Dr Erta Kalanxhi
Fellow and Director of Partnerships, One Health Trust
Vaccines don’t just prevent disease; they also slow the rise of antimicrobial resistance. As immunisation rates fall, experts warn we risk losing one of medicine’s best defences.
Vaccines and antibiotics have revolutionised public health. The introduction of the Expanded Program on Immunisation in the 1970s led to remarkable reductions in child mortality rates.1
Similarly, the widespread clinical use of antibiotics starting in the 1940s drastically reduced infection-related deaths and paved the way for progress in modern medicine.2 Yet, amid these accomplishments, there is a growing sense of complacency. Immunisation rates are declining, while we rely heavily on antibiotics that were discovered decades ago.3
Antibiotic resistance undermines modern medicine
Antibiotics are losing their effectiveness due to the rise of antibiotic-resistant bacteria ,4 a phenomenon known as antimicrobial resistance, or AMR. For many patients, AMR makes infections harder to treat, often necessitating the use of more sophisticated and costly antibiotics.
Unfortunately, much of the public does not know that AMR can manifest subtly, lurking beneath other issues, such as post-surgical complications, prolonged hospital stays or interrupted cancer treatment. Currently, over 1 million lives are lost annually due to bacterial AMR, with countless more deaths linked to conditions worsened by these resistant bacteria.5
Antibiotics are losing their effectiveness due
to the rise of antibiotic-resistant bacteria
Aligning AMR and immunisation policy and practice
Immunisation and AMR control strategies are connected, each reinforcing the other in ways that benefit us all. Vaccine-averted mortality and societal costs from AMR-related infections further enhance the value of vaccines. Reductions in the transmission of drug-resistant infections and antibiotic use put the brakes on the development of AMR.
This connection extends to viral vaccines as well: viral infections can be mistakenly treated with antibiotics or increase our vulnerability to secondary bacterial infections. Considering the growing evidence of vaccines’ role in tackling AMR, there is untapped potential in both policy and practice. Better alignment of AMR and immunisation strategies could facilitate a better understanding and acceptance of the broader societal benefits that vaccines provide.
[1] Shattock, A J et al. 2024. Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization. The Lancet, Volume 403, Issue 10441, 2307 – 2316.
[2] Shlaes, D M, and Bradford, P A. 2018. Antibiotics-From There to Where?: How the antibiotic miracle is threatened by resistance and a broken market and what we can do about it. Pathogens & immunity vol. 3,1 19-43. 22 Feb. 2018, doi:10.20411/pai.v3i1.231
[3] Haeuser, E. et al. 2025. Global, regional, and national trends in routine childhood vaccination coverage from 1980 to 2023 with forecasts to 2030: a systematic analysis for the Global Burden of Disease Study 2023.
[4] Laxminarayan, R. 2022. The overlooked pandemic of antimicrobial resistance. The Lancet, Volume 399, Issue 10325, 606 – 607.
[5] Naghavi, M, et al. Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050. The Lancet, Volume 404, Issue 10459, 1199 – 1226.
