Co esponding au ho : Venugopal Reddy. I
Copy igh © 2025 Au ho (s) e ain he copy igh o his a icle. This a icle is published unde he e ms o he C ea i e Commons A ibu ion License 4.0.
The Role o Pedia ic Immuniza ion in Comba ing An imic obial Resis ance: A Global
Re iew (wi h an India Focus)
Venugopal Reddy. I 1, * and Bhaska Shenoy 2
1 Depa men o Pedia ics, O um Woman and Child Speciali y Hospi al, Banaglo e.
2 Depa men o Pedia ics and Pedia ic In ec ious Diseases, Manipal Hospi al,Bangalo e, India
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 24(02), 018-026
Publica ion his o y: Recei ed on 24 Sep embe 2025; e ised on 01 No embe 2025; accep ed on 03 No embe 2025
A icle DOI: h ps://doi.o g/10.30574/wjbphs.2025.24.2.0977
Abs ac
An imic obial esis ance (AMR) h ea ens child heal h by inc easing he isk o ea men ailu e, p olonged illness,
complica ions, and mo ali y. Vaccines a e a powe ul bu unde -used AMR in e en ion: hey p e en bac e ial
in ec ions di ec ly, a e i al illnesses ha a e o en inapp op ia ely ea ed wi h an ibio ics, educe ansmission
(including o esis an s ains), and lowe heal hca e exposu e whe e esis an o ganisms ci cula e. This e iew
syn hesizes he biological mechanisms linking immunisa ion o AMR educ ion, e idence by accine (pneumococcal
conjuga e accine [PCV], Haemophilus in luenzae ype b [Hib], yphoid conjuga e accine [TCV], in luenza, o a i us,
measles, pe ussis, a icella), and popula ion-le el ou comes (an ibio ic consump ion, esis an disease, o i is media,
hospi aliza ion). We in eg a e global policy (WHO Global Ac ion Plan on AMR; Immuniza ion Agenda 2030) wi h an
India-speci ic lens (Na ional Ac ion Plan on AMR, ICMR AMR su eillance, Uni e sal Immunisa ion P og amme
in oduc ions o PCV/TCV). We p opose me ics o ack accine AMR impac , implemen a ion s a egies ha align
immunisa ion wi h an imic obial s ewa dship, and a o wa d agenda o esea ch (nex gen accines o p io i y AMR
pa hogens, ma e nal in an s a egies, and digi al da a in eg a ion).
Keywo ds: Pedia ic Immunisa ion; An imic obial Resis ance; PCV; Hib; TCV; In luenza; Ro a i us; India; ICMR;
An imic obial S ewa dship; Vaccine-P e en able Diseases
1. In oduc ion
AMR is among he leading global heal h h ea s, wi h millions o dea hs associa ed wi h esis an bac e ial in ec ions
each yea [1–3]. Child en a e disp opo iona ely a ec ed due o high in ec ion incidence, empi ical an ibio ic use, and
exposu e in communi y and hospi al se ings. Vaccina ion is one o he ew in e en ions ha simul aneously educes
in ec ion incidence, an ibio ic demand, and ansmission o esis an o ganisms, he eby lowe ing selec ion p essu e
and slowing AMR eme gence [4–7]. Global s a egies (WHO Global Ac ion Plan on AMR, Immuniza ion Agenda 2030)
explici ly call ou accina ion as a co e AMR pilla [5,8,9]. In India, whe e in ec ious bu den and an ibio ic consump ion
a e high, he Uni e sal Immunisa ion P og amme (UIP) and Na ional Ac ion Plan on AMR (NAP-AMR) posi ion accines
as cen al o s ewa dship goals [10–12].
2. Mechanisms: how accines educe AMR
2.1. Biological and epidemiological pa hways
•Di ec p e en ion o bac e ial disease (e.g., PCV p e en s in asi e pneumococcal disease): ewe in ec ions
→ ewe an ibio ic cou ses → less selec ion o esis ance [4,6,13].
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• He d p o ec ion: educed ca iage/ ansmission o bo h suscep ible and esis an s ains (e.g., conjuga e
accines educe nasopha yngeal ca iage) [14–16].
