Vaccines and antimicrobial resistance: from science to policy

29 - 30 April 2024 09:00 - 17:00 The Royal Society Watch online
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Graphic representing the global nature of vaccinations and antimicrobial resistance

Science+ meeting organised by Professor Calman MacLennan and Dame Sally Davies FMedSci FRS.

Vaccines for humans and animals represent an attractive means to counter the growing global pandemic of antimicrobial resistance (AMR) but are only available against a few key bacterial pathogens. The meeting will review the science of how vaccines reduce AMR, identify research gaps in developing AMR vaccines and discuss policy in advancing development and equitable deployment of such vaccines.

The schedule of talks and speaker biographies will be available soon. Speaker abstracts will be available closer to the meeting date. 

Attending this event

This event is intended for researchers in relevant fields.

  • Free to attend, an optional lunch is available to purchase during registration or on the day
  • Online attendance available. Please register using the above link
  • Advance registration is essential

Enquiries: contact the Scientific Programmes team

Schedule

09:05-09:30 Burden of disease evidence for impact of AMR
Professor Ramanan Laxminarayan, Princeton University, One Health Trust, USA

Professor Ramanan Laxminarayan, Princeton University, One Health Trust, USA

09:30-09:45 Discussion
09:45-10:15 The economic burden of AMR

Juan Pablo Uribe:

Antimicrobials have become part of the infrastructure of modern society; but their longevity is under threat, compromising our ability to treat many health conditions cost-effectively and quickly. In 2017, the World Bank estimated that by 2050, left unchecked, AMR could wipe away 3.8 percent of global gross domestic product each year and push 28 million people into poverty (World Bank 2017). Ongoing efforts have highlighted that the socioeconomic burden of AMR remains substantial. However, the challenge posed by AMR is not universally intractable; from improving handwashing in health care settings to banning the use of antimicrobials as growth promoters in agriculture, there is much that can be done. Supporting investments in health system strengthening, such as infection, prevention and control, is an area where the World Bank, through technical assistance and financing, can positively impact the fight to preserve antimicrobials. Currently, the World Bank finances and collaborates with governments worldwide across a portfolio of more than 60 projects that are addressing AMR. In addition, the World Bank brings a comparative advantage in its multisectoral approach, and has identified 20 intervention areas (across the Health, Water, Agriculture and Food and Environment sectors) that be advanced through, its financing, to better address AMR in the coming years.

Dr Juan Pablo Uribe, World Bank, USA

Dr Juan Pablo Uribe, World Bank, USA

Anthony McDonnell, Center for Global Development, UK

Anthony McDonnell, Center for Global Development, UK

10:15-10:30 Discussion
10:30-11:00 Break
11:00-11:30 Scientific evidence for how vaccines reduce AMR
11:30-11:45 Discussion
11:45-12:15 Technologies for AMR vaccine development
Dr Rino Rappuoli, Novartis Vaccines, Italy

Dr Rino Rappuoli, Novartis Vaccines, Italy

12:15-12:30 Discussion
13:30-14:00 Pneumococcal and typhoid vaccine AMR impact
Professor Farah Qamar, The Aga Khan University, Pakistan

Professor Farah Qamar, The Aga Khan University, Pakistan

14:00-14:15 Discussion
14:15-14:45 Vaccine impact against AMR in the food chain/aquaculture

Aquaculture is the fastest growing food-producing sector in the world and Norway is the leading producer of farmed Atlantic salmon worldwide, with over 1.6 million tons produced in 2022. Since its start in the late 1960s, expansion of the fish farming industry in Norway has not been without biological problems. During the early years, serious bacterial infections caused significant losses. Large quantities of antibiotics were prescribed, peaking at almost 50 tonnes of active antibacterial substances used in production of less than 100,000 tonnes of farmed salmon in 1987. AMR to several antibiotic classes was rapidly discovered. However, following development and rapid, widespread adoption of effective vaccines against the major bacterial diseases in the late ‘80s and ‘90s, antibiotic use fell dramatically. All salmon farmed in Norway are now vaccinated against as many as six bacterial pathogens. Only 425 kg antibiotics were used in Norwegian aquaculture (all fish species) in 2022. While this low antibiotic use is undoubtedly due to the success of available vaccines and recognition of the dangers of AMR development, negative consumer perception relating to antibiotic use in farmed fish may also be an important influence. AMR is now only very rarely identified amongst fish pathogenic bacteria in Norway. This presentation will introduce the main bacterial diseases in intensive Norwegian salmon aquaculture, the vaccines and vaccination strategies used to combat these challenges and the limited AMR identified over the years. 

