Assembly,” the report says. “This is a crucial time for the world to make significant progress – a moment that needs to be seized.”

The project is chaired by Lord Jim O’Neill, the former chief economist for Goldman Sachs, who is also Commercial Secretary to the Treasury in Cameron’s government. “Drug resistant infections could be compared to a slow-motion car crash,” he said. “Antibiotics are important to tackle this threat, but if we can encourage the development and use of vaccines and other alternatives we give the world a better chance of beating drug resistance.”

In the newest report, the Review proposes that better use of vaccines, along with development of new vaccines and other non-antibiotic compounds, could reduce the need for antibiotic use. But what stands in the way, it says, is a lack of funding both for getting existing vaccines to vulnerable populations, and also for developing crucially needed new vaccines.

Vaccines, it says, can reduce the occurrence of bacterial infections for which antibiotics are used; viral infections, for which the drugs are often given in error, increasing resistance; infections that occur in hospitals, a setting in which bacteria often become multi-drug resistant; and infections in farm animals, forestalling the huge use of antibiotics on farms.

Crucially needed vaccines are not being developed.
Crucially needed vaccines are not being developed.
Graphic courtesy the Review on Antimicrobial Resistance.

The report finds that existing vaccines are not being used as much as they might be: globally, pneumococcal and rotavirus vaccines reach only 31 percent, and 18 percent, of children eligible for them. If pneumococcal vaccine were fully deployed, it says, the lives of 800,000 children younger than 5 could be saved every year—and in addition, 11.4 million days of antibiotic consumption, almost half the global usage for that disease, could be prevented.

But there is also a need for new vaccines to address specific diseases which antibiotic resistance makes worse. In 2013, the US Centers for Disease Control and Prevention compiled a long list of the resistant bacteria that it considers the most serious threats to health. There are no vaccines for the problems that it ranked as most urgent: resistant gonorrhea, Clostridium difficile, and bacteria such as E. coli and Klebsiella that have become resistant to the last-resort antibiotic class carbapenems and collectively are known as CRE.

Unlike antibiotics, vaccines can be attractive moneymakers for pharma companies, but the size of the clinical trials needed to get them to market means that many candidates stall in development, the report notes. To improve vaccine’s prospects in the market, it proposes additional funding to buy existing vaccines for low-income countries and to support early-stage research, and the creation of reward commitments (also known as advance market commitments or market entry rewards) for vaccines that make it through the development pipeline and reach the market.

Elizabeth Jungman, director of public health at The Pew Charitable Trusts, said about the proposals:  “This report highlights the need to take a multifaceted approach to addressing antibiotic resistance. Vaccines and some alternatives can play a critical role in the fight against antibiotic resistance by preventing infections, and other alternatives can make antibiotics more effective or even replace them for treatment.”

Vaccine syringes.
Vaccine syringes.
Photograph by Debora Cartagena, CDC.gov.

The new report is being released just after midnight in Britain, and a number of experts gave the Review their comments to release at the time of publication.

Dr. Jeremy Farrar, Director of the Wellcome Trust, said: “Our own analysis on how we might use vaccines and other alternatives to tackle this crisis supports the O’Neill team’s report, and suggests they will be an important way we can reduce – but not replace – our need for antibiotics. Vaccines are also critical for controlling epidemics, like Ebola, and endemic diseases such as TB and dengue fever, and how we incentivise developing news ones must take the whole picture into account.”

Dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance—which is praised in the report for innovative funding strategies that allow vaccines to flow to poor countries—said: “It is exciting to see such a powerful argument on the important roles vaccines play, not just in preventing diseases and therefore reducing antibiotic usage, but also in directly reducing antimicrobial resistance. New incentives are needed to further accelerate their development.”

