Abstract
There is rapid spread of infectious disease globally. Emergence of antimicrobial resistance has made it difficult to contain the spread and the associated escalating costs of treatment. Rational use of antibiotics and an effective infection control strategy in health-care facilities can reduce the growing spread of infectious disease dramatically but these are often not possible in developing countries due to overburdened health-care structure. Nevertheless the infectious disease has to be contained.
The immune system in the human body is responsible for protection against disease. Once vaccines are introduced into the body they mimic natural infection and stimulate immune responses, which are directed to act against invading organisms. The protection thus conferred is often long lasting. Most vaccines act in this way against acute infections. Advanced molecular techniques can also be used to produce vaccines against pathogens causing chronic infections.
The success of the smallpox vaccine has been a history-making event and the World Health Organization’s Expanded Programme of Immunization (EPI) has become a hallmark of disease containment with a bare minimum cost of $2 per person against six major infectious diseases. There is evidence from an US study that a savings of $53.2 billion can be met by immunizing children of a specific year birth cohort while the expenditure for the vaccination programme will only be $5.1 billion in terms of direct and indirect (societal) costs. Success stories have also been recorded with vaccines against invasive pneumococcal and Hib diseases and that of yellow fever in terms of lives saved.
Vaccine and antibiotics are not competitors but are equally important for the containment of the infectious disease. Antibiotic is a rescue measure while the vaccine can be seen as a long-term remedy. The ultimate goal is to reduce disease burden and the use of antibiotics. An effective vaccine can almost stand-alone as a cost-effective containment strategy against antimicrobial resistance and should augment the fight against infection in a cost-effective way.
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References
Acharya A, Diaz-Ortega JL, Tambini G, de Quadros C and Arita I. 2002. “Cost-effectiveness of measles elimination in Latin America and the Caribbean: a prospective analysis.” Vaccine 20: 3332–3341.
Adegbola RA, Hill PC, Secka O, Ikumapayi UN, Lahai G, Greenwood BM and Corrah T. 2006. “Serotype and antimicrobial susceptibility patterns of isolates of Streptococcus pneumoniae causing invasive disease in The Gambia 1996–2003.” Trop Med Int Health 11: 1128–1135.
Berzofsky JA, Ahlers JD, Janik J, Morris J, Oh S, Terabe M and Belyakov IM. 2004. “Progress on new vaccine strategies against chronic viral infections.” J Clin Invest 114: 450–462.
Black S, Lieu TA, Ray GT, Capra A and Shinefield HR. 2000. “Assessing costs and cost effectiveness of pneumococcal disease and vaccination within Kaiser Permanente.” Vaccine 19 Suppl 1: S83–S86.
Black S, Shinefield H, Fireman B, Lewis E, Ray P, Hansen JR, Elvin L, Ensor KM, Hackell J, Siber G, Malinoski F, Madore D, Chang I, Kohberger R, Watson W, Austrian R and Edwards K. 2000. “Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Northern California Kaiser Permanente Vaccine Study Center Group.” Pediatr Infect Dis J 19:187–195.
Bloom DE and Canning D. 2000. “Policy forum: public health. The health and wealth of nations.” Science 287:1207–1209.
Bryce J, Black RE, Walker N, Bhutta ZA, Lawn JE and Steketee RW. 2005. “Can the world afford to save the lives of 6 million children each year?” Lancet 365: 2193–2200.
Capra AM, Lieu TA, Black SB, Shinefield HR, Martin KE and Klein JO. 2000. “Costs of otitis media in a managed care population.” Pediatr Infect Dis J 19: 354–355.
Carlin JB, Jackson T, Lane L, Bishop RF and Barnes GL. 1999. “Cost effectiveness of rotavirus vaccination in Australia.” Aust N Z J Public Health 23:611–616
Cutts FT, Zaman SM, Enwere G, Jaffar S, Levine OS, Okoko JB, Oluwalana C, Vaughan A, Obaro SK, Leach A, McAdam KP, Biney E, Saaka M, Onwuchekwa U, Yallop F, Pierce NF, Greenwood BM and Adegbola RA. 2005. “Efficacy of nine-valent pneumococcal conjugate vaccine against pneumonia and invasive pneumococcal disease in The Gambia: randomised, double-blind, placebo-controlled trial.” Lancet 365: 1139–1146.
Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N and de Bernis L. 2005. “Evidence-based, cost-effective interventions: how many newborn babies can we save?” Lancet 365: 977–988.
Daud S, Mohammad T and Ahmad A. 1981. “Tetanus neonatorum (a preliminary report of assessment of different therapeutic regimens).” J Trop Pediatr 27:308–311.