• A e ing i al illnesses equen ly mismanaged wi h an ibio ics (in luenza, measles, o a i us): ewe
inapp op ia e an ibio ic p esc ip ions and ewe seconda y bac e ial in ec ions [7,17–19].
• Lowe heal hca e exposu e: ewe clinic/ED isi s and admissions educe isk o acqui ing esis an
o ganisms (e.g., ESBL, MRSA) [20].
• Se o ype eplacemen mode a ed by b oade - alen accines: highe - alen PCVs main ain ne AMR
bene i e en i some non- accine se o ypes expand [21].
• Syne gy wi h s ewa dship: accina ion educes baseline disease p essu e, allowing na owe empi ic
egimens and sho e cou ses [22].
3. E idence by Vaccine (Co e Pedia ic Schedule)
3.1. Pneumococcal conjuga e accine (PCV10/13/15/20)
3.1.1. Ou comes
Sha p declines in in asi e pneumococcal disease (IPD), pneumonia, acu e o i is media (AOM), all-cause an ibio ic
p esc ibing, and penicillin/cephalospo in- esis an IPD [13–16,21,23].
3.1.2. Mechanisms
Reduced ca iage o accine se o ypes (many his o ically esis an ) → he d e ec s in un accina ed g oups [14,15].
3.1.3. AMR link
Mul i-coun y analyses show subs an ial declines in esis an IPD a e PCV in oduc ion; o e all an ibio ic use in
child en alls due o ewe AOM/pneumonia episodes [13,16,21,23].
3.2. Haemophilus in luenzae ype b (Hib)
3.2.1. Ou comes
Ma ked educ ion in Hib meningi is/pneumonia and associa ed an ibio ics [24,25].
3.2.2. AMR link
Lowe disease bu den educes β-lac am exposu e; su eillance shows declines in Hib disease whe e esis ance had
been eme ging [24–26].
3.3. Typhoid conjuga e accine (TCV)
3.3.1. Ou comes
Signi ican educ ion o yphoid e e in endemic se ings and declines in mul id ug- esis an and luo oquinolone-
nonsuscep ible Salmonella Typhi [27–29].
3.3.2. India ele ance
TCV in oduc ion suppo s con ol o ex ensi ely d ug- esis an (XDR) yphoid h ea s ac oss Sou h Asia [10,27–30].
3.4 In luenza accine
3.3.3. Ou comes
Fewe eb ile espi a o y illnesses and ewe seconda y bac e ial complica ions ansla e in o lowe an ibio ic
p esc ip ions (o en inapp op ia e o i al disease) [17,31].
3.3.4. AMR link
E en modes inc eases in in luenza co e age can educe la ge olumes o unnecessa y an ibio ics a popula ion le el
[17,31].
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3.4. Ro a i us accine
3.4.1. Ou comes
La ge educ ions in se e e dia hoea and hospi aliza ion; s udies show educed an ibio ic use o gas oen e i is in
accina ed se ings [18,32].
3.4.2. AMR link
Cu ailing an ibio ic o e use in i al dia hoea di ec ly educes selec ion p essu e in he gu mic obiome [18,32].
3.5. Measles accine
3.5.1. Ou comes
A e s measles and pos -measles bac e ial in ec ions; dec eases an ibio ic exposu e associa ed wi h complica ions
(o i is media, pneumonia) [19,33].
3.5.2. AMR link
P e en ion o measles ou b eaks educes su ge-d i en, o en unnecessa y an ibio ic use [19,33].
3.6. Pe ussis and a icella accines
3.6.1. Ou comes
Lowe pe ussis and a icella incidence, ewe seconda y bac e ial in ec ions (e.g., a icella-associa ed impe igo) → less
an ibio ic use [34–36].
3.6.2. Take-home
Ac oss mul iple accines, he consis en pa e n is ewe in ec ions → ewe an ibio ic cou ses → less esis ance.
4. Popula ion-Le el Ou comes: An ibio ic Use and Resis ance
4.1.1. An ibio ic consump ion
A e PCV and Hib in oduc ions, se e al coun ies obse ed 10–30% educ ions in pedia ic ou pa ien an ibio ic
p esc ibing, especially o AOM and RTIs [16,21,23,37].
