Gender differences in vaccine therapy: where are we in COVID-19 pandemic?


  • Tiziana Ciarambino | Internal Medicine Department, Marcianise Hospital, ASL Caserta, Italy.
  • Elena Barbagelata Department of Internal Medicine, Lavagna Hospital, Genoa, Italy.
  • Graziamaria Corbi Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
  • Immacolata Ambrosino Local Healthcare Unit of Bari, Health District 10, Post-acute Care Triggiano, Bari, Italy.
  • Cecilia Politi Head of Gender Medicine Area F.A.D.O.I., Internal Medicine Department, Isernia, Italy.
  • Franco Lavalle Vicepresident OMCEO (Provincial order of surgeons and dentists), Bari, Italy.
  • Anna Ruggieri Center for Gender Specific Medicine, Istituto Superiore Sanità, Rome, Italy.
  • Annamaria Moretti President of GISeG (Italian Group for Health and Gender), Bari, Italy.


Vaccination is one of the greatest achievements of public health. Vaccination programs have contributed to the decline in mortality and morbidity of various infectious diseases. This review aims to investigate the impact of sex/gender on the vaccine acceptance, responses, and outcomes. The studies were identified by using PubMed, until 30th June 2020. The search was performed by using the following keywords: SARS-CoV-2, COVID-19, gender, sex, vaccine, adverse reaction. Clinical trials, retrospective and prospective studies were included. Studies written in languages other than English were excluded. Studies were included if gender differences in response to vaccination trials were reported. All selected studies were qualitatively analyzed. Innate recognition and response to viruses, as well as, adaptive immune responses during viral infections, differ between females and males. Unfortunately, a majority of vaccine trials have focused on healthy people, with ages between 18 to 65 years, excluding the elderly, pregnant women, post-menopausal female and children. In conclusion, it is apparent that the design of vaccines and vaccine strategies should be sex-specific, to reduce adverse reactions in females and increase immunogenicity in males. It should be mandatory to examine sex-related variables in pre-clinical and clinical vaccine trials, such as their crucial role for successful prevention of pandemic COVID-19.



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COVID-19 - Collection of articles on the Coronavirus outbreak
Gender and/or sex differences, vaccine, adverse reaction, COVID-19, SARS-CoV-2
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How to Cite
Ciarambino, Tiziana, Elena Barbagelata, Graziamaria Corbi, Immacolata Ambrosino, Cecilia Politi, Franco Lavalle, Anna Ruggieri, and Annamaria Moretti. 2021. “Gender Differences in Vaccine Therapy: Where Are We in COVID-19 Pandemic?”. Monaldi Archives for Chest Disease, April.

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