Sex-based differences in immune function and responses to vaccination

Trans R Soc Trop Med Hyg. 2015 Jan;109(1):9-15. doi: 10.1093/trstmh/tru167.


Females typically develop higher antibody responses and experience more adverse reactions following vaccination than males. These differences are observed in response to diverse vaccines, including the bacillus Calmette-Guerin vaccine, the measles, mumps and rubella vaccine, the yellow fever virus vaccine and influenza vaccines. Sex differences in the responses to vaccines are observed across diverse age groups, ranging from infants to aged individuals. Biological as well as behavioral differences between the sexes are likely to contribute to differences in the outcome of vaccination between the sexes. Immunological, hormonal, genetic and microbiota differences between males and females may also affect the outcome of vaccination. Identifying ways to reduce adverse reactions in females and increase immune responses in males will be necessary to adequately protect both sexes against infectious diseases.

Keywords: Estrogen; Gender; Microbiome; Sex difference; Vaccine; X chromosome.

Publication types

  • Review

MeSH terms

  • Adaptive Immunity / drug effects*
  • Adverse Drug Reaction Reporting Systems / statistics & numerical data
  • Antibodies, Viral / biosynthesis*
  • BCG Vaccine / administration & dosage
  • BCG Vaccine / adverse effects
  • Cytokines / immunology*
  • Gonadal Steroid Hormones / immunology*
  • Humans
  • Immunity, Innate / drug effects*
  • Immunization Schedule
  • Influenza Vaccines / administration & dosage
  • Influenza Vaccines / adverse effects
  • Measles-Mumps-Rubella Vaccine / administration & dosage
  • Measles-Mumps-Rubella Vaccine / adverse effects
  • Risk Assessment
  • Sex Factors
  • Vaccination* / statistics & numerical data
  • Yellow Fever Vaccine / administration & dosage
  • Yellow Fever Vaccine / adverse effects


  • Antibodies, Viral
  • BCG Vaccine
  • Cytokines
  • Gonadal Steroid Hormones
  • Influenza Vaccines
  • Measles-Mumps-Rubella Vaccine
  • Yellow Fever Vaccine