4.1.2. Resis an disease
Dec eases in penicillin- esis an IPD (PCV), MDR Typhi (TCV), and β-lac am-nonsuscep ible Hib a e documen ed in
su eillance epo s [13,24,27–29].
4.1.3. Heal hca e u iliza ion
Lowe hospi aliza ions educe nosocomial AMR exposu es (e.g., ESBL-En e obac e ales) [20].
4.1.4. Equi y
Gains a e g ea es whe e baseline disease bu den and an ibio ic exposu e a e high (LMICs) [7,18,27,32].
5. India: Bu den, Policy, and P og am In eg a ion
5.1. Bu den and su eillance
India aces a high incidence o pedia ic bac e ial and i al in ec ions wi h ising esis ance among p io i y pa hogens
(S. pneumoniae, H. in luenzae, S. Typhi, E. coli, K. pneumoniae) [10–12,38,39]. The ICMR AMR Su eillance Ne wo k and
he In eg a ed Heal h In o ma ion Pla o m (IHIP) p o ide expanding da a on esis ance pa e ns and accine-
p e en able disease ends [11,12,38].
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5.2. Policy amewo k
5.2.1. Na ional Ac ion Plan on AMR (NAP-AMR)
Recognizes immunisa ion as a co e p e en ion s a egy aligned wi h One Heal h [10].
5.2.2. Uni e sal Immunisa ion P og amme (UIP)
Na ionwide inco po a ion o Hib, PCV, o a i us, measles– ubella, and TCV (p og essi ely scaled). These educe illness
episodes ha ypically d i e an ibio ic demand [40–43].
5.2.3. Implemen a ion p io i ies
S eng hen dis ic -le el co e age, ca ch-up o missed doses, in eg a e accine/an ibio ic da a s eams, and expand
TCV in high- isk geog aphies.
5.3 Ea ly signals o impac
• Pos -PCV da a show downwa d ends in se e e pneumococcal disease; o a i us accine scale-up associa es
wi h ewe dia hea admissions (and an ibio ics) [41–43].
• TCV pilo s and phased ollou s in Indian s a es epo ewe yphoid cases and acili y isi s, wi h implica ions
o MDR Typhi con ol [28–30,41].
6. In eg a ion wi h An imic obial S ewa dship (AMS)
• Clinic/ED algo i hms combining accine s a us wi h RTI/AOM pa hways educe unnecessa y an ibio ic
ini ia ion (e.g., “ accine up- o-da e + mild i al URTI → no an ibio ics + e iew in 48–72 h”) [22,37].
• Hospi al s ewa dship ies discha ge an ibio ic du a ion o accine-media ed isk p o iles; e.g., pos -PCV AOM
p o ocols shi o wa ch ul wai ing mo e o en [23,37].
• Pe i-ou b eak esponse: Rapid accina ion (measles, in luenza) + AMS messaging → less panic p esc ibing
du ing ou b eaks [19,31].
• Digi al heal h: Link EIR/IIS wi h e-p esc ibing so ha accina ion episodes, missed doses, and an ibio ic ills
can be co-analyzed o quali y imp o emen [44–46].
7. Economics and Value o Money
Vaccines a oid di ec ea men cos s and AMR ex e nali ies (longe s ays, second-line d ugs). PCV, Hib, o a i us, and
TCV epea edly demons a e cos -e ec i eness when AMR cos s a e included. Modeling sugges s ha s ong accine
po olios could a e billions o dolla s in AMR- ela ed cos s o e decades in high-bu den se ings [6,29,32,47,48].
8. Implemen a ion challenges
• Co e age gaps (missed ze o-dose and unde -immunised communi ies) educe AMR bene i s [8,9].
• Se o ype/pa hogen eplacemen equi es ongoing su eillance and highe - alen o upda ed accines [21].
• Supply/ inancing cons ain s may delay in oduc ions (e.g., TCV) whe e AMR bene i is la ge [28,29].
• Da a agmen a ion be ween immunisa ion and pha macy/AMS da ase s hinde s a ibu ion o AMR gains [44–
46].