Professor Duncan Colquhoun, Norwegian Veterinary Institute, Norway

Professor Duncan Colquhoun, Norwegian Veterinary Institute, Norway

14:45-15:00 Discussion
15:00-15:30 break
15:30-16:00 The manufacturers' perspective

Annaliesa Anderson:

Antimicrobial resistance (AMR) represents a significant global health threat, with over one million global deaths attributed to difficult-to-treat bacterial infections in 20191. Vaccines are well-positioned for helping to address this challenge by providing protection against infectious diseases that might otherwise result in antibiotic use — or misuse. Vaccines that target bacterial and viral infections each have a role to play. For example, pneumococcal conjugate vaccines (PCV) such as PCV13 is estimated to have prevented more than 175-million cases of IPD and over 600,000 deaths globally in children under five years of age alone between 2010 and 20192. Influenza vaccines prevent antibiotic misuse, in addition to bacterial superinfections that can result from the viral insult, thus resulting in an inverse relationship between influenza vaccine coverage and circulating antimicrobial resistance3. Despite this positive outlook, much more needs to be done to utilize the advantage of vaccines in AMR prevention. This presentation will focus on progress towards advancing vaccines to help answer this call-to-action.

1. Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022;399(10325):629-655.
2. Chapman, R. et al. Ten year public health impact of 13-valent pneumococcal conjugate vaccination in infants: A modelling analysis. Vaccine 38, 7138-7145 (2020). 
3. Barchitta M, Maugeri A, Vinci R, Agodi A. The Inverse Relationship between Influenza Vaccination and Antimicrobial Resistance: An Ecological Analysis of Italian Data. Vaccines (Basel). 2022 Apr 3;10(4):554.

 

 Frédéric Descamps:

There is more and more pressure, implementation measures and incentives to reduce antimicrobial use in food-producing animals in the European Union (EU) (and elsewhere); accordingly, the use of antimicrobials in food-producing animals has significantly decreased in EU in the recent past. On the other hand, it is widely recognized and reported that veterinary vaccines may contribute to reduce antimicrobial use and indirectly reduce the risk of antimicrobial selection and/or antimicrobial resistance (AMR) development. The vaccines against bacterial infections and immunosuppressive viruses are especially relevant in this regard. The presentation will briefly review the current status and industry trends relative to the development and availability of vaccines that may be of interest in that context. The specificities of the veterinary vaccine industry (versus human vaccine industry) will be summarized. Relevant regulatory requirements will be shortly described. Possible next steps towards the development of veterinary vaccines which may play a role in the reduction of antimicrobial use and AMR will then be discussed, together with the technical and regulatory challenges faced by the industry. Clearly, this is a topic of growing interest from a regulatory, public health and industry standpoint and support for innovation in the area will be important. 

Dr Annaliesa Anderson, Pfizer, USA

Dr Annaliesa Anderson, Pfizer, USA

Dr Frédéric Descamps, Zoetis, Belgium

Dr Frédéric Descamps, Zoetis, Belgium

16:00-16:15 Discussion
16:15-16:45 Poster session
16:45-17:00 Discussion
09:00-09:30 Translating science on AMR and vaccines into policy
09:30-09:45 Discussion
09:45-10:15 Lessons from Covid/ the 100 days mission and AMR

Both the rising number of antimicrobial resistant superbugs and the increasing cadence of emerging pandemic threats are acute and urgent global health risks. Tackling them requires sustained, focussed international collaboration at all levels, from community health workers, to health and social policymakers, to innovative scientists. 
The parallels between vaccine development for epidemic or pandemic preparedness and efforts to combat rising antimicrobial resistance can enhance and accelerate solutions. CEPI’s 100 Days Mission - a plan for the world to able to develop vaccines and medical other countermeasures within 100 days of a new pandemic threat being recognised – has lessons for the world’s battle to stem the rise in antimicrobial resistance. Learning from each other, we can fight superbugs and epidemics together. 

Dr Richard Hatchett, Coalition for Epidemic Preparedness Innovations (CEPI), Norway

Dr Richard Hatchett, Coalition for Epidemic Preparedness Innovations (CEPI), Norway

10:15-10:30 Discussion
10:30-11:00 Break
11:00-11:30 AMR vaccines global perspective

Javier Yugueros-Marcos:

Vaccines, as well other alternative products, can help minimize the need for antibiotics by preventing and controlling infectious diseases in animal populations (i.e., poultry, swine, cattle, aquatic animals, etc.). Various studies have demonstrated that their animal agricultural use can lead to significant reductions in antibiotic consumption, making them promising alternatives to antibiotics. To be widely used in food producing animals, vaccines have to be safe, effective, easy to use, and cost‑effective. Many current vaccines fall short in one or more of these respects. Scientific advancements may allow many of these limitations to be overcome, but progress is highly funding‑dependent.
In a world which numerous competing priorities and scarce public resources, it is it is of paramount importance to identify those areas of potentially greatest impact first, as well as to foster synergies to mobilise private investments into vaccine development and implementation. The World Organisation for Animal Health (WOAH) has released a series of documents prioritising diseases on which vaccines could reduce antimicrobial use in animals, providing also outputs from expert panel discussions regarding opportunities, challenges, needs, new approaches and potential solutions for the development of such vaccines. 
This talk will provide an overall view of priorities, focusing on those areas to invest first and now, for the sake of a synergistic approach to optimise the use of antimicrobials and across sectors, and the setting of complementary actions to curb antimicrobial resistance.

