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Men lag behind women on COVID vaccination in Washington

By Evan Bush, The Seattle Times
Published: April 30, 2021, 7:33am

Men in Washington — who represent 53% of deaths from the coronavirus — are at the same time receiving far less than their share of life-protecting vaccines.

It’s a trend vexing researchers studying COVID-19, physicians treating it and public health officials leading the charge against the disease.

Of those fully vaccinated as of April 19, 57.1% were women. Men, meanwhile, were at 42.2%, with gender going unreported or reported as “other” in the remainder of data shared by the Washington Department of Health. Washington’s vaccine gender gap mirrors the nationwide trend.

Why the lagging rates for those with a y chromosome?

“Women are smarter than men? I don’t know,” quipped Dr. Chris Baliga, an infectious disease physician with Virginia Mason Franciscan Health, during a recent news conference, before noting that women seek health care at higher rates.

With vaccine demand beginning to soften, identifying what’s holding some men back on vaccination — and what messages resonate for those yet to receive shots — will be crucial to providing more widespread protection to Washingtonians.

Experts say men likely trail women in vaccination data for a combination of reasons.

In Washington, the earliest days of the vaccine rollout tilted toward women.

First to become eligible were health workers, those living in nursing homes and people ages 65 and older.

Women tend to live longer and Census Bureau data for Washington state estimates there are at least 106,000 more women than men who are at least 65.

And in many professions in the earliest stages of vaccination, such as health care, “women are overrepresented,” said Samantha Clark, a doctoral researcher studying at the University of Washington’s Comparative Health Outcomes, Policy, and Economics Institute.

With everyone over age 16 now eligible for vaccines, Clark expects the gap to narrow over time. Differences in state data between those who have received at least one shot and those already finished with their regimen suggests the narrowing process has begun already.

But researchers say other factors are likely responsible for the gap, though they caution that most theories rely on observational data that doesn’t necessarily indicate a cause and effect relationship.

Men’s past behavior suggests they could be harder to convince to come in for vaccines — or set up visits to a doctor, generally.

“Historically, influenza vaccination is much higher among females,” Clark said. “Part of this difference does get down to care seeking.”

Men are less likely to have a primary care physician and less likely to get recommended screenings, Clark said, citing a 2013 survey from the Kaiser Family Foundation.

“Getting young men in primary care and preventative care is very difficult,” said Carl Latkin, a professor in the Department of Health, Behavior, and Society at Johns Hopkins University. “I don’t know if guys talk much about — ‘Oh, I’m going to go get my checkup.’”

Research also suggests that men’s perception of COVID-19 risk differs when compared with that of women.

Since last March, Latkin has been surveying a diverse group of about 800 people about their opinions and behaviors during the pandemic.

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“Women were more concerned about getting COVID and more concerned about family members — kids — getting COVID,” Latkin said. “The interesting thing is women were also less trusting of the vaccine.”

Latkin’s theory: Women are simply “paying more attention” and could be more likely to get vaccinated to protect the health of others, such as children or a parent.

Other research suggests a gender difference in who is susceptible to misinformation about COVID-19. A study published in Politics & Gender found that women were less likely to endorse conspiracy theories about the disease.

There is no shortage of vaccine conspiracy theories or misinformation online, and that could be influencing men disproportionately, Clark suggested.

Politics could play a role, too, Latkin and Clark said.

“How you identify is tied up in vaccine uptake,” Clark said.

Polling shows Republicans are less intent on vaccination. Men are more likely to vote for Republicans.

In a survey conducted by NPR, PBS Newshour and Marist Institute for Public Opinion, Republican men were the group least likely to choose to receive the vaccine if it was offered.

To Latkin and Clark, men represent an opportunity in the quest to protect more Americans with vaccine.

Latkin said his research suggests that most people fall into one of three categories. They’re either eager for vaccine, “fence-sitters” — waiting and watching before they decide; or people who are decidedly anti-vaccine.

Men are often fence-sitters, Latkin said, and “that’s the group you really want to focus on.”

He thinks many might benefit from a push from their peers — other men — to go get the shot.

It’s something state health officials are thinking about.

“What are the questions and concerns? What is the information people need to feel confident in their decision to be vaccinated? … Who are the trusted messengers?” said Michele Roberts, acting assistant secretary of health, when asked of the disparity during a recent news conference.

After all, men are the ones whom data suggests are most at risk from COVID, Clark said. Although men are only 48% of cases in Washington, they represent 52% of hospitalizations and 53% of statewide deaths.

“Men are the enigma,” Clark said. “If you’re more likely to die, why would you not go get vaccinated?”

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