Journal of Vaccine Research 2024, Vol.14, No.2, 54-64 http://medscipublisher.com/index.php/jvr 56 3 Vaccination as a Strategy to Mitigate AMR Antimicrobial resistance (AMR) poses a significant threat to global health, leading to increased mortality, prolonged hospital stays, and higher medical costs. Vaccination has emerged as a promising strategy to combat AMR by reducing the incidence of infections, thereby decreasing the need for antibiotics and limiting the spread of resistant strains. 3.1 Mechanisms of vaccines in reducing AMR Vaccines alleviate AMR through multiple mechanisms. Studies have found that vaccines play a crucial role in reducing AMR. The impact of vaccines on AMR includes both direct and indirect effects. Directly, vaccines can significantly reduce the prevalence and infection of specific pathogens, thereby decreasing the use of antibiotics and the spread of resistant strains (Figure 1). Indirectly, vaccines can further prevent the spread of resistant strains through herd immunity mechanisms. For example, influenza vaccines can reduce inappropriate use of antibiotics and prevent secondary bacterial infections (Micoli et al., 2021). Additionally, vaccines can decrease the prevalence of pathogens that cause specific clinical syndromes, making it possible to use narrow-spectrum antibiotics in empirical treatments (Lipsitch and Siber, 2016). Figure 1 Effects of vaccines on antimicrobial resistance (Adopted from Micoli et al., 2021) Image caption: Figure a illustrates how antimicrobial-resistant strains spread among individuals and communities in the absence of vaccines, leading to antibiotic treatment failures and widespread dissemination of resistant strains. Figure b demonstrates that vaccines reduce antibiotic use and the spread of resistant strains by preventing infections and establishing herd immunity, thereby lowering the incidence of AMR. The results indicate that vaccines play a critical role in mitigating the spread of AMR (Adapted from Micoli et al., 2021) Additionally, herd immunity extends protection to unvaccinated individuals, further reducing the spread of infections and the need for antibiotics (Lipsitch and Siber, 2016; Buchy et al., 2019; Micoli et al., 2021). Some vaccines have shown a disproportionate effect on drug-resistant lineages within target species, which can be strategically exploited in vaccine design (Lipsitch and Siber, 2016).
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