Imbalances in the immune system: Antibiotics can reduce the effectiveness of vaccinations in children

Immune system defect
Antibiotics can reduce the effectiveness of vaccination in children

There has been evidence for some time that antibiotics can impair the effectiveness of a vaccine. A research team is now investigating the effect on young children who have been vaccinated. In fact, the immune response decreases after taking the medications. But there are still questions.

If antibiotics are prescribed to young children, different vaccinations may have a worse effect. This is suggested by an American study whose results were published in the Journal of Pediatrics. As doctors believe, the intestinal microbiome, whose balance has been disrupted by antibiotics, can impair the success of vaccination – an argument, according to German experts, conclusive. The interaction of microorganisms in the intestine is important for digestion, among other things, but also for the immune system.

In fact, a 2019 study previously reported that antibiotics can reduce the effectiveness of vaccinations in adults. A team led by physicians Timothy Chapman and Michael Pichichiro of the Rochester General Hospital Research Institute analyzed blood samples from 560 children over a period of 6 to 24 months. The samples were taken as part of several examinations and when acute otitis media has occurred. 342 children in this group received approximately 1,700 units of antibiotics in the first 24 months of life, while 218 children received no antibiotics.

The researchers then analyzed the children’s antibody levels to the diphtheria, tetanus, polio, whooping cough, influenza and pneumococcal vaccines. The result: Antibody levels in children treated with antibiotics were, on average, lower than in those who did not receive antibiotics.

In those children who received antibiotics between the ages of nine and twelve months or more frequently, these levels were particularly often lower than the concentrations considered relevant for immune protection. “This would put them at risk for infection caused by the pathogens they have been vaccinated against,” explains Ulrich Schaible, director of the infection program at Borstel Research Centre, in an independent evaluation.

Shorter antibiotics seem to be better

A more differentiated look at the results shows that the antibiotic amoxicillin alone had no effect, but in combination with clavulanic acid it did. These combination drugs are prescribed due to their extended antibacterial effect. “It was also interesting that the combination of amoxicillin and clavulanate had less effect on antibody production five days later than it did after taking it for ten days,” Chapel notes, “so giving the antibiotics for a shorter period seems better.”

However, the expert also emphasizes that the effect of diseases for which antibiotics were administered on antibody formation after vaccination should be analyzed independently of antibiotic administration. This may mean screening children with similar conditions who have not received antibiotics. In addition, antibodies are only part of the immune response to the vaccine, adds Claudius Meyer of the University Medical Center Mainz: “The T-cell-mediated immune memory was not examined in the study, but according to a reasonable understanding, it would also have been induced and thus be It has a protective effect that can be mediated.” As the authors themselves wrote, they did not take any stool samples from children. However, these are necessary to determine the effect of antibiotics on the gut microbiome.

“Antibiotics, often prescribed in early childhood against middle ear infections, not only attack dangerous bacteria in the ear, but also beneficial bacteria in the gut microbiome,” says Cornelia Gocek of the University of Halle-Wittenberg. Connection. “The balance between bacteria and our immune system is disturbed as a result and it is conceivable that vaccinations will not be fully effective, which could lead to reduced immune protection.”

Probiotics can have an effect

This association remains theoretical in the current study, as the gut microbiome has not been examined. It’s possible that taking probiotics to protect the gut microbiome could reduce the effect observed in the study, Gocek added. However, this still needs to be researched.

It is also not currently possible to determine whether children treated with antibiotics should be boosted, Mayer adds: “It may be useful to have a follow-up examination at the age of three or five to determine the need for a booster dose.” In some countries, some vaccines will be boosted Under study during childhood anyway. “Only a follow-up study with the same children can show whether children who received antibiotics can still be distinguished from the control group after the booster vaccination.”

Overall, the new study provides excellent evidence for the problematic side effects of antibiotics, and Mayer summarizes: “Not only the development of resistance when antibiotics are given, but also the physiological effects should prompt us to use antibiotics carefully in childhood and limit them to what is absolutely necessary.” .

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