Internal Medicine Department, Marcianise Hospital, ASL Caserta.
Department of Internal Medicine, Lavagna Hospital, Genoa.
Monaldi Arch Chest Dis. 2021 Apr 8;91(4). doi: 10.4081/monaldi.2021.1669.
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.
疫苗接种是公共卫生领域最伟大的成就之一。疫苗接种计划有助于降低各种传染病的死亡率和发病率。本综述旨在探讨性别对疫苗接种接受度、反应和结果的影响。使用 PubMed 数据库，检索截至 2020 年 6 月 30 日的相关文献。检索词为“SARS-CoV-2、COVID-19、性别、疫苗、不良反应”。纳入临床试验、回顾性和前瞻性研究。排除非英文发表的文献。仅纳入报道疫苗接种试验中性别差异的研究。对所有入选研究进行定性分析。女性和男性在对病毒的先天识别和反应以及病毒感染期间的适应性免疫反应方面存在差异。不幸的是，大多数疫苗试验都集中在 18 至 65 岁的健康人群，排除了老年人、孕妇、绝经后女性和儿童。总之，显然疫苗的设计和疫苗策略应该具有性别特异性，以减少女性的不良反应并提高男性的免疫原性。在疫苗临床试验的临床前和临床研究中，应该强制性地检查与性别相关的变量，例如它们对成功预防大流行 COVID-19 的重要作用。
