The Role of Adult Pneumococcal Vaccination in Combating Antimicrobial Resistance: An Indian Perspective.

Respiratory infections, particularly pneumococcal infections, present a significant global health challenge, especially in developing countries like India. Streptococcus pneumoniae is a leading cause of lower respiratory tract infections (LRTIs), with high morbidity and mortality rates. In India, pneumococcal infections, compounded by antimicrobial resistance (AMR), have resulted in a substantial disease burden, particularly among older adults. Vaccination is a critical tool in reducing the burden of disease and combating AMR. Pneumococcal vaccines have been shown to significantly decrease the incidence of invasive pneumococcal disease (IPD) and antibiotic resistance in both vaccinated and unvaccinated populations through herd immunity. The use of pneumococcal conjugate vaccines (PCVs) such as PCV13, PCV15, and PCV20 for adults has significantly reduced hospitalizations, outpatient visits, and antibiotic prescriptions, highlighting their broad public health benefits in developed nations. On the contrary, India faces challenges in adult vaccination coverage due to low awareness, high costs, vaccine hesitancy, lack of provider recommendations, and national guidelines. Addressing these barriers through increased public awareness, dedicated vaccination centers, and collaboration with government and insurance stakeholders is essential to improve coverage and reduce the disease burden. Integrating vaccination into antimicrobial stewardship programs (AMSP), rational antibiotic use, and improved diagnostics are key to mitigating AMR.