https://doi.org/10.4081/monaldi.2021.1669

Gender differences in vaccine therapy: where are we in COVID-19 pandemic?

Vol. 91 No. 4 (2021)
Submitted: November 7, 2020
Accepted: March 24, 2021
Published: April 8, 2021
Gender and/or sex differences, vaccine, adverse reaction, COVID-19, SARS-CoV-2
Abstract Views: 9073
PDF: 2312
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Tiziana Ciarambino
tiziana.ciarambino@gmail.com
Internal Medicine Department, Marcianise Hospital, ASL Caserta, Italy.
Elena Barbagelata
Department of Internal Medicine, Lavagna Hospital, Genoa, Italy.
Graziamaria Corbi
Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
Immacolata Ambrosino
Local Healthcare Unit of Bari, Health District 10, Post-acute Care Triggiano, Bari, Italy.
Cecilia Politi
Head of Gender Medicine Area F.A.D.O.I., Internal Medicine Department, Isernia, Italy.
Franco Lavalle
Vicepresident OMCEO (Provincial order of surgeons and dentists), Bari, Italy.
Anna Ruggieri
Center for Gender Specific Medicine, Istituto Superiore Sanità, Rome, Italy.
Annamaria Moretti
President of GISeG (Italian Group for Health and Gender), Bari, Italy.