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10 thoughts on “As Antibiotics Fail, We Need More Vaccines

  1. Okay guys, you are in a rut.
    NEWS FLASH! Vaccines are NOT the only way to protect people from the ravages of these diseases!
    I’m going to sound like I’m from the loony bin here, but we need LESS vaccines NOT more!
    They are not 100% safe and never will be. We don’t know what the long term effects are because no one is looking.
    The answer to every question ISN’T another vaccine. We start the Chicken Pox vaccine and now 20 years later we’re getting an unprecedented number of Shingles cases in 20 and 30 year olds. Maybe we need to slow down here a bit and really figure out how to help our Immune System build a more natural life long immunity to these diseases rather than simply trying to trick it into building a temporary immunity like the just announced problem of the whooping cough (pertussis) being effective for about a year or two.
    Or are we building in planned obsolescence so they can require expensive booster shots every two years through our teenage years to make an obscene amount of money from a relatively low mortality from this disease?
    I know you probably don’t want to hear it, but a 10,000 mg shot of about $0.65 worth of Sodium Ascorbate will stop the Whooping Cough in it’s tracks, no vaccine needed. It can even be administered to a baby as young as 1 day old, not the 10,000 mg dose, but easily 50 mg to 250 mg per day and Dr. Klenner even devised a schedule based on the weight of the baby or the years of children 1 year old and up. Sodium Ascorbate isn’t toxic, you can’t overdose on it. The body uses what it needs and discards the rest.
    If you don’t believe this, I dare anyone to test it and prove these protocols wrong! Good luck with that, but I’d love to have you try, don’t be surprised if you get phenomenal results as you watch a 2 month old baby stop the whooping in just a couple of hours or so.
    Dr. Klenner said after years of successfully treating many different viral and bacterial infections with these protocols, that unfortunately, “Some physicians would stand by and see their patients die rather than use ascorbic acid because in their finite minds it exists only as a vitamin. Vitamin C should be given to the patient while the doctors ponder the diagnosis.”
    bit dot ly / out-ahead to learn more

    1. Nicholas, please provide the references that indicate clinical trial results to support your claims. This avenue of thought was debunked many years ago.

      1. Since he’s trotting out the “Vitamin C cures whooping cough” myth, I don’t think you’ll get anything reasonable out of him.

        1. As for Overdosing on Vitamin C, I’m going to leave that in your court, provide even ONE single document from the CDC or any poisons organization that shows of a single death attributed to vitamins or minerals.
          Good luck with that, they don’t exist but you questioned it, I say there aren’t any and beings I can’t prove a negative, it will be up to you to prove that there are deaths from overdosing vitamin C or any other vitamin.
          We can provide tens of thousands of successful treatments of hundreds of diverse illnesses both viral and bacterial.
          Here’s my question to you, your baby or child gets whooping cough, I’ve recommended you look into the use of Vitamin C to treat whooping cough. Would you sit by and let your child die rather than at least try the therapy? I’d hope not.

    2. I suppose asking for evidence to support your claims would be a bit much. We do actually know the long-term effects of vaccines. We see it in increasing life expectancies and lowering rates of infant and maternal mortality. Pardon the pun, but vaccine safety is routinely put under the microscope. It’s one of the most closely monitored aspects of modern medicine. Evidence that the rate of shingles among people in their 20s and 30s is increasing would be nice, as would an accounting for confounding factors if you’re correct, which, again, you haven’t proven. Natural immunity to pertussis wears off fairly quickly as well. That argument is invalid. Your claims about vitamin C have also been weighed, and it has not been found to prevent… anything except scurvy. And it is actually possible to overdose on vitamin C.

    3. There is no evidence to support your claims, and in fact, considerable evidence that shows no relationship between Sodium Ascorbate (which is more commonly known as Vitamin C) and any illness other than scurvy.
      You are making claims that date back to Linus Pauling, claims that have been roundly debunked over the world.
      You claim that vaccines are not 100% safe, so we shouldn’t use them. Learn the real risks and benefits. The risks of great harm from a vaccine are miniscule, you are more likely to get killed driving to get a vaccine than to suffer harm FROM the vaccine.
      Here is an article rebutting your claim about shingles and the chickenpox vaccine.
      I appreciate you want to help people stay healthy. That’s really good, and I want you to understand that I know you want to help.
      Perhaps you could do more research. Good research would make you pro vaccine.

  2. This article fails to mention the very important vaccine against MAP, or Micobacterium Avium subspecies Paratuberculosis, that has been developed at Kings College London and is now being manufactured at the Jenner Institute ready for Phase 1 trials to begin in the spring. This vaccine is expected to eradicate Johnes Disease in cattle as well as Crohn’s Disease in humans.

  3. Way to go, National G! Play right into the anti-vaxers’ hands by implying vaccines are great money-makers for pharma companies. I was going to use your article as evidence that vaccines are good, until I read that. The AVs will lap it right up!

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