Immunization as a tool to combat antimicrobial resistance.

Vaccines and immunization programs can play a key role in addressing the growing challenge of antimicrobial resistance (AMR). Amongst the high priority vaccines in development are several AMR pathogens, including: Clostridium difficile, Staphylococcus aureus, Streptococcus pneumoniae, Mycobacterium tuberculosis and Neisseria gonorrhoeae. There is evidence that vaccination can reduce the prevalence of AMR microbes, as demonstrated by both pneumococcal and Haemophilus influenza b vaccines. Research continues on many vaccine-preventable diseases, many of these AMR pathogens, including HIV and universal influenza vaccines. Not only do vaccines prevent infections, they can also prevent secondary opportunistic infections from AMR microbes-for example, bacterial pneumonia following influenza infections. The reduced need to treat these opportunistic infections would also mitigate the advance of AMR microbes in our communities. However, vaccines are not a panacea. One downside to the use of vaccines to address AMR is vaccine hesitancy, which undermines efforts to achieve herd immunity, but this is being increasingly addressed by public health education campaigns.