Vaccination versus Antibiotics during this age of resistance? Watch

VigneshSB
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Hey guys,

I'm doing a personal project analysing the situation with the antibiotics
we have at the moment, and for alternative actions, I was wondering
whether vaccination(active immunity) could be used instead of antibiotics?

I've already analysed serum therapy, with antibodies for passive immunity,
and found a few papers, that did some trials, and found that it was not
a very good solution.

However, I haven't come across any good sources that compare vaccination
with antibiotics. What are the main challenges we face with simply vaccinating
the population from all diseases?

The points I came up with:

-> Each vaccine only works against one specific bacterium
-> Takes time to develop vaccine
-> Requires trained staff to administer(costly procedure)
etc.

But would it not be more cost effective to simply vaccinate vs wasting so much on antibiotics?

If anyone would mind referring me to a source, or adding in their own thoughts, I would most appreciate it!
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Hype en Ecosse
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We simply can't vaccinate against many infectious diseases yet (as in, we don't currently have the knowledge of how to create one), and some are so rapidly mutating that it's simply not feasible to create a vaccine for. It's not a matter of medical science collectively thinking "Naaaaaaaaah...it'd be better if we just let people get sick and then give them antibiotics". Medicine would much rather prevent disease, than treat it once it comes about! We just have the problem that how we can prevent diseases is limited.

Remember antibiotics only treat bacterial infections, but vaccines can act against all sorts of microorganisms - so you're limiting yourself just by looking at antibiotics, when we have lots of other drug classes that we treat infectious disease with.
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Brachioradialis
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Unfortunately it's not as simple as just vaccinating everyone; you first have to find a suitable way to stimulating the immune system enough to properly produce a response when reinfected. That might sound simple, but it's not as proven by the fact that many vaccines require you to vaccinate more than once for the same disease. Sometimes you need 3 initial doses, for example, and for others you might need regular (e.g. 5-yearly) injections. I don't know what level you're educated to, but during degree-level study you'll learn of the ways the immune system is stimulated. You can also learn about the different methods of vaccination, including their downsides. For example, 'attenuated' (live but weakened) vaccines aren't very good in people with bad immune systems because there's a small chance that the pathogen can regain it's virulence. On the other hand, using dead pathogens in vaccines, in their various forms, tend to produce a worse immune response than attenuated vaccines.

If you want to read up on why live and dead vaccines have different immune stimulation rates, read up on the concepts of monoclonal and polyclonal responses.

As above, there are also issues with mutations, particularly with viruses where there tend to be many strains around at the same time. Think flu vaccine: it only protects against 3 of hundreds of possible strains of influenza!

It also comes down to economics, for a few reasons in particular. The first is that pharmaceutical companies are largely unwilling to cure diseases unless there is a very good profit. It's much more favourable for them to sell drugs which solve the problem temporarily i.e. antimicrobial drugs.
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ash92:)
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It wouldn't be better in terms of cost, as:

a new vaccine would have to be developed against each strain
(Workers, vaccine development and production)

Vaccine distribution and administration is difficult in terms of cost and universality in administration (even then, immunisation may be temporary and antibiotics would still be in use).

Vaccination would need to be implemented for several-fold more numerous pathogens than present, more jabs = much more costs.



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edchoi
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Well one major point is... antibiotics won't do anything to viral infections, although they might be useful for controlling secondary infections. The drawbacks are, of course, regiment adherence, development of resistance and allergy.

There are many different types of vaccines now. Some are prophylactic, some therapeutic. We can now vaccinate against viruses, bacteria and even certain tumours. Regrettably, it's not always possible to make vaccines that are fully protective in the long-term, and some vaccinations require boosters after a few years. With seasonal flu viruses that switch strains every year, we even need to immunize every year, until we have a universal flu jab in the market. With HIV and TB, we can only hope there will be a reliable HIV or TB vaccine one day.
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Brachioradialis
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And we're on the way towards fungal vaccination too, pretty helpful in terms of patients with HIV & indeed TB (~25% of primary TB --> chronic pulmonary aspergillosis).
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