TY - JOUR
T1 - Differences by sex in IgG levels following infant and childhood vaccinations: An individual participant data meta-analysis of vaccination studies
AU - Boef, Anna G. C.
AU - van der Klis, Fiona R. M.
AU - Berbers, Guy A. M.
AU - Buisman, Anne-Marie
AU - Sanders, Elisabeth A. M.
AU - Kemmeren, Jeanet M.
AU - van der Ende, Arie
AU - de Melker, Hester E.
AU - Rots, Nynke Y.
AU - Knol, Mirjam J.
PY - 2018
Y1 - 2018
N2 - Background: If immune responses to vaccination differ between males and females, sex-specific vaccination schedules may be indicated. We systematically reanalysed childhood vaccination studies conducted in The Netherlands for sex-differences in IgG-responses. To assess the impact of potential sex-differences in IgG-responses, we explored sex-differences in vaccine failure/effectiveness and reactogenicity. Methods: Six studies with IgG-measurements for 1577 children following infant pneumococcal(PCV7/ PCV10/PCV13) and/or DTaP-IPV-Hib(-HepB) vaccinations, or the pre-school DTaP-IPV booster were included. We performed one-stage individual participant data meta-analyses per time-point of the effect of sex on IgG levels against pneumococcal serotypes, diphtheria toxoid, tetanus toxoid, pertussis Ptx/FHA/Prn and Hib-PRP using linear mixed models. Using existing study data, we compared reactogenicity after PCV7/PCV10 and DTaP-IPV-Hib(-HepB) vaccination in girls and boys. Vaccine failure/effectiveness was compared between girls and boys for invasive pneumococcal disease (IPD), invasive Hib disease and pertussis using notification data. Results: For pneumococcal vaccination, the geometric mean concentration ratio of IgG levels in girls versus boys pooled across serotypes was 1.15 (95%Cl 0.91-1.45) 1 month following the primary series, 1.16 (1.02-1.32) at age 8 months, 1.12 (1.02-1.23) pre-booster (age 11 months) and 0.99 (0.89-1.10) post booster (age 12 months). Diphtheria toxoid, tetanus toxoid, pertussis Ptx/FHA/Prn and Hib-PRP IgG levels did not differ between girls and boys, except for Hib post-booster (1.24; 95%CI 1.01-1.52) and tetanus before pre-school booster (0.71; 0.53-0.95). We found no difference between boys and girls in reactogenicity at age 4 or 11 months or in vaccine failure/effectiveness for IPD, invasive Hib disease or pertussis. Conclusion: For most vaccine antigens investigated, there were no consistent differences in vaccine induced IgG levels. Vaccine-induced pneumococcal IgG levels were slightly higher in girls, but only between the primary series and the 11-month booster. These results, along with similar reactogenicity and vaccine failure/effectiveness, support the uniform infant vaccination schedule in the Dutch national immunisation programme. (C) 2017 Elsevier Ltd. All rights reserved
AB - Background: If immune responses to vaccination differ between males and females, sex-specific vaccination schedules may be indicated. We systematically reanalysed childhood vaccination studies conducted in The Netherlands for sex-differences in IgG-responses. To assess the impact of potential sex-differences in IgG-responses, we explored sex-differences in vaccine failure/effectiveness and reactogenicity. Methods: Six studies with IgG-measurements for 1577 children following infant pneumococcal(PCV7/ PCV10/PCV13) and/or DTaP-IPV-Hib(-HepB) vaccinations, or the pre-school DTaP-IPV booster were included. We performed one-stage individual participant data meta-analyses per time-point of the effect of sex on IgG levels against pneumococcal serotypes, diphtheria toxoid, tetanus toxoid, pertussis Ptx/FHA/Prn and Hib-PRP using linear mixed models. Using existing study data, we compared reactogenicity after PCV7/PCV10 and DTaP-IPV-Hib(-HepB) vaccination in girls and boys. Vaccine failure/effectiveness was compared between girls and boys for invasive pneumococcal disease (IPD), invasive Hib disease and pertussis using notification data. Results: For pneumococcal vaccination, the geometric mean concentration ratio of IgG levels in girls versus boys pooled across serotypes was 1.15 (95%Cl 0.91-1.45) 1 month following the primary series, 1.16 (1.02-1.32) at age 8 months, 1.12 (1.02-1.23) pre-booster (age 11 months) and 0.99 (0.89-1.10) post booster (age 12 months). Diphtheria toxoid, tetanus toxoid, pertussis Ptx/FHA/Prn and Hib-PRP IgG levels did not differ between girls and boys, except for Hib post-booster (1.24; 95%CI 1.01-1.52) and tetanus before pre-school booster (0.71; 0.53-0.95). We found no difference between boys and girls in reactogenicity at age 4 or 11 months or in vaccine failure/effectiveness for IPD, invasive Hib disease or pertussis. Conclusion: For most vaccine antigens investigated, there were no consistent differences in vaccine induced IgG levels. Vaccine-induced pneumococcal IgG levels were slightly higher in girls, but only between the primary series and the 11-month booster. These results, along with similar reactogenicity and vaccine failure/effectiveness, support the uniform infant vaccination schedule in the Dutch national immunisation programme. (C) 2017 Elsevier Ltd. All rights reserved
U2 - https://doi.org/10.1016/j.vaccine.2017.11.070
DO - https://doi.org/10.1016/j.vaccine.2017.11.070
M3 - Article
C2 - 29223483
SN - 0264-410X
VL - 36
SP - 400
EP - 407
JO - Vaccine
JF - Vaccine
IS - 8
ER -