• Hesi ancy and communica ion issues can spike inapp op ia e an ibio ic demand du ing ou b eaks [31,33].
9. Measu ing he Vaccine–AMR E ec : P ac ical Me ics
9.1. P og am me ics
Co e age (by dose and dis ic ), imeliness, ze o-dose a e.
9.2. Clinical me ics
AOM/RTI isi s pe 1,000 child en; dia hea admissions; in luenza-like illness.
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9.3. An ibio ic me ics
Ou pa ien an ibio ic p esc ip ions/1,000 child-mon hs; “an ibio ics o i al diagnoses”; hospi al DOT (days o he apy)
o b oad-spec um agen s.
9.4. AMR me ics
IPD due o penicillin-nonsuscep ible S. pneumoniae; MDR Typhi incidence; Hib β-lac am nonsuscep ibili y; ESBL
coloniza ion among pedia ic admissions.
9.5. In eg a ed dashboa ds
Combine EIR/IIS + e-pha macy + lab AMR su eillance; epo qua e ly a dis ic /s a e/na ional le els [11,12,44–46].
10. Policy Recommenda ions (Global and India)
• Make accines a o mal AMR indica o . T ack accine co e age and AMR- ele an ou comes in AMR na ional
plans and WHO Join Ex e nal E alua ions [5,8,9].
• Accele a e in oduc ions and ca ch-up o PCV, Hib, o a i us, TCV, in luenza in high-bu den dis ic s;
p io i ize u ban slums and emo e blocks (India) [40–43].
• Link immunisa ion wi h AMS: embed accine p omp s in p esc ibing sys ems; audi “an ibio ics o i al
diagnoses”; publish accine-AMS sco eca ds [22,37,44].
• S eng hen su eillance: und ICMR/s a e labs o pedia ic AMR panels; couple wi h se o ype/s ain yping
(PCV) and S. Typhi esis ance genomics [11,12,21,28].
• In es in communica ion: explain he accine–AMR link o clinicians and pa en s; du ing ou b eaks, combine
accina ion d i es wi h a ge ed AMS messages [31,33].
• Plan o nex -gen accines a ge ing AMR-p io i y bac e ia (e.g., E. coli, K. pneumoniae); suppo ma e nal
immunisa ion o p o ec ea ly in ancy [49–51].
• Use digi al heal h: na ional dashboa ds ha o e lay co e age, an ibio ic use, and AMR wi h geo-analy ics
o ocus ou each [44–46].
Table 1 Pedia ic Vaccines and Thei AMR Pa hways/E ec s
Vaccine
P ima y Pa hogen/Illness
Main AMR Pa hways
Illus a i e Ou comes
PCV
(10/13/15/20)
S. pneumoniae (IPD,
pneumonia, AOM)
↓ in ec ions; ↓ ca iage
o esis an se o ypes;
he d e ec s
↓ penicillin/cephalospo in- esis an
IPD; ↓ AOM and an ibio ics [13–
16,21,23]
Hib
Hib meningi is/pneumonia
↓ disease and β-lac am
exposu e
↓ Hib disease; ewe an ibio ics [24–
26]
TCV
Salmonella Typhi
↓ MDR/XDR Typhi
ci cula ion
↓ yphoid incidence; ↓ esis an
Typhi [27–30]
In luenza
Vi al RTIs
↓ inapp op ia e
an ibio ics; ↓ seconda y
bac e ial in ec ions
↓ communi y an ibio ic use [17,31]
Ro a i us
Vi al dia hea
↓ an ibio ics o
gas oen e i is
↓ an ibio ic cou ses in child en
[18,32]
Measles
Measles and pos -measles
bac e ial in ec ions
↓ seconda y in ec ions
→ ↓ an ibio ics
↓ an ibio ic exposu e du ing
ou b eaks [19,33]
Pe ussis/Va icella
Pe ussis; a icella ±
seconda y skin in ec ions
↓ disease → ↓ an ibio ics
↓ an ibio ic demand [34–36]
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Table 2 S a egies o Maximise Vaccine Impac on AMR (Global + India)
Le el
