For months, local, state and federal officials have wondered how to persuade Americans who are suspicious of the COVID-19 vaccine to get vaccinated anyway. Much of the conversation focused on specific demographic groups and how to overcome certain cultural factors to get vaccines into people’s arms. Experts were concerned about the low participation rate among women, who reported significantly more reluctance to vaccinate than men before the vaccine rolled out. And public health officials have warned that non-Hispanic black Americans would be more hesitant than other racial groups because of the historical abuse and exclusion they have suffered from medical professionals and researchers.
But the data on actual gender differences in immunization rates veered in an unexpected direction, leaving an entire group of Americans hesitant about largely untargeted immunization: men.
On Monday morning, the Centers for Disease Control and Prevention reported that nearly 9.5 million more women than men had been vaccinated in the United States, and in the 42 states that collect data on gender, one more large proportion of women also receive the vaccine. The size of the gender gap varies from state to state, but has hovered just below 10 percentage points on average over the past month.
According to experts and the latest research, the reasons why we are seeing this persistent gap are complicated. On the surface, it’s a question of which groups were targeted at first, but when we take a closer look, other behavioral and ideological divisions between women and men seem to be at play. These four hypotheses may explain the imbalance. .
Hypothesis 1: Early access
The simplest explanation for the immunization gender gap is that women are ahead of the game. Among older Americans, who had early access to the vaccine, women outnumber men: The US Census Bureau estimates that women make up about 55% of all adults 65 and older. And in specific occupational groups with early access in most states, women also outnumber men – among childcare workers and health professionals, for example, women represent about 95% and 74%, respectively.
It seems logical enough, except that those early restrictions on who can get the vaccine are now gone. The figures remain imbalanced, however, so other factors must also contribute to the disparity.
Hypothesis 2: Traditional masculinity
COVID-19 isn’t the only health issue that men are less likely to be proactive about. Compared to women, they tend to see a doctor less often and use harmful substances such as alcohol and illicit drugs more often; men also tend to eat less fiber and fruit, and they are even less likely to use sunscreen than women. According to Dr Jonathan Metzl, director of the Center for Medicine, Health, and Society at Vanderbilt University, men’s shorter lifespans are the result of the cumulative effects of poor health decisions, not the physiology. “There is no real biological reason why men die sooner,” Metzl said. “The things that make you successful, cool, and tough in America are also inversely related to health and longevity. ”
Researchers are almost unanimous in their claim that traditional masculinity – the idea that men should be self-reliant, physically resilient, and emotionally stoic – is a risk factor for men’s health. James Mahalik, a masculinity and health outcomes expert at Boston College, studies how traditional masculinity hinders health-promoting behaviors. Research from his mask-wearing lab indicates that men who abide by traditional masculine norms have lower levels of empathy towards those vulnerable to COVID-19, and they are less likely to trust the scientific community. Mahalik suspects the same is true of their take on the vaccine.
Hypothesis 3: Preventive health behaviors
My conversation with Mahalik led me to ask other researchers about the potential differences in the way men and women assess medical evidence. Jennifer Reich, a sociologist at the University of Colorado at Denver who has studied vaccine behavior for over a decade, told me that women are more accustomed than men to making decisions about their own health and the health of their family. family. “Women are used to seeking health care in the form of reproductive health from an early age on a semi-annual or annual basis, so much so that women are more inclined to think about disease prevention in a way that men tend not to participate. until they are about 50 years old, ”she said.
According to Reich, women are generally held responsible for the health of others in a way that men are not: “Women know that if family members get sick, they will be responsible for the care. Although vaccine distributors do not track the gender of people who schedule vaccine appointments with family members, sociologists fear that women are taking on most of the work – an extension of what has been said. called the “second shift” of women. The greater responsibility of women in maintaining not only their own health, but also the health of others, makes Reich believe that women are more likely to be in contact with health services and seek related information. to health. Social expectations that women take care of others and vigilantly monitor their reproductive health demand it of them.
Hypothesis 4: Political ideology and susceptibility to conspiracy thought
Making a doctor’s appointment or putting on sunscreen is relatively uncontroversial; getting the COVID-19 vaccine is not. According to a national poll by the Kaiser Family Foundation, 29% of Republicans said they “definitely won’t” get the vaccine, compared to just 5% of Democrats. This discrepancy may partly explain the gender gap in immunization when considering gender differences in policy direction. Women are more likely than men to say they lean towards the Democratic Party, while men are more likely than women to say they identify as Republicans or independents.
“I think it’s government control,” Calvin Lambert, a 65-year-old carpenter living in West Virginia, said when I contacted him by phone. “First you will take the vaccine that the government asks you to give yourself, and then you will only be entitled to a certain amount of money per month. ”
I spoke with six other men across the country who identified themselves as Conservatives, and they echoed Lambert’s concerns and had more to add. All were concerned about the vaccine’s role in facilitating the rise of socialism, and two of them mistakenly believed that COVID-19 vaccines contain government-controlled tracking devices. José Rodríguez, a community worker who partners with hospitals and churches to run immunization clinics in West Virginia, said misinformation was a major obstacle in persuading men to get vaccinated. Her concerns align with research on gender differences in susceptibility to misinformation about COVID-19: At the start of the pandemic, men – especially those who identified themselves as conservatives – were more likely than women to subscribe to COVID-19 conspiracy theories. Researchers have yet to collect data for 2021, so we don’t know if that’s still the case.
Reduce the gap
Appealing to traditional masculinity, such as framing the vaccine as a way to strengthen the body against the virus, could be one way to bridge the gap. This approach may reinforce ideologies known to be harmful to men’s health on the whole, but it could be worth the trade-off. “You have to recognize where people are coming from,” Metzl said.
And states seem to be making an effort to do just that. Several have announced new vaccination initiatives, offering things like hunting and fishing licenses, free beer, and even personalized guns to those who receive the jab. While not explicitly directed at men, many of these incentives have strong cultural associations with traditional masculinity.
But beyond the call for masculinity, one of the best ways to increase immunization rates among those who hesitate might be to make information about vaccines readily available in places where there is already confidence, like churches or hairdressing salons. Reich put it this way: “There are often other community leaders, trusted brokers or allies who have influence with people beyond physicians. In many ways, solutions really need to educate and empower community members to understand information in accessible ways. “