Professor Alejandro Cravioto, National Autonomous University of Mexico, Mexico

Professor Alejandro Cravioto, National Autonomous University of Mexico, Mexico

Dr Javier Yugueros-Marcos, World Health Organisation, France

Dr Javier Yugueros-Marcos, World Health Organisation, France

11:30-11:45 Discussion
11:45-12:15 AMR vaccine implementation
12:15-12:30 Discussion
13:30-14:00 The regulatory perspective on AMR vaccines
Dr David Kaslow, Office of Vaccines Research and Review, USA

Dr David Kaslow, Office of Vaccines Research and Review, USA

14:00-14:15 Discussion
14:15-14:45 Supporting AMR vaccine R&D

Ed Buurman:

CARB-X (Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator; https://carb-x.org/about/overview/) supports the discovery and development of new antibacterial therapeutics and preventatives, as well as diagnostics to allow their development and prudent use. CARB-X funding comes from several governments (US, UK, Germany and Canada) and global health foundations including Wellcome, the Bill & Melinda Gates Foundation and the Novo Nordisk Foundation. The CARB-X funding model is unique in several ways: (1) it is non-dilutive; (2) it does not take an IP position; (3) it requires a contractual agreement to prepare and follow a Stewardship and Access Plan so that these products reach those who need them most; and (4) it provides a multi-layered support model. The model begins with an internal R&D champion; builds around each project a tailored company support team, comprised of external subject-matter experts representing the breadth and depth of expertise needed to help each team move towards human clinical trials; layers on clinical advisories, portfolio-level customized research tools, and access to free preclinical assays and services; and aids in the pursuit of additional investors and advanced-development partners.
All projects enter the portfolio in response to open-funding calls. Increasingly more thematic in nature, these calls emphasize syndromes with the greatest burden of disease, the bacterial pathogens that cause them and the performance characteristics that clinicians and patients need. These priorities are informed by external strategic review panels, and applications are juried by external experts. The funding scope covers hit-to-lead efforts (notably not including reverse vaccinology activities) through to safety and immunogenicity evaluation as part of First-in-Human clinical trials. Following the 2023 funding rounds, five vaccine projects were selected for funding: two gonococcal vaccines and three vaccines to protect against neonatal sepsis. Themes and timelines of new funding rounds will be announced soon.

Dr Ed Buurman, CARB-X, Boston University, USA

Dr Ed Buurman, CARB-X, Boston University, USA

14:45-15:00 Discussion
15:00-15:30 Break
15:30-16:00 AMR vaccines: communication and trust

Effective communication of the value of vaccines as tools to combat AMR presupposes that we ourselves have carefully determined their true value.  Unfortunately, there is hardly a consensus, even within the medical community, as to what their role might be.  On the one hand, vaccines have been essentially ignored in many review articles and editorials about AMR, both in the popular press and the scientific literature, in favor of discussions of potential new antibiotics, bacteriophages, as well as better antimicrobial stewardship, implying their impact is and would be marginal.  On the other hand, vaccines in theory are equally effective against antimicrobially-resistant pathogens as they are against sensitive pathogens, as impressively demonstrated by the high effectiveness of typhoid vaccine against extremely drug resistant, epidemic S. typhi in Pakistan.  Continued accrual of these types of data, coupled with the knowledge that a panoply of new technologies is being employed to develop vaccines against all sorts of resistant pathogens, could lead to much more sanguine views.  Yet this enthusiasm too must be tempered by the knowledge that each vaccine directed against a single pathogen can only prevent the AMR and antimicrobial use associated with that pathogen—and there are many such pathogens, as well as many vaccines already being administered.  As vaccines don’t prevent disease, only vaccination does, the tremendous potential value of vaccines against AMR will only be realized if we devise ways to deliver and pay for multiple vaccines identified as public health priorities within a minimal number of separate administrations.

Dr Bill Hausdorff, Center for Vaccine Innovation and Access, PATH, USA

Dr Bill Hausdorff, Center for Vaccine Innovation and Access, PATH, USA

16:00-16:15 Discussion
16:15-17:00 Panel discussion: Setting course to the UN General Assembly on AMR vaccines