The Role of Pediatric Immunization in Combating Antimicrobial Resistance: A Global Review (with an India Focus)

Antimicrobial resistance (AMR) threatens child health by increasing the risk of treatment failure, prolonged illness, complications, and mortality. Vaccines are a powerful but under-used AMR intervention: they prevent bacterial infections directly, avert viral illnesses that are often inappropriately treated with antibiotics, reduce transmission (including of resistant strains), and lower healthcare exposure where resistant organisms circulate. This review synthesizes the biological mechanisms linking immunisation to AMR reduction, evidence by vaccine (pneumococcal conjugate vaccine [PCV], Haemophilus influenzae type b [Hib], typhoid conjugate vaccine [TCV], influenza, rotavirus, measles, pertussis, varicella), and population-level outcomes (antibiotic consumption, resistant disease, otitis media, hospitalization). We integrate global policy (WHO Global Action Plan on AMR; Immunization Agenda 2030) with an India-specific lens (National Action Plan on AMR, ICMR AMR surveillance, Universal Immunisation Programme introductions of PCV/TCV). We propose metrics to track vaccine AMR impact, implementation strategies that align immunisation with antimicrobial stewardship, and a forward agenda for research (next gen vaccines for priority AMR pathogens, maternal infant strategies, and digital data integration).