Vaccines, Pharmacists Rome: Anti-pneumococcus against infections and antibiotic resistance

Maximum vaccination protection is a public good and should be guaranteed homogeneously at the national level. This is particularly true for pediatric vaccination against pneumococcal diseases, which has a significant impact on the reduction and use of antibiotics, and could thus contribute significantly to the reduction of antibiotic resistance (Abr), a growing health concern. In fact, pneumococcus is one of the main causes of serious and antibiotic-resistant invasive bacterial diseases, especially in children and the elderly. Anti-pneumococcal conjugate vaccines, by reducing nasopharyngeal colonization and decreasing transmission, therefore also contribute to combating antibiotic resistance. These are, in summary, the contents of the document drawn up by the Order of Pharmacists of Rome entitled ‘Ethics and deontology of vaccinations: focus on pneumococcus in pediatrics’.

One of the main pathogens responsible for serious and antibiotic-resistant diseases – the document states – is pneumococcus. In Italy, it is the first cause of invasive bacterial disease with two peaks (over 65 and children between 0 and 4 years); furthermore, the bacterium, in the form of colonization, is present in the nasopharynx of 27% of children between 4 and 9 years, who are therefore the main carriers.

In Italy, antibiotic-resistant strains are increasing. Vaccinations, especially anti-pneumococcal conjugate (Pcv) vaccines, play a fundamental role in countering the spread of resistant strains, especially among children, who are the main carriers of the bacterium, because they protect against the acquisition of nasopharyngeal colonization. This protection is the key to reducing the transmission of the microorganism and, therefore, for indirect protection from the disease in unvaccinated subjects. In fact, the vaccinated subject is less likely to be a carrier. Anti-pneumococcal vaccination in pediatric age is therefore a public health measure because it impacts both the circulation of antibiotic-resistant strains and the development of antibiotic-resistant diseases, with better outcomes the greater the number of serotypes present in the vaccine.

In light of this evidence, the document emphasizes the importance of adopting vaccines with broader coverage that protect against a greater number of serotypes. In particular, PCV20 has proven effective in preventing infections from antibiotic-resistant strains and in reducing antibiotic prescriptions. Studies conducted in the United States have shown that vaccination with PCV20 could prevent over 256,000 infections from resistant strains and save more than 720,000 antibiotic prescriptions.

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In Italy, Campania was the first region to adopt Pcv20 in the pediatric population, recognizing the urgency of ensuring maximum vaccine protection for newborns. The use of broad-spectrum vaccines, such as Pcv20, has also been associated with a reduction in the burden of pneumococcal diseases, both invasive and non-invasive, and with an improvement in long-term economic and clinical conditions. Positive experiences of co-administration of vaccines, already applied for other pathologies, indicate that this practice can improve vaccination coverage without increasing the burden on health workers.

In addition to the need to improve surveillance and diagnostic systems for more accurate monitoring of infections, the document supports the need for broader serotype coverage to protect the most vulnerable population and counteract the increase in antibiotic-resistant infections. Furthermore, from an ethical point of view, not protecting children with the most effective vaccines against pneumococcus, especially against lethal serotypes, is unacceptable.