Diphtheria-tetanus-pertussis (DTP) vaccine is associated with increased female-male mortality rate ratios. A meta-analysis of studies of DTP administered before and after measles vaccine
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Diphtheria-tetanus-pertussis (DTP) vaccine is associated with increased female-male mortality rate ratios. A meta-analysis of studies of DTP administered before and after measles vaccine. / Hanifi, Syed Manzoor Ahmed; Fisker, Ane Bærent; Welaga, Paul; Rieckmann, Andreas; Jensen, Aksel Georg; Benn, Christine Stabell; Aaby, Peter.
In: The Journal of Infectious Diseases, Vol. 223, No. 11, 2021, p. 1984–1991.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Diphtheria-tetanus-pertussis (DTP) vaccine is associated with increased female-male mortality rate ratios. A meta-analysis of studies of DTP administered before and after measles vaccine
AU - Hanifi, Syed Manzoor Ahmed
AU - Fisker, Ane Bærent
AU - Welaga, Paul
AU - Rieckmann, Andreas
AU - Jensen, Aksel Georg
AU - Benn, Christine Stabell
AU - Aaby, Peter
N1 - © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
PY - 2021
Y1 - 2021
N2 - BACKGROUND: The third dose of diphtheria-tetanus-pertussis (DTP3) is used to monitor immunization programs. DTP has been associated with higher female mortality.METHODS: We updated previous literature searches for DTP-studies of mortality by sex. We examined the female/male (F/M) mortality rate ratio (MRR) with increasing number of doses of DTP and for subsequent doses of measles vaccine (MV) after DTP and of DTP after MV.RESULTS: Eight studies had information on both DTP1 and DTP3. The F/M MRR was 1.17 (0.88-1.57) after DTP1 and increased to 1.66 (1.32-2.09) after DTP3. Following receipt of MV the F/M MRR declined to 0.63 (0.42-0.96). In 11 studies the F/M MRR increased to 1.73 (1.33-2.27) when DTP-containing vaccine was administered after MV.CONCLUSIONS: The F/M MRR increased with increasing doses of DTP. After MV, females had lower mortality than males. If DTP was provided after MV, mortality increased again for females relative to males. No bias can explain these changes in the F/M MRR. DTP does not improve male survival substantially in situations with herd immunity to pertussis and the higher F/M MRR after DTP may therefore reflects an absolute increase in female mortality.
AB - BACKGROUND: The third dose of diphtheria-tetanus-pertussis (DTP3) is used to monitor immunization programs. DTP has been associated with higher female mortality.METHODS: We updated previous literature searches for DTP-studies of mortality by sex. We examined the female/male (F/M) mortality rate ratio (MRR) with increasing number of doses of DTP and for subsequent doses of measles vaccine (MV) after DTP and of DTP after MV.RESULTS: Eight studies had information on both DTP1 and DTP3. The F/M MRR was 1.17 (0.88-1.57) after DTP1 and increased to 1.66 (1.32-2.09) after DTP3. Following receipt of MV the F/M MRR declined to 0.63 (0.42-0.96). In 11 studies the F/M MRR increased to 1.73 (1.33-2.27) when DTP-containing vaccine was administered after MV.CONCLUSIONS: The F/M MRR increased with increasing doses of DTP. After MV, females had lower mortality than males. If DTP was provided after MV, mortality increased again for females relative to males. No bias can explain these changes in the F/M MRR. DTP does not improve male survival substantially in situations with herd immunity to pertussis and the higher F/M MRR after DTP may therefore reflects an absolute increase in female mortality.
U2 - 10.1093/infdis/jiaa684
DO - 10.1093/infdis/jiaa684
M3 - Journal article
C2 - 33125458
VL - 223
SP - 1984
EP - 1991
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
SN - 0022-1899
IS - 11
ER -
ID: 258765175