Vaccines are different from antibiotics in that they are designed to use your own immune system. Whereas an antibiotic targets a bacterial weakness which the bacteria can fix, the immune system watches for both specific invaders and possible variations of those invaders.
Vaccines are very different to antibiotics. Antibiotics are agents which kill bacteria, whereas vaccines train the body to respond to infection using its own antibodies. Vaccines do nothing once you've been infected: they're about increasing your body's immune response to an infection down the line.
Additionally, most of the diseases we vaccinate against are caused by viruses. Whilst it's possible for viruses to mutate, this isn't a huge problem because we can simply modify the vaccine to use the new strain (hence why the flu vaccine is given annually). This doesn't apply for antibiotics: we need to find a new agent, which may not exist.
But that is the point being made. These two are not similar.
Antibiotics are a general purpose thing. Using them on trivial cases can increase antibiotic resistance which is bad for the cases where we really need antibiotics.
Vaccines are specific. You can't accrue "vaccine resistance" as a catch all thing by applying vaccines to everyone. You may create pressure for a virus to work around specific vaccines, but the only risk is that we will need to adjust the vaccine. Unlike with antibiotics where we really just need to try and find a new alternative.
Antibiotics are, by and large, reactive. Vaccines are, by and large, prophylactic.
I am the furthest thing from an expert in this field, but the herd immunity from vaccines provides an entirely different protection than a 'toolset' of working antibiotics.
My naive understanding is that if you have 100% vaccine coverage, it's simply way more unlikely that a virus or bacterium can catch a foothold of reproduction that would even make possible the mutations that result in resistance. And then you have viruses like influenza that are so widespread and elusive that they change annually. But we've gotten really good at responding to that rapid change as well.
Vaccines never prevent infection, your immune system always takes a while to spin up.
What vaccines do is dramatically shorten the time needed for a strong immune response because your body built infrastructure to help fight that specific disease. This tends to dramatically alter what happens afterwards. To the point you may not notice the symptoms or have significant symptoms instead of a hospitalization etc.
Seeing as we've wiped out multiple viruses completely, but have yet to eliminate any bacterial diseases, I believe there is an important difference between vaccines and antibiotics.
Perhaps viruses are simply more specialized, so it's easier to eliminate anywhere to hide by innocculating affected populations, while bacteria are more general purpose and can survive even without living hosts.
All vaccines boost the immune system. It seems like a lot of people misunderstand how vaccines work (not saying you do). Vaccines don't fight of infections for you, they train the immune system to correctly identify pathogens so the immune system can fight them off more efficiently.
There are reasons to believe, and some experience to point to, that this effect doesn’t work with vaccines as much as it does with antibiotics.
It’s a long story, but part of the reason is that bacteria evolve resistance in the presence of the antibiotic, while here, the virus would need to randomly evolve it in the unvaccinated, then sustain useless adaption for a while until it gets the opportunity to infect a vaccinated person.
Vaccines are very different from antibiotics. Antibiotics are single molecules that bind a very specific target. A single mutation of a single protein can render an antibiotic useless. Vaccines induce the immune system to generate a repertoire of antibodies, each of which binds in a different way and each of which is then selected and "evolved" (hypermutation) for increased efficacy. And each individual person creates a different starting and ending repertoire of antibodies. A single mutation, or even a large group of mutations, does not so easily side step all this diversity of antibody types/binding modes. Moreover, we have evidence that the idea that vaccines increase the likelihood of variants is just wrong. We do not see that effect for mumps, polio, smallpox, or any other virus. Moreover, delta appears to have arisen in India, which at the time had vaccination rates very close to zero. Again, providing strong evidence that vaccines are not applying selective pressure for more virulent strains.
"Here we argue that vaccines are less vulnerable to pathogen evolution than are antimicrobial drugs because of differences in the way drugs and vaccines work. We contend that two key features of vaccines have large, synergistic effects on the rate at which resistance arises and then spreads"
"(a) Timing of action - For most infectious diseases, hours to days elapse between exposure to a pathogen and symptomatic infection in a host ... Pathogen replication during this incubation period creates opportunities for mutations to arise"
"(b) Multiplicity of therapeutic targets within and between hosts - The benefit of combination therapy is based on the premise that resistance can only be acquired by the simultaneous acquisition of resistance to each component drug. The probability of simultaneous acquisition becomes vanishingly small as the number of drugs increases. A vaccine, however, often exposes the host immune system to multiple pathogen proteins (antigens), and multiple potential binding sites (epitopes) on each antigen. Epitopes are recognized and bound by components of the immune system analogously to how biochemical molecules would interact with a drug or its downstream products. This means that immunity is in effect acting like combination therapy, but with substantially more component effectors (and hence targets) than any drug cocktail."
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"One set of differences between vaccines and drugs stem from the fact that vaccine effects are mediated through host immune responses while drugs effects are mediated through chemical pathways"
They discount this as being a major factor but the only evidence they provide is that "resistance is seen against drugs such as solfonamides that also act indirectly."
It could also be considered that the immune system is adaptive and its capacities evolve during a person's lifetime and that the collective immune system within a population group evolves depending on the spread (or lack there of) of disease within the population group.
With vaccines we are triggering the evolution of individual and group immune systems in ways that we don't fully understand and so unlike with drugs where once resistance is formed we have to develop a new drug, individual and group immune systems continue to evolve even if the vaccines don't change. The same vaccine administered now may be triggering different responses than it did 100 years ago.
This is incorrect. A vaccine is not an antibiotic; the presence of one does not cause virulent strains. Vaccinations trigger the body's immune response to the virus; nothing else. They provide for a more effective response faster, but do not otherwise provide any forcing function.
Mutations and variants occur all the time as the virus reproduces. Variants are not a response to any vaccine; they have appeared primarily (entirely? I haven't been following all of them) in regions where the vaccine is not yet widely available because that is where the virus is able to multiply (and thus mutate) the fastest.
Vaccines prevent _diseases_ that can be dangerous, or even deadly. Vaccines greatly reduce the _risk_ of infection by working with the body’s natural defenses to safely develop immunity to disease.
Kurzgesagt made a good explainer video on this recently: https://www.youtube.com/watch?v=LmpuerlbJu0
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