ArticleImmunity & ageing : I & A2023
The intersection of biological sex and gender in adverse events following seasonal influenza vaccination in older adults.
Article in Immunity & ageing : I & A, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 14 citations in OpenAlex.
- Adverse Events Following Yellow Fever Vaccination in Older Adults in Colombia, 2024-2025: A National Pharmacovigilance Analysis.Vaccines · 2026Article
- Factors determining first influenza vaccination among individuals with type 2 diabetes in the CONSTANCES cohort by age group (younger than 65 years or 65 and older).Human vaccines & immunotherapeutics · 2025Article
- Pharmacovigilance assessment of adverse events following yellow fever vaccination: Disproportionality analysis of VAERS reports, 2015-2025.Human vaccines & immunotherapeutics · 2025Article
- Applicability of Retrospective and Prospective Gender Scores for Clinical and Health Data: Protocol for a Scoping Review.JMIR research protocols · 2025Article
- Reconsidering tools for measuring gender dimensions in biomedical research.Biology of sex differences · 2024Article
- Adverse Events as a Function of Biological Sex in a Multicenter Clinical Trial of Melanoma Vaccines.Cancers · 2024Article
- Sex and gender differences in adverse events following influenza and COVID-19 vaccination.Biology of sex differences · 2024Article
- Review
- SARS-CoV-2 mucosal vaccine protects against clinical disease with sex bias in efficacy.Vaccine · 2024Article
- Fundamental and frontier research of immune responses to influenza vaccines in human aging: from cross-sectional and longitudinal studies to clinical trials and the geroscience perspective.Immunity & ageing : I & A · 2023Article
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13 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundWomen/females report more adverse events (AE) following immunization than men/males for many vaccines, including the influenza and COVID-19 vaccines. This discrepancy is often dismissed as a reporting bias, yet the relative contributions of biological sex and gender are poorly understood. We investigated the roles of sex and gender in the rate of AE following administration of the high-dose seasonal influenza vaccine to older adults (≥ 75 years) using an AE questionnaire administered 5-8 days post-vaccination. Participant sex (male or female) was determined by self-report and a gender score questionnaire was used to assign participants to one of four gender categories (feminine, masculine, androgynous, or undifferentiated). Sex steroid hormones and inflammatory cytokines were measured in plasma samples collected prior to vaccination to generate hypotheses as to the biological mechanism underpinning the AE reported.
resultsA total of 423 vaccines were administered to 173 participants over four influenza seasons (2019-22) and gender data were available for 339 of these vaccinations (2020-22). At least one AE was reported following 105 vaccinations (25%), by 23 males and 82 females. The majority of AE occurred at the site of injection, were mild, and transient. The odds of experiencing an AE were 3-fold greater in females than males and decreased with age to a greater extent in females than males. The effects of gender, however, were not statistically significant, supporting a central role of biological sex in the occurrence of AE. In males, estradiol was significantly associated with IL-6 and with the probability of experiencing an AE. Both associations were absent in females, suggesting a sex-specific effect of estradiol on the occurrence of AE that supports the finding of a biological sex difference.
conclusionsThese data support a larger role for biological sex than for gender in the occurrence of AE following influenza vaccination in older adults and provide an initial investigation of hormonal mechanisms that may mediate this sex difference. This study highlights the complexities of measuring gender and the importance of assessing AE separately for males and females to better understand how vaccination strategies can be tailored to different subsets of the population.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.