Dittmann S, Wharton M, Vitek C, Ciotti M, Galazka A, Guichard S, Hardy I, Kartoglu U, Koyama S, Kreysler J, Martin B, Mercer D, Ronne T, Roure C, Steinglass R, Strebel P, Sutter R and Trostle M. 2000. “Successful control of epidemic diphtheria in the states of the Former Union of Soviet Socialist Republics: lessons learned.” J Infect Dis 181 Suppl 1:S10–S22.
Dolin PJ, Raviglione MC and Kochi A. 1994. “Global tuberculosis incidence and mortality during 1990–2000.” Bull World Health Organ 72:213–220.
Dougan G, Huett A and Clare S. 2002. “Vaccines against human enteric bacterial pathogens.” Br Med Bull 62:113–123.
Ehreth J. 2003. “The global value of vaccination.” Vaccine 21:596–600.
Ekwueme DU, Strebel PM, Hadler SC, Meltzer MI, Allen JW and Livengood JR. 2000. “Economic evaluation of use of diphtheria, tetanus, and acellular pertussis vaccine or diphtheria, tetanus, and whole-cell pertussis vaccine in the United States, 1997.” Arch Pediatr Adolesc Med 154:797–803.
Eskola J, Kilpi T, Palmu A, Jokinen J, Haapakoski J, Herva E, Takala A, Kayhty H, Karma P, Kohberger R, Siber G and Makela PH. 2001. “Efficacy of a pneumococcal conjugate vaccine against acute otitis media.” N Engl J Med 344:403–409.
Fruth U and Young D. 2004. “Prospects for new TB vaccines: Stop TB Working Group on TB Vaccine Development.” Int J Tuberc Lung Dis 8:151–155.
Galazka AM and Robertson SE. 1995. “Diphtheria: changing patterns in the developing world and the industrialized world.” Eur J Epidemiol 11:107–117.
Galazka AM, Robertson SE and Oblapenko GP. 1995. “Resurgence of diphtheria.” Eur J Epidemiol 11:95–105.
Hudeãková H, Szilágyiová, M, Nováková, E, Huboãan, P and Oleár V. 2004. “Public health importance of vaccination against selected communicable diseases.” Acta Medica Martiniana 4:34–37.
Hudeckova H and Straka S. 2000. Health and economic benefits of compulsory regular vaccination in the Slovak Republic. I. Methods. Epidemiol Mikrobiol Imunol 49:24–27.
Ibanga HB, Brookes RH, Hill PC, Owiafe PK, Fletcher HA, Lienhardt C, Hill AV, Adegbola RA and McShane H. 2006. “Early clinical trials with a new tuberculosis vaccine, MVA85A, in tuberculosis-endemic countries: issues in study design.” Lancet Infect Dis 6:522–528.
Kollaritsch H and Wiedermann U. 2007. “Examples for vaccines against diarrheal diseases – rotavirus and traveller's diarrhea”. Wien Med Wochenschr 157:102–106.
Le Gonidec G. 1985. “The expanded WHO vaccination program”. Ann Inst Pasteur Immunol 136D:167–174.
Levine MM and Noriega F. 1995. “A review of the current status of enteric vaccines.” P N G Med J 38:325–331.
Miller MA and Shahab CK. 2005. “Review of the cost effectiveness of immunisation strategies for the control of epidemic meningococcal meningitis.” Pharmacoeconomics 23:333–343.
MMWR. 1997. “Measles eradication: recommendations from a meeting cosponsored by the World Health Organization, the Pan American Health Organization, and CDC.” MMWR Recomm Rep 46:1–20.
Monath TP and Nasidi A. 1993. “Should yellow fever vaccine be included in the expanded program of immunization in Africa? A cost-effectiveness analysis for Nigeria.” Am J Trop Med Hyg 48:274–299.
Mulholland EK and Adegbola RA. 1998. “The Gambian Haemophilus influenzae type b vaccine trial: what does it tell us about the burden of Haemophilus influenzae type b disease?” Pediatr Infect Dis J 17:S123–S125.
Nicolle LE. 2001. “Infection control programmes to contain antimicrobial resistance.” WHO/CDS/CSR/DRS/2001.7.
Orme IM. 2005. “Tuberculosis vaccines: current progress.” Drugs 65:2437–2444.
Parent du Chatelet I, Gessner BD and da Silva A. 2001. “Comparison of cost-effectiveness of preventive and reactive mass immunization campaigns against meningococcal meningitis in West Africa: a theoretical modeling analysis.” Vaccine 19:3420–3431.
