Is there a difference in the immune response, efficacy, effectiveness and safety of seasonal influenza vaccine in males and females? – A systematic review

Tadount, Fazia; Doyon-Plourde, Paméla; Rafferty, Ellen; MacDonald, Shannon E.; Sadarangani, Manish; Quach, Caroline

doi:10.1016/j.vaccine.2019.10.091

Cited by 40 publications

(41 citation statements)

References 67 publications

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“…Although this elevated response is helpful in clearing virus, women of reproductive age also experience higher mortality and hospitalizations ( 64 – 68 ), possibly from collateral tissue damage to the lungs. The vigorous immune response in women also means that women experience more adverse events after vaccination ( 69 ). Indeed, a systems biology approach identified that high testosterone was correlated with a blunted response to the flu vaccine in men ( 24 ).…”

Section: Sex Differences In Human Lung and Lung Diseasesmentioning

confidence: 99%

Androgen and Androgen Receptors as Regulators of Monocyte and Macrophage Biology in the Healthy and Diseased Lung

2020

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Androgens, the predominant male sex hormones, drive the development and maintenance of male characteristics by binding to androgen receptor (AR). As androgens are systemically distributed throughout the whole organism, they affect many tissues and cell types in addition to those in male sexual organs. It is now clear that the immune system is a target of androgen action. In the lungs, many immune cells express ARs and are responsive to androgens. In this review, we describe the effects of androgens and ARs on lung myeloid immune cells-monocytes and macrophages-as they relate to health and disease. In particular, we highlight the effect of androgens on lung diseases, such as asthma, chronic obstructive pulmonary disease and lung fibrosis. We also discuss the therapeutic use of androgens and how circulating androgens correlate with lung disease. In addition to human studies, we also discuss how mouse models have helped to uncover the effect of androgens on monocytes and macrophages in lung disease. Although the role of estrogen and other female hormones has been broadly analyzed in the literature, we focus on the new perspectives of androgens as modulators of the immune system that target myeloid cells during lung inflammation.

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Section: Sex Differences In Human Lung and Lung Diseasesmentioning

confidence: 99%

Androgen and Androgen Receptors as Regulators of Monocyte and Macrophage Biology in the Healthy and Diseased Lung

2020

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“…26,[33][34][35][36][37][38][39][40][41][42][43] The latter by far outnumber those studies showing the presence of sex differences. A systematic review by Tadount et al (2019) highlighted that of the published studies investigating sex differences in influenza vaccine immunogenicity, the majority found no sex differences. 44 Only studies investigating adult participants were included, so whether this is the case for children remains unknown.…”

Section: Immunogenicity Studiesmentioning

confidence: 99%

“…A systematic review by Tadount et al (2019) highlighted that of the published studies investigating sex differences in influenza vaccine immunogenicity, the majority found no sex differences. 44 Only studies investigating adult participants were included, so whether this is the case for children remains unknown. Metaanalyses using individual participant data from the original trial data sets would be a more reliable approach to investigating sex differences than a systematic review.…”

Section: Immunogenicity Studiesmentioning

confidence: 99%

“…Rarely were sex differences in efficacy evaluated in these studies, as it is poor practice to assess subgroup comparisons not prespecified in the trial protocol. 46 A single efficacy study stratified by sex met eligibility criteria to be included by Tadount et al (2019) in their systematic review. 44 This phase III RCT found a significantly higher TIV efficacy in healthy young males compared to age-matched females.…”

Section: Efficacy and Effectiveness Studiesmentioning

confidence: 99%

“…46 A single efficacy study stratified by sex met eligibility criteria to be included by Tadount et al (2019) in their systematic review. 44 This phase III RCT found a significantly higher TIV efficacy in healthy young males compared to age-matched females. 32 This result is likely to be affected by interference of confounding factors such as vaccination history.…”

Section: Efficacy and Effectiveness Studiesmentioning

confidence: 99%

See 2 more Smart Citations

The effect of sex on responses to influenza vaccines

Denly

2020

Human Vaccines & Immunotherapeutics

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The poor uptake and limited effectiveness of seasonal influenza vaccines mean that influenza continues to create a significant burden of disease. It has been hypothesized that sex differences are present in responses to seasonal influenza vaccines, and that these differences may contribute to this poor vaccine success. This has led to the suggestion that vaccines should be tailored to an individual's biological sex. However, studies in this field are often low quality. Comprehensive analysis of the available literature reveals that there is insufficient evidence to support sex differences in vaccine immunogenicity, effectiveness, or efficacy. Nonetheless, differences in vaccine safety are consistently observed, with females reporting adverse events following immunization more frequently than males. Bas introduced by gender differences in passive reporting of adverse effects may underlie this phenomenon. Highly controlled studies are required in future before any conclusions can be made about potential sex differences in response to seasonal influenza vaccines.

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The Effect of Sex on the Incidence, Latency, Duration and Perceived Burden of Adverse Events Following Seasonal Influenza Vaccination in the Netherlands

Slingerland,

van Hunsel,

Lieber

et al. 2023

Drug Saf

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Is there a difference in the immune response, efficacy, effectiveness and safety of seasonal influenza vaccine in males and females? – A systematic review

Cited by 40 publications

References 67 publications

Androgen and Androgen Receptors as Regulators of Monocyte and Macrophage Biology in the Healthy and Diseased Lung

Androgen and Androgen Receptors as Regulators of Monocyte and Macrophage Biology in the Healthy and Diseased Lung

The effect of sex on responses to influenza vaccines

The Effect of Sex on the Incidence, Latency, Duration and Perceived Burden of Adverse Events Following Seasonal Influenza Vaccination in the Netherlands

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