Sex-Differential and Non-specific Effects of Vaccines Over the Life Course

Laura A.St Clair, Sabal Chaulagain, Sabra L. Klein, Christine Stabell Benn, Katie L. Flanagan*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingBook chapterResearchpeer-review


Biological sex and age have profound effects on immune responses throughout the lifespan and impact vaccine acceptance, responses, and outcomes. Mounting evidence from epidemiological, clinical, and animal model studies show that males and females respond differentially to vaccination throughout the lifespan. Within age groups, females tend to produce greater vaccine-induced immune responses than males, with sex differences apparent across all age groups, but are most pronounced among reproductive aged individuals. Females report more adverse effects following vaccination than males. Females, especially among children under 5 years of age, also experience more non-specific effects of vaccination. Despite these known sex- and age-specific differences in vaccine-induced immune responses and outcomes, sex and age are often ignored in vaccine research. Herein, we review the known sex differences in the immunogenicity, effectiveness, reactogenicity, and non-specific effects of vaccination over the lifespan. Ways in which these data can be leveraged to improve vaccine research are described.

Original languageEnglish
Title of host publicationSex and Gender Differences in Infection and Treatments for Infectious Diseases
EditorsSabra L. Klein, Craig W. Roberts
Number of pages27
Publication date2023
ISBN (Print)978-3-031-35138-9
ISBN (Electronic)978-3-031-35139-6
Publication statusPublished - 2023
SeriesCurrent Topics in Microbiology and Immunology


  • Adverse reaction
  • Antibody response
  • Sex chromosomes
  • Sex steroids
  • Vaccine acceptance
  • Vaccine efficacy


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