S a egy
Ope a ional Elemen s
Expec ed AMR Bene i
Na ional (Global)
Make accines explici AMR
indica o s
Include co e age + AMR
ou comes in NAP-AMR M and E
Alignmen , accoun abili y
[5,8,9]
India
(MoHFW/ICMR)
Scale PCV, TCV; s eng hen
Hib/ o a i us/MR
Dis ic mic oplans; ca ch-up;
high- isk geog aphies
↓ an ibio ic consump ion; ↓
MDR Typhi; ↓ esis an IPD
[10–12,40–43]
Sys ems
In eg a e EIR/IIS wi h e-
p esc ibing and lab AMR
HL7-FHIR in e aces;
qua e ly dashboa ds
T ackable accine–AMR signal
[44–46]
Clinical (AMS)
Vaccine-awa e an ibio ic
algo i hms
“No an ibio ics o i al
diagnoses”; AOM wa ch ul
wai ing
↓ inapp op ia e ou pa ien
an ibio ics [22,23,37]
Ou b eaks
Rapid accina ion + AMS
comms
In luenza/measles campaigns;
ho line sc ip s
↓ panic p esc ibing [19,31,33]
R and D
Nex -gen AMR-p io i y
accines
Public–p i a e pa ne ships,
ma e nal/in an ocus
Fu u e educ ion in esis an
pa hogens [49–51]
Figu e 1 Mechanis ic Pa hways Linking Pedia ic Vaccina ion and AMR (ASCII, B/W)
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Fu u e Di ec ions
• Nex -gen accines o AMR p io i y pa hogens (E. coli, K. pneumoniae, S. au eus), op imized adju an s, and
ma e nal immunisa ion o p o ec neona es [49–51].
• Geno-su eillance in eg a ion: pai accine impac wi h pa hogen genomics o wa ch se o ype/s ain shi s and
esis ance e olu ion [21,28,49].
• Digi al con e gence: uni y immunisa ion, p esc ibing, and lab AMR da a; c ea e dis ic -le el dashboa ds o
a ge gaps and measu e AMR bene i in nea - eal ime [44–46].
• Beha io al science: design pa en /clinician nudges linking “ accines sa e an ibio ics” o p ac ical decisions
(e.g., AOM wa ch ul wai ing) [22,37].
• Equi y: p io i ise ze o-dose and emo e communi ies o cap u e he la ges AMR gains [8,9].
11. Conclusion
Pedia ic immunisa ion is a on -line AMR in e en ion. By p e en ing in ec ions, cu bing an ibio ic demand, limi ing
ansmission o esis an s ains, and educing heal hca e exposu e, accines deli e measu able AMR bene i s. Globally
and pa icula ly in India maximising PCV, Hib, TCV, o a i us, measles, and in luenza co e age, in eg a ing
immunisa ion wi h AMS, and linking da a sys ems o join accine–AMR moni o ing can subs an ially educe esis an
in ec ions and an ibio ic use. As nex -gene a ion accines and digi al in as uc u e ma u e, accina ion should be
ecognised and unded as a co e pilla o AMR con ol.
Compliance wi h e hical s anda ds
Disclosu e o con lic o in e es
No Con lic o In e es
Re e ences
[1] Wo ld Heal h O ganiza ion. Global An imic obial Resis ance and Use Su eillance Repo . Gene a: WHO; 2023.
[2] Mu ay CJL, Iku a KS, Sha a a F, e al. Global bu den o bac e ial an imic obial esis ance in 2019. Lance .
2022;399(10325):629–655.
[3] Cen e s o Disease Con ol and P e en ion. An ibio ic Resis ance Th ea s Repo . A lan a: CDC; 2023.
[4] Le in BR, An ia R, Blowe S, e al. A heo e ical amewo k o accines as ools o comba an imic obial
esis ance. Clin Mic obiol Re . 2017;30(4):937–976.
[5] Wo ld Heal h O ganiza ion. Global Ac ion Plan on An imic obial Resis ance. Gene a: WHO; 2015.
