Why Men Are Falling Behind in COVID-19 Vaccination

In the United States, COVID-19 has been more likely to kill men than women: about 13 men have died of the disease for every 10 women, according to data collected by The Sex, Gender and Covid-19 Project at University College London. Fortunately, there’s one clear way to reduce the disparity: the three vaccines authorized for use in the U.S. have all been shown to reduce patients’ risk of dying of or being hospitalized with COVID-19 to nearly zero.

However, many men in the U.S. aren’t racing to get vaccinated. As of May 3, about 38.5% of the male population has been vaccinated, compared to 43.3% of the female population, according to Centers for Disease Control and Prevention data. These data are somewhat surprising, given what prior surveys on the topic seemed to suggest: according to an April Economist/YouGov poll, women were slightly more likely than men to say they had already been vaccinated (39% vs. 36%), but the unvaccinated men were slightly more likely to want the vaccine (24% vs. 21%).

Rosemary Morgan, a research scientist at Johns Hopkins University, and Derek Griffith, the director of the Center for Research on Men’s Health at Vanderbilt University, say a variety of forces are likely resulting in the vaccination gender imbalance thus far. For one thing, Morgan notes, women in the U.S. tend to live about five years longer than men, and make up 55% of the country’s 65-and-up population, who were eligible for their shot earlier than other groups. Women also account for a larger proportion of essential workers, who were also prioritized for vaccination—for example, as of 2019, women held about 76% of all healthcare jobs, according to the U.S. Census Bureau.

Indeed, the gender imbalance is getting less severe over time, per TIME’s analysis of CDC data, but it persists. As of Feb. 9, women—who account for 50.8% of the U.S. population—had received 60% of the first doses administered thus far. That disparity had dropped to 56% by late March, and stands at 53.7% as of May 3.

The fact that men remain comparatively under-vaccinated may come down to behavior. Women have long been more proactive about health care—during the 2019-20 influenza season, for instance, 52% of U.S. women got their flu shot, compared to just 44% of men, per CDC data. Morgan says this is partly because women often have more contact with the health care system in general—they need to seek sexual and reproductive care from an early age, and are more likely to serve as caregivers for children and older people.

At least some portion of this gap could come down to politics: men are more likely to identify as Republicans, who are less likely to want the vaccine. A March NPR/PBS NewsHour/Marist poll found that only 50% of Republican men planned to get the vaccine or had already received it, compared to 60% of men generally and 92% of male Democrats. Meanwhile, only 12% of Republicans said they were very concerned about the virus, per an October poll from KFF.

Overall, however, women have been more worried about the risk of being infected themselves, or of someone in their family getting sick. In that same NPR/PBS NewsHour/Marist poll, 57% Republican women said that they planned to get the vaccine or had already received it. According to the October KFF poll, 73% of women said that they were at least somewhat worried that they or someone in their family could get COVID-19, compared to 58% of men. Accordingly, women have taken more precautions to protect themselves and the people around them from the virus, such as masking, maintaining physical distance, and seeking medical help, according to a July 2020 review published in Preventing Chronic Disease. These findings suggest women may be more eager to get vaccinated in order to keep themselves and those around them safe.

Men and women have also faced different economic pressures during the pandemic. Research suggests that when families are under pressure to balance work and family, men tend to prioritize work while women prioritize caregiving, even when men are eligible for paid leave. Some men, Griffith says, may view taking time off of work to get vaccinated as a distraction. Those without paid time off, meanwhile, may not want to risk side effects that could sideline them or cut into their pay. Conversely, as Morgan points out, women have disproportionately lost or quit their jobs amid the pandemic—some to take care of children or relatives—and many may view vaccination as a big step towards post-pandemic life. “I’d imagine for a lot of women, especially young mothers with young children, there’s probably a very high desirability for things to go back to normal,” Morgan says.

What can be done to convince more men to get their COVID-19 vaccine? First of all, to encourage vaccination in general, it’s essential for providers to make it as quick and easy as possible, Griffith says. Moreover, public health officials need to better understand what’s holding men back in order to better address the imbalance. “Attitudes and behavior don’t necessarily align,” Griffith says. “So just because somebody is interested in something or willing to do something, doesn’t necessarily mean…they’re actually going to turn around and do it.”

—With reporting from Chris Wilson