Trans R Soc Trop Med Hyg (2015) 109 (1): 1-2. doi: 10.1093/trstmh/tru188
Vaccines have sex differential non-targeted heterologous effects: a new dawn in vaccine research
Katie L. Flanagan Key words
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The WHO Strategic Advisory Group of Experts (SAGE) on immunization recently published their conclusions from a systematic review of the ?non-specific? or ?heterologous effects? of vaccines, hailing a new era in our understanding of what vaccines do to the immune system.1 The report recognizes that bacille Calmette-Gu?rin (BCG) vaccine and measles vaccine (MV) may provide survival benefits against infectious diseases other than those targeted by the vaccine. These non-specific or heterologous effects of vaccines, whereby vaccines alter susceptibility to infections other than that targeted by the vaccine, can be beneficial as is the case for BCG and MV; but other vaccines such as diphtheria-tetanus-pertussis (DTP) vaccine may increase susceptibilty to infections, although WHO conclude that the data supporting deleterious effects of DTP are inconclusive.1 As a rule females seem to be more susceptible to these vaccine-induced heterologous effects than males.2,3
Vaccines have sex differential non-targeted heterologous effects: a new dawn in vaccine research
Katie L. Flanagan Key words
Next Section
The WHO Strategic Advisory Group of Experts (SAGE) on immunization recently published their conclusions from a systematic review of the ?non-specific? or ?heterologous effects? of vaccines, hailing a new era in our understanding of what vaccines do to the immune system.1 The report recognizes that bacille Calmette-Gu?rin (BCG) vaccine and measles vaccine (MV) may provide survival benefits against infectious diseases other than those targeted by the vaccine. These non-specific or heterologous effects of vaccines, whereby vaccines alter susceptibility to infections other than that targeted by the vaccine, can be beneficial as is the case for BCG and MV; but other vaccines such as diphtheria-tetanus-pertussis (DTP) vaccine may increase susceptibilty to infections, although WHO conclude that the data supporting deleterious effects of DTP are inconclusive.1 As a rule females seem to be more susceptible to these vaccine-induced heterologous effects than males.2,3
Trans R Soc Trop Med Hyg (2015) 109 (1): 77-84. doi: 10.1093/trstmh/tru186
]Sex-differential and non-specific effects of routine vaccinations in a rural area with low vaccination coverage: an observational study from Senegal
Results At 12 months the vaccination coverage was 44%, 46% and 9%, respectively, for BCG, DTP1 and MV. Most children received BCG+DTP1-first and this combination was associated with a significantly lower mortality rate ratio (MRR) of 0.69 (0.53?0.89) compared with unvaccinated children. There was no benefit for children receiving BCG-first or DTP1-first. The female-male MRR was 0.79 (0.64?0.96) among unvaccinated children, but was significantly inversed with 1.45 (1.00?2.10) for children receiving DTP vaccination (test of homogeneity, p=0.006). Children who had received DTP simultaneously with MV or DTP after MV had significantly higher mortality (MRR=2.59 [1.32?5.07]) compared with children having MV-only as their most recent vaccination. After 9 months, the female-male MRR was 0.61 (0.31?1.19) for measles-vaccinated children but remained 1.54 (1.03?2.31) for DTP-vaccinated children who had not received MV (p=0.01).
Conclusions The sequence of routine vaccinations is important for the overall impact on child survival and these vaccines are associated with sex-differential effects.
]Sex-differential and non-specific effects of routine vaccinations in a rural area with low vaccination coverage: an observational study from Senegal
Results At 12 months the vaccination coverage was 44%, 46% and 9%, respectively, for BCG, DTP1 and MV. Most children received BCG+DTP1-first and this combination was associated with a significantly lower mortality rate ratio (MRR) of 0.69 (0.53?0.89) compared with unvaccinated children. There was no benefit for children receiving BCG-first or DTP1-first. The female-male MRR was 0.79 (0.64?0.96) among unvaccinated children, but was significantly inversed with 1.45 (1.00?2.10) for children receiving DTP vaccination (test of homogeneity, p=0.006). Children who had received DTP simultaneously with MV or DTP after MV had significantly higher mortality (MRR=2.59 [1.32?5.07]) compared with children having MV-only as their most recent vaccination. After 9 months, the female-male MRR was 0.61 (0.31?1.19) for measles-vaccinated children but remained 1.54 (1.03?2.31) for DTP-vaccinated children who had not received MV (p=0.01).
Conclusions The sequence of routine vaccinations is important for the overall impact on child survival and these vaccines are associated with sex-differential effects.
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