Do Pentavalent (DTwP-Hib-HBV) vaccines have sex-differential nonspecific effects? An observational study

Vaccines may alter the ability to combat infections unrelated to the target disease, i.e. have “nonspecific effects.” The non-live Diphtheria-Tetanus-Pertussis vaccine (DTP) has been associated with increased child mortality, especially for females. In 2008, the DTP-containing Pentavalent vaccine re...

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Main Authors: Thomas Aamand, Ane Bærent Fisker, Claudino Correia, Manuel Fernandes, Clara Clipet-Jensen, Sanne Marie Thysen
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Human Vaccines & Immunotherapeutics
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Online Access:https://www.tandfonline.com/doi/10.1080/21645515.2023.2288297
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author Thomas Aamand
Ane Bærent Fisker
Claudino Correia
Manuel Fernandes
Clara Clipet-Jensen
Sanne Marie Thysen
author_facet Thomas Aamand
Ane Bærent Fisker
Claudino Correia
Manuel Fernandes
Clara Clipet-Jensen
Sanne Marie Thysen
author_sort Thomas Aamand
collection DOAJ
description Vaccines may alter the ability to combat infections unrelated to the target disease, i.e. have “nonspecific effects.” The non-live Diphtheria-Tetanus-Pertussis vaccine (DTP) has been associated with increased child mortality, especially for females. In 2008, the DTP-containing Pentavalent vaccine replaced DTP vaccine in Guinea-Bissau. We investigate female relative to male mortality after Penta vaccination. In Guinea-Bissau, Bandim Health Project (BHP) registered children’s vaccination and vital status at biannual village visits and provided vaccines. Among children Penta-vaccinated by BHP, we compared mortality of males and females in Cox proportional hazards models. Children aged 6 weeks to 8 months entered the analysis at the date of vaccination and were followed for up to 6 months. Between September 2008 and December 2017, 33,989 children aged 6 weeks to 8 months were under surveillance. Of these 12,753 (females: 6,363; males: 6,390) received Penta by the BHP and entered the study contributing with 19,667 observations. The mortality rate following Penta vaccination was 25.2 per 1,000 person years for females and 26.6 for males, resulting in an adjusted Female/Male mortality rate ratio of (F/M aMRR) 1.01 (0.82–1.25). The association between sex and mortality differed by timeliness of vaccination, F/M aMRR: 0.62 (0.41–0.93) for children vaccinated below median age, and F/M aMRR: 1.38 (0.90–2.13) for children vaccinated above median age. We did not find higher overall mortality in females than males after Penta vaccination. Our findings suggest that mortality differences between males and females following Penta vaccination may depend on timeliness of Penta vaccination.
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spelling doaj-art-2d2fb9a6996743528ec7a5544762442e2025-08-20T02:31:56ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2023-12-0119310.1080/21645515.2023.2288297Do Pentavalent (DTwP-Hib-HBV) vaccines have sex-differential nonspecific effects? An observational studyThomas Aamand0Ane Bærent Fisker1Claudino Correia2Manuel Fernandes3Clara Clipet-Jensen4Sanne Marie Thysen5Bandim Health Project, Indepth Network, Bissau, Guinea-BissauBandim Health Project, Indepth Network, Bissau, Guinea-BissauBandim Health Project, Indepth Network, Bissau, Guinea-BissauBandim Health Project, Indepth Network, Bissau, Guinea-BissauBandim Health Project, Indepth Network, Bissau, Guinea-BissauBandim Health Project, Indepth Network, Bissau, Guinea-BissauVaccines may alter the ability to combat infections unrelated to the target disease, i.e. have “nonspecific effects.” The non-live Diphtheria-Tetanus-Pertussis vaccine (DTP) has been associated with increased child mortality, especially for females. In 2008, the DTP-containing Pentavalent vaccine replaced DTP vaccine in Guinea-Bissau. We investigate female relative to male mortality after Penta vaccination. In Guinea-Bissau, Bandim Health Project (BHP) registered children’s vaccination and vital status at biannual village visits and provided vaccines. Among children Penta-vaccinated by BHP, we compared mortality of males and females in Cox proportional hazards models. Children aged 6 weeks to 8 months entered the analysis at the date of vaccination and were followed for up to 6 months. Between September 2008 and December 2017, 33,989 children aged 6 weeks to 8 months were under surveillance. Of these 12,753 (females: 6,363; males: 6,390) received Penta by the BHP and entered the study contributing with 19,667 observations. The mortality rate following Penta vaccination was 25.2 per 1,000 person years for females and 26.6 for males, resulting in an adjusted Female/Male mortality rate ratio of (F/M aMRR) 1.01 (0.82–1.25). The association between sex and mortality differed by timeliness of vaccination, F/M aMRR: 0.62 (0.41–0.93) for children vaccinated below median age, and F/M aMRR: 1.38 (0.90–2.13) for children vaccinated above median age. We did not find higher overall mortality in females than males after Penta vaccination. Our findings suggest that mortality differences between males and females following Penta vaccination may depend on timeliness of Penta vaccination.https://www.tandfonline.com/doi/10.1080/21645515.2023.2288297Pentavalent vaccinesnonspecific effectschild mortalitysex-differential effectsvaccines
spellingShingle Thomas Aamand
Ane Bærent Fisker
Claudino Correia
Manuel Fernandes
Clara Clipet-Jensen
Sanne Marie Thysen
Do Pentavalent (DTwP-Hib-HBV) vaccines have sex-differential nonspecific effects? An observational study
Human Vaccines & Immunotherapeutics
Pentavalent vaccines
nonspecific effects
child mortality
sex-differential effects
vaccines
title Do Pentavalent (DTwP-Hib-HBV) vaccines have sex-differential nonspecific effects? An observational study
title_full Do Pentavalent (DTwP-Hib-HBV) vaccines have sex-differential nonspecific effects? An observational study
title_fullStr Do Pentavalent (DTwP-Hib-HBV) vaccines have sex-differential nonspecific effects? An observational study
title_full_unstemmed Do Pentavalent (DTwP-Hib-HBV) vaccines have sex-differential nonspecific effects? An observational study
title_short Do Pentavalent (DTwP-Hib-HBV) vaccines have sex-differential nonspecific effects? An observational study
title_sort do pentavalent dtwp hib hbv vaccines have sex differential nonspecific effects an observational study
topic Pentavalent vaccines
nonspecific effects
child mortality
sex-differential effects
vaccines
url https://www.tandfonline.com/doi/10.1080/21645515.2023.2288297
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