[6] O ganisa ion o Economic Co-ope a ion and De elopmen . S emming he Supe bug Tide: Jus a Few Dolla s
Mo e. Pa is: OECD; 2018.
[7] Ga i, he Vaccine Alliance. Vaccines as Tools o Figh An imic obial Resis ance: E idence Syn hesis. Gene a: Ga i;
2022.
[8] Wo ld Heal h O ganiza ion. Immuniza ion Agenda 2030: A Global S a egy o Lea e No One Behind. Gene a:
WHO; 2021.
[9] UNICEF. Immuniza ion Roadmap 2030. New Yo k: UNICEF; 2022.
[10] Minis y o Heal h and Family Wel a e, Go e nmen o India. Na ional Ac ion Plan on An imic obial Resis ance.
New Delhi: MoHFW; 2017 (upda ed edi ions).
[11] Indian Council o Medical Resea ch (ICMR). An imic obial Resis ance Su eillance Ne wo k Annual Repo . New
Delhi: ICMR; 2023.
[12] Na ional Cen e o Disease Con ol (NCDC) and ICMR. Na ional AMR Su eillance and Resea ch Ne wo k –
Me hods and Indica o s. New Delhi: NCDC/ICMR; 2022–2024.
[13] O’B ien KL, Wol son LJ, Wa JP, e al. Impac o pneumococcal conjuga e accine on an ibio ic- esis an
pneumococcal disease. N Engl J Med. 2009;360(3):244–256.
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 24(02), 018-026
25
[14] Moo e MR, Link-Gelles R, Scha ne W, e al. He d immuni y and se o ype shi s a e pneumococcal conjuga e
accine in oduc ion. J In ec Dis. 2015;211(6):881–891.
[15] B ueggemann AB, Pichon B, Panagio ou S, e al. Changes in pneumococcal ca iage and esis ance a e accine
in oduc ion. Clin In ec Dis. 2019;69(10):1831–1841.
[16] Madhi SA, e al. Pneumococcal conjuga e accine and educ ions in o i is media and an ibio ic use. Pedia ics.
2012;129(3):e561–e568.
[17] Dohe y M, Buchy P, S andae B, e al. In luenza accina ion and an ibio ic use: modelling and empi ical
e idence. Vaccine. 2016;34(50):6529–6536.
[18] Pi ze VE, e al. Ro a i us accina ion and an ibio ic p esc ibing o dia hoea. J Pedia ic In ec Dis Soc.
2020;9(5):540–549.
[19] Moss WJ. Measles con ol and educ ion o seconda y bac e ial in ec ions. In ec Dis Clin No h Am.
2011;25(1):179–193.
[20] Tacconelli E, Ca a a E, Sa oldi A, e al. Reducing nosocomial exposu e h ough p e en ion s a egies. Lance
In ec Dis. 2018;18(2):e306–e375.
[21] Hausdo WP, Dagan R, Klugman KP. Se o ype eplacemen and highe - alen pneumococcal accines:
implica ions o an imic obial esis ance. Vaccine. 2020;38(32):4932–4944.
[22] He sh AL, Fleming-Du a KE, Shapi o DJ, e al. Ou pa ien an ibio ic s ewa dship in pedia ics. Pedia ics.
2018;142(2):e20181165.
[23] Fi eman B, Black SB, Shine ield HR, e al. Pneumococcal conjuga e accine and an ibio ic p esc ibing ends o
acu e o i is media. Pedia ics. 2019;144(1):e20190510.
[24] Wa JP, Wol son LJ, O’B ien KL, e al. Global decline in Haemophilus in luenzae ype b disease a e accina ion.
Lance . 2009;374(9696):903–911.
[25] Collins S, e al. Hib accine impac on esis ance pa e ns. J An imic ob Chemo he . 2014;69(1):121–127.
[26] Cen e s o Disease Con ol and P e en ion. Hib Su eillance – Pos -Vaccine E a Summa ies. A lan a: CDC; 2022.
[27] Qad i F, e al. E ec i eness o yphoid conjuga e accine in Sou h Asia. Lance Glob Heal h. 2021;9(8):e1047–
e1055.