Peltola H. 2000a. “Worldwide Haemophilus influenzae type b disease at the beginning of the 21st century: global analysis of the disease burden 25 years after the use of the polysaccharide vaccine and a decade after the advent of conjugates.” Clin Microbiol Rev 13: 302–317.
Peltola H. 2000b. “Emergency or routine vaccination against meningococcal disease in Africa?” Lancet 355:3.
Ray GT, Butler JC, Black SB, Shinefield HR, Fireman BH and Lieu TA. 2002. “Observed costs and health care use of children in a randomized controlled trial of pneumococcal conjugate vaccine.” Pediatr Infect Dis J 21:361–365.
Reiff FM, Roses M, Venczel L, Quick R and Witt VM. 1996. “Low-cost safe water for the world: a practical interim solution.” J Public Health Policy 17:389–408.
Rudan I, Tomaskovic L, Boschi-Pinto C and Campbell H. 2004. “Global estimate of the incidence of clinical pneumonia among children under five years of age.” Bull World Health Organ 82:895–903.
Sabin AB. 1984. “Strategies for elimination of poliomyelitis in different parts of the world with use of oral poliovirus vaccine.” Rev Infect Dis 6 Suppl 2:S391–S396.
Satcher D. 1998. “Testimony on Eradication of Polio and Control or Elimination of Measles” Testimony presented before the Senate Committee on Appropriations, Subcommittee on Labor, Health and Human Services, Education and Related Agencies. September 23, 1998.
Shann F. 1986. “Etiology of severe pneumonia in children in developing countries.” Pediatr Infect Dis 5:247–252.
Svennerholm AM and Steele D. 2004. “Microbial-gut interactions in health and disease. Progress in enteric vaccine development.” Best Pract Res Clin Gastroenterol 18:421–445.
Takala AK, Koskenniemi E, Joensuu J, Makela M and Vesikari T. 1998. “Economic evaluation of rotavirus vaccinations in Finland: randomized, double-blind, placebo-controlled trial of tetravalent rhesus rotavirus vaccine.” Clin Infect Dis 27:272–282.
Thompson KM, Duintjer Tebbens RJ, Pallansch MA, Kew OM, Sutter RW, Aylward RB, Watkins M, Gary H, Alexander JP, Venczel L, Johnson D, Caceres VM, Sangrujee N, Jafari H and Cochi SL. 2006. “Development and consideration of global policies for managing the future risks of poliovirus outbreaks: insights and lessons learned through modeling.” Risk Anal 26:1571–1580.
Tomori O. 2002. “Yellow fever in Africa: public health impact and prospects for control in the 21st century.” Biomedica 22:178–210.
Wardlaw T, Salama P, Johansson EW and Mason E. 2006. “Pneumonia: the leading killer of children.” Lancet 368:1048–1050.
WHO. 2006. “WHO vaccine-preventable diseases: monitoring system.2006 global summary.” WHO/IBV/2006.
WHO. 2007. “The evolving vaccine pipeline.” www.who.int/immunization_delivery/new_vaccines/Evolving-vaccine-pipeline.pdf accessed on 27th March, 2008 at 1310 hrs.
Wiedermann U and Kollaritsch H. 2006. “Vaccines against traveler's diarrhoea and rotavirus disease – a review.” Wien Klin Wochenschr 118:2–8.
Williams RJ and Heymann DL. 1998. “Containment of antibiotic resistance.” Science 279: 1153–1154.
Williamson ED. 2001. “Plague vaccine research and development.” J Appl Microbiol 91:606–608.
Wilton P, Smith R, Coast J and Millar M. 2002. “Strategies to contain the emergence of antimicrobial resistance: a systematic review of effectiveness and cost-effectiveness.” J Health Serv Res Policy 7:111–117.
Zhou F, Santoli J, Messonnier ML, Yusuf HR, Shefer A, Chu SY, Rodewald L and Harpaz R. 2005. “Economic evaluation of the 7-vaccine routine childhood immunization schedule in the United States, 2001.” Arch Pediatr Adolesc Med 159:1136–1144.
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Adegbola, R.A., Saha, D. (2010). Vaccines: A Cost-Effective Strategy to Contain Antimicrobial Resistance. In: Sosa, A., Byarugaba, D., Amábile-Cuevas, C., Hsueh, PR., Kariuki, S., Okeke, I. (eds) Antimicrobial Resistance in Developing Countries. Springer, New York, NY. https://doi.org/10.1007/978-0-387-89370-9_27
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