Sex and gender differences in the outcomes of vaccination over the life course

Katie L. Flanagan, Ashley L. Fink, Magdalena Plebanski, Sabra L. Klein

Research output: Contribution to journalArticleResearchpeer-review

309 Citations (Scopus)


Both sex (i.e., biological differences) and gender (i.e., social or cultural influences) impact vaccine acceptance, responses, and outcomes. Clinical data illustrate that among children, young adults, and aged individuals, males and females differ in vaccine-induced immune responses, adverse events, and protection. Although males are more likely to receive vaccines, following vaccination, females typically develop higher antibody responses and report more adverse effects of vaccination than do males. Human, nonhuman animal, and in vitro studies reveal numerous immunological, genetic, hormonal, and environmental factors that differ between males and females and contribute to sex- and gender-specific vaccine responses and outcomes. Herein, we address the impact of sex and gender variables that should be considered in preclinical and clinical studies of vaccines.

Original languageEnglish
Pages (from-to)577-599
Number of pages23
JournalAnnual Review of Cell and Developmental Biology
Publication statusPublished - 6 Oct 2017


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

Cite this