Is diphtheria-tetanus-pertussis (DTP) associated with increased female mortality? A meta-analysis testing the hypotheses of sex-differential non-specific effects of DTP vaccine.
In seven studies of BCG-vaccinated children, DTP vaccination was associated with a 2.54 (95% Cl 1.68- 3.86) increase in mortality in girls (with no increase in boys [ratio 0.96, 0.55-1.68]). The ways in which the female and the male immune systems may respond differently to vaccinations in infants are only beginning to be studied.
Peter Aaby, Henrik Ravn, Ane B. Fisker, Amabelia Rodrigues, and Christine S. Benn; Transactions of the Royal Society of Tropical Medicine and Hygiene. 2016 Dec; 110(10): 570–581.doi: 10.1093/trstmh/trw073.
Ten years ago, we formulated two hypotheses about whole-cell diphtheria-tetanus-pertussis (DTP) vaccination: first, when given after BCG (bacille Calmette-Guerin, is a vaccine for tuberculosis), DTP increases mortality in girls and, second, following DTP there is an increase in the female/male mortality rate ratio (MRR). A recent review by WHO found no convincing evidence that DTP increases mortality in females. Now, ten years later, we have tested the two hypotheses using studies from before, but also those published since formulation of the hypotheses. All studies published after the formulation of the hypotheses of the association of DTP with increased mortality.