Vaccination is one of the greatest achievements of public health. Vaccination programs have contributed to the decline in mortality and morbidity of various infectious diseases. This review aims to investigate the impact of sex/gender on the vaccine acceptance, responses, and outcomes. The studies were identified by using PubMed, until 30th June 2020. The search was performed by using the following keywords: SARS-CoV-2, COVID-19, gender, sex, vaccine, adverse reaction. Clinical trials, retrospective and prospective studies were included. Studies written in languages other than English were excluded. Studies were included if gender differences in response to vaccination trials were reported. All selected studies were qualitatively analyzed. Innate recognition and response to viruses, as well as, adaptive immune responses during viral infections, differ between females and males. Unfortunately, a majority of vaccine trials have focused on healthy people, with ages between 18 to 65 years, excluding the elderly, pregnant women, post-menopausal female and children. In conclusion, it is apparent that the design of vaccines and vaccine strategies should be sex-specific, to reduce adverse reactions in females and increase immunogenicity in males. It should be mandatory to examine sex-related variables in pre-clinical and clinical vaccine trials, such as their crucial role for successful prevention of pandemic COVID-19.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Centers for Disease Control and Prevention (CDC). Ten great public health achievements--United States, 1900-1999. MMWR Morb Mortal Wkly Rep 1999;48:241-3.
Fine P, Eames K, Heymann DL. “Herd immunity”: a rough guide. Clin Infect Dis 2011;52:911- 6. DOI: https://doi.org/10.1093/cid/cir007
Omer SB, Salmon DA, Orenstein WA, et al. Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. N Engl J Med 2009;360:1981-8. DOI: https://doi.org/10.1056/NEJMsa0806477
Leask J. Target the fence-sitters. Nature 2011;473:443-5. DOI: https://doi.org/10.1038/473443a
Leask J, Kinnersley P, Jackson C, et al. Communicating with parents about vaccination: a framework for health professionals. BMC Pediatr 2012;12:154. DOI: https://doi.org/10.1186/1471-2431-12-154
Klein SL, Jedlicka A, Pekosz A. The Xs and Y of immune responses to viral vaccines. Lancet Infect Dis 2010;10:338–49. DOI: https://doi.org/10.1016/S1473-3099(10)70049-9
Potluri T, Fink AL, Sylvia KE, et al. Age associated changes in the impact of sex steroids on influenza vaccine responses in males and females. NPJ Vaccines 2019;4:29. DOI: https://doi.org/10.1038/s41541-019-0124-6
Ambrosino I, Barbagelata E, Ortona E, et al. Gender differences in patients with COVID-19: a narrative review. Monaldi Arch Chest Dis 2020;90:1389. DOI: https://doi.org/10.4081/monaldi.2020.1389
Zeng F, Dai C, Cai P, et al. A comparison study of SARS-CoV-2 IgG antibody between male and female COVID-19 patients: a possible reason underlying different outcome between gender. J Med Virol 2020;92:2050-4. DOI: https://doi.org/10.1002/jmv.25989
Ruggieri A, Anticoli S, D'Ambrosio A, et al. The influence of sex and gender on immunity, infection and vaccination. Ann Ist Super Sanita 2016;52:198-204.
Fischinger S, Boudreau CM, Butler AL, et al. Sex differences in vaccine-induced humoral immunity. Semin Immunopathol 2019;41:239-49. DOI: https://doi.org/10.1007/s00281-018-0726-5
Trigunaite A. Suppressive effects of androgens on the immune system. Cell Immunol 2015;294:87-94. DOI: https://doi.org/10.1016/j.cellimm.2015.02.004
Beyer WE, Palache AM, Kerstens R, Masurel N. Gender differences in local and systemic reactions to inactivated influenza vaccine, established by a meta-analysis of fourteen independent studies. Eur J Clin Microbiol Infect Dis 1996;15:65–70. DOI: https://doi.org/10.1007/BF01586187
Castelo-Branco C, Soveral I. The immune system and aging: a review. Gynecol Endocrinol 2014;30:16–22. DOI: https://doi.org/10.3109/09513590.2013.852531
Fink AL, Klein SL. Sex and gender impact immune responses to vaccines among the elderly. Physiology (Bethesda) 2015;30:408-16.
Wang CS, Wang ST, Chou P. Efficacy and cost-effectiveness of influenza vaccination of the elderly in a densely populated and unvaccinated community. Vaccine 2002;20:2494-9. DOI: https://doi.org/10.1016/S0264-410X(02)00181-0
Roper RL, Rehm KE. SARS vaccines: where are we? Expert Rev Vaccines 2009;8:887-98. DOI: https://doi.org/10.1586/erv.09.43
Graham RL, Donaldson EF, Baric RS. A decade after SARS: strategies for controlling emerging coronaviruses. Nat Rev Microbiol 2013;11:836-48. DOI: https://doi.org/10.1038/nrmicro3143
World Health Organization. DRAFT landscape of COVID-19 candidate vaccines. World Health Organization; 2020. Available from: https://www.who.int/docs/default-source/a-future-for-children/novel-coronavirus_landscape_covid-19.pdf?sfvrsn=4d8bd201_1&download=true
Clinical Trials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). Identifier: NCT04357028. Measles vaccine in HCW (MV-COVID19). 2020 April 22. Available from: https://clinicaltrials.gov/ct2/show/NCT04357028
Cutolo M, Smith V, Paolino S. Understanding immune effects of oestroges to explain the reduced morbidity and mortality in female versus male Covid-19 patients: comparison with autoimmunity and vaccination Clin Exp Rheumatol 2020;38:383-6.
Jackson LA, Anderson EJ, Rouphael NG, et al. An mRNA Vaccine against SARS-CoV-2 - Preliminary report. N Engl J Med 2020;383:1920-31. DOI: https://doi.org/10.1056/NEJMoa2022483
Perrotta F, Corbi G, Mazzeo G, et al. COVID-19 and the elderly: insights into pathogenesis and clinical decision-making. Aging Clin Exp Res 2020;32:1599-608. DOI: https://doi.org/10.1007/s40520-020-01631-y
Pagliano P, Scarpati G, Sellitto C, et al. Experimental pharmacotherapy for COVID-19: The latest advances. J Exp Pharmacol 2021;13:1-13. DOI: https://doi.org/10.2147/JEP.S255209

How to Cite

Ciarambino, Tiziana, Elena Barbagelata, Graziamaria Corbi, Immacolata Ambrosino, Cecilia Politi, Franco Lavalle, Anna Ruggieri, and Annamaria Moretti. 2021. “Gender Differences in Vaccine Therapy: Where Are We in COVID-19 Pandemic?”. Monaldi Archives for Chest Disease 91 (4). https://doi.org/10.4081/monaldi.2021.1669.
Copyright (c) 2021 The Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.