ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
Association of Frailty, Age, and Biological Sex With Severe Acute Respiratory Syndrome Coronavirus 2 Messenger RNA Vaccine-Induced Immunity in Older Adults.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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41 citing papers in PubMed, 60 citations in OpenAlex.
- Trial
- Associations between biological age acceleration and hospitalization burden of community-acquired pneumonia: a cohort study.GeroScience · 2026Article
- Variability in the TLR3 type I interferon pathway is predictive of RNA vaccine responses.Science advances · 2026Article
- The problem with one-size-fits-all medicine: Biological sex and the aging immune system.PLoS biology · 2026Article
- Long-term kinetics of anti-RBD IgG antibodies 16 months after COVID-19 vaccination in Morocco: a longitudinal cohort study.Scientific reports · 2026Article
- Sex differences in immune responses to viruses, bacteria and vaccines.Nature immunology · 2026Review
- Adherence to the Mediterranean diet, particularly olive oil intake, and metabolic health parameters are independently associated with SARS-CoV-2 vaccine-induced IgG responses.Metabolism open · 2026Article
- Observational
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- COVID-19 mRNA or viral vector vaccine type and subject sex influence the SARS-CoV-2 T-cell response.Vaccine · 2025Article
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- COVID-19 booster doses reduce sex disparities in antibody responses among nursing home residents.Aging clinical and experimental research · 2025Article
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- Nucleic acid vaccines: innovations, efficacy, and applications in at-risk populations.Frontiers in immunology · 2025Review
- Application of machine learning algorithms to identify serological predictors of COVID-19 severity and outcomes.Communications medicine · 2024Article
- Reconsidering tools for measuring gender dimensions in biomedical research.Biology of sex differences · 2024Article
- Health characteristics associated with persistence of SARS-CoV-2 antibody responses after repeated vaccinations in older persons over time: the Doetinchem cohort study.Immunity & ageing : I & A · 2024Article
- Sex differences in symptoms following the administration of BNT162b2 mRNA COVID-19 vaccine in children below 5 years of age in Germany (CoVacU5): a retrospective cohort study.Biology of sex differences · 2024Article
- Immunogenicity of an Inactivated COVID-19 Vaccine in People Living with HIV in Guangxi, China: A Prospective Cohort Study.Viruses · 2024Article
- Impact of ageing on homologous and human-coronavirus-reactive antibodies after SARS-CoV-2 vaccination or infection.NPJ vaccines · 2024Article
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27 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundMale sex and old age are risk factors for severe coronavirus disease 2019, but the intersection of sex and aging on antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines has not been characterized.
methodsPlasma samples were collected from older adults (aged 75-98 years) before and after 3 doses of SARS-CoV-2 mRNA vaccination, and from younger adults (aged 18-74 years) post-dose 2, for comparison. Antibody binding to SARS-CoV-2 antigens (spike protein [S], S receptor-binding domain, and nucleocapsid), functional activity against S, and live-virus neutralization were measured against the vaccine virus and the Alpha, Delta, and Omicron variants of concern (VOCs).
resultsVaccination induced greater antibody titers in older females than in older males, with both age and frailty associated with reduced antibody responses in males but not females. Responses declined significantly in the 6 months after the second dose. The third dose restored functional antibody responses and eliminated disparities caused by sex, age, and frailty in older adults. Responses to the VOCs, particularly the Omicron variant, were significantly reduced relative to the vaccine virus, with older males having lower titers to the VOCs than older females. Older adults had lower responses to the vaccine and VOC viruses than younger adults, with greater disparities in males than in females.
conclusionsOlder and frail males may be more vulnerable to breakthrough infections owing to low antibody responses before receipt of a third vaccine dose. Promoting third dose coverage in older adults, especially males, is crucial to protecting this vulnerable population.
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