[28] B i o C, Dyson ZA, Duchene S, e al. Ex ensi ely d ug- esis an yphoid and he ole o conjuga e accine. Clin
In ec Dis. 2020;71(10):e185–e192.
[29] An illón M, Bilcke J, Pi ze VE. Typhoid conjuga e accine cos -e ec i eness and AMR implica ions. Lance In ec
Dis. 2017;17(7):729–739.
[30] Indian Council o Medical Resea ch (ICMR). Typhoid accina ion and an imic obial use educ ion in India: Policy
B ie . New Delhi: ICMR; 2023.
[31] Smi h DRM, e al. In luenza accina ion and an ibio ic p esc ibing in p ima y ca e. BMJ Open.
2021;11(7):e046883.
[32] Aliabadi N, Ta e JE, Haynes AK, e al. Declines in an ibio ic use a e o a i us accine in oduc ion. Clin In ec
Dis. 2019;69(11):2059–2066.
[33] Pe y RT, e al. Measles accina ion and seconda y bac e ial complica ions. J In ec Dis. 2012;205(Suppl 1):S28–
S33.
[34] Che y JD. Pe ussis accine impac on clinical disease and an ibio ic use. Pedia In ec Dis J. 2012;31(3):S47–
S50.
[35] Ma in M, e al. Va icella accina ion: complica ions and an ibio ic use. Clin In ec Dis. 2016;62(3):S60–S66.
[36] Le e A, e al. Bac e ial skin in ec ions seconda y o a icella: p e en ion by accina ion. J In ec .
2010;60(4):311–318.
[37] Fleming-Du a KE, e al. Inapp op ia e ou pa ien an ibio ic p esc ibing in child en. JAMA. 2016;315(17):1864–
1873.
[38] Cha e jee P, e al. Bu den o an ibio ic use in India. J An imic ob Chemo he . 2020;75(10):3051–3061.
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 24(02), 018-026
26
[39] Balasub amanian S, e al. Pedia ic in ec ious diseases and an imic obial esis ance in India. Indian Pedia .
2021;58(11):1021–1030.
[40] Minis y o Heal h and Family Wel a e (MoHFW). Uni e sal Immunisa ion P og amme – PCV Scale-up Policy
No es. New Delhi: MoHFW; 2022.
[41] Minis y o Heal h and Family Wel a e (MoHFW). Typhoid Conjuga e Vaccine (TCV) Pilo and Rollou Upda es.
New Delhi: MoHFW; 2023.
[42] Uni e sal Immunisa ion P og amme (UIP). Ro a i us and Measles-Rubella Co e age Repo s. New Delhi:
MoHFW; 2019–2024.
[43] Wo ld Heal h O ganiza ion – India. Immuniza ion P og amme Moni o ing Upda es. New Delhi: WHO India; 2025.
[44] Cen e s o Disease Con ol and P e en ion and HL7. Immuniza ion In o ma ion Sys ems and FHIR Guidance.
A lan a: CDC; 2023.
[45] Dis ic Heal h In o ma ion So wa e (DHIS2) T acke . Immuniza ion and AMR Indica o In eg a ion Guidance.
Oslo: DHIS2; 2024.
[46] Pan Ame ican Heal h O ganiza ion and Wo ld Heal h O ganiza ion. Linking Immunisa ion and AMR Da a
Sys ems: Technical B ie . Washing on DC: PAHO/WHO; 2023.
[47] Klugman KP, Black S. Impac o accines on an imic obial esis ance and economics. Vaccine. 2018;36(44):6606–
6612.
[48] Laxmina ayan R, e al. Economic bu den o AMR and p e en ion scena ios. Heal h Policy Plan. 2021;36(8):1249–
1257.
[49] Wo ld Heal h O ganiza ion. WHO P io i y Pa hogens Lis – Bac e ial AMR Upda e. Gene a: WHO; 2024.
[50] Micoli F, Adamo R, Cos an ino P, e al. Glycoconjuga e and p o ein accines agains AMR pa hogens. NPJ Vaccines.
2021;6(1):112.
[51] Madhi SA, e al. Ma e nal immunisa ion s a egies and in an p o ec ion. Lance . 2020;396(10255):688–700.
