FIGHTING THE ANTIBIOTIC RESISTANCE CRISIS: An Exploration into the Role of the Pneumococcal Vaccine and its Non-Specific Effects in Ameliorating Antibiotic Resistance

Abstract

Antibiotic resistance kills thousands and costs millions in healthcare-related expenses worldwide. A lack of investment in new antibiotics coupled with the ineffectiveness of current stewardship programs has created a need for innovative solutions to reduce resistance rates. This paper aims to determine if the pneumococcal vaccine (PCV), which protects against S. pneumoniae bacteria, is a candidate to combat antibiotic resistance. Recent studies have demonstrated that vaccines possess non-specific effects which are positive health impacts outside the intended impact of the vaccine. They are a result of immunomodulation or changes to the immune system by the vaccine. PCV has been shown to have non-specific effects that reduce disease incidence. It was hypothesized that this health improvement leads to a diminished need for antibiotics, which in turn would slow rates of resistance. To investigate this hypothesis, data from demographic health surveys (DHS), collected in 2017-2018 by the United States Agency for International Development (USAID) in Pakistan was analyzed to compare the odds of disease incidence and antibiotic use between children vaccinated with PCV and those who were not. Pakistan’s over-the-counter policy regarding antibiotics, national use of PCV, and the availability of such recent survey data made it a strong candidate for this analysis. The analysis was stratified by gender, age, sex, breastfeeding status, wealth, region, and maternal education level. The results illustrate a decrease in the incidence of illness symptoms (diarrhea and acute respiratory illness) correlating with increasing doses of the pneumococcal vaccine. Additionally, the data also demonstrate a decrease in the odds of antibiotic use in vaccinated children, antibiotic use was further reduced with each additional PCV dose and was statistically significant and especially pronounced in breastfed children. These findings delineate the potential for utilization of the pneumococcal vaccine as a deterrent for antibiotic use and therefore as a potential solution for the rapidly worsening antibiotic resistance crisis.