The Washington PostDemocracy Dies in Darkness

Why might women be less eager to get the coronavirus vaccine? An investigation.

(Pool/Reuters)
Placeholder while article actions load

A trio of surveys released in the past few weeks upended what we knew, or thought we knew, about women’s and men’s behaviors and beliefs during the pandemic. With coronavirus vaccines on the horizon, Pew Research asked nearly 13,000 Americans whether they intended to get one. Women were 13 percentage points less likely than men, 54 to 67 percent, to say they did. A National Geographic survey a few days later reinforced the discrepancy with an even larger gap, women trailing by a full 19 points. In a Gallup poll, the gap was smaller, but women were still 6 points less likely than men to say they planned to get a coronavirus vaccine.

What on earth is going on?

“Gotta wonder how this ties into social media and online wellness communities,” tweeted Ben Collins, a journalist who reports on disinformation and conspiracy theories.

Is it possible that the online Goop and QAnon communities have formed an unholy, pastel alliance? Have women, taken in by a mash-up of my body is a temple, my government is a pedophile ring rhetoric, Instagrammed and Pinterested their way to covid denialism?

That theory is worrisome,

tantalizing, and perhaps too easy. I love activated charcoal as much as the next vegetarian; I know the power of Gwyneth Paltrow. But we are talking about the best and quickest solution to a natural disaster that has killed 300,000 Americans, wrought untold damage on the bodies of millions more, ruined holidays, closed schools and theaters and churches and ballparks. Nobody loves activated charcoal that much.

Plus, the women in the surveys didn’t seem addled by denialism or conspiracy thinking. In the Pew study, they were more likely to worry about becoming sick with covid than were men. They were more likely to be bothered when people around them weren’t wearing masks. In general, women have been more responsive to hygiene regulations. The gender gap on masks became serious enough that public health experts brainstormed mask-ulinity campaigns to convince men that mask-wearing is cool and heroic.

Why, when it came to vaccines, would the numbers swing the other way?

Time for an investigation.

I called Cary Funk, the author of the Pew study, who ran some controls for me. The biggest factor in a person’s likeliness to want a vaccine was their political party. But when Funk compared Democratic women with Democratic men, or Republican men with Republican women, the gender gap was still there. And it wasn’t new, either. Back in September, before a vaccine had anything close to resembling a release date, Pew had done another survey, and women were more hesitant about a vaccine then, too.

Funk pointed out a few other things. In previous unrelated studies, men have been more gung-ho in embracing new genetic technologies. Women have tended toward a wait-and-see approach. It’s possible, Funk said, that these women do intend to be vaccinated, eventually. They just don’t want to go first.

It was also possible that some women were following medical guidance, not from online anti-vaxxers but actual medical caregivers. Pregnant and lactating women were excluded from Pfizer and Moderna’s coronavirus vaccine trials, as they are from many clinical trials (a few dozen participants inadvertently became pregnant during the course of the studies). This means the existing safety assurances might not feel as reassuring to the subset of women who fear not only for their own health but also for their babies’.

To discuss that complicating factor, I called Ruth Faden. Faden is the founder of the Johns Hopkins Berman Institute of Bioethics; one of her areas of study is women’s health and pregnancy.

People who are breastfeeding, pregnant or even trying to conceive are warned away from everything from caffeine to cold cuts for fear of miscarriages — or, in some cases, for fear of being blamed for their miscarriages. “The frame around pregnancy is generally very precautionary,” Faden said. It’s not unreasonable, she said, to wonder whether a cohort of women of childbearing age would look at a vaccine that had not been extensively tested on bodies like theirs and say, “No, thank you.” Or at least “Not yet.”

Faden, who said she’d been puzzling through the same surveys, noted that women are typically charged with being the guardians for their entire family’s health. They’re the ones who schedule pediatrician visits, who read up on new research. In pondering a medical decision, a woman might be weighing a lot of factors, Faden said: “Is this really in the best interest of not only me, but my partner, my children, my parents, my community?”

Those societal roles, the biomedical ethicist said, have existed through history. So it was time to call a historian.

Nancy Tomes is a professor of history at Stony Brook University and author of “The Gospel of Germs: Men, Women, and the Microbe in American Life.” And yes, she said, historically, women have been charged with protecting their families against “microbial menaces,” putting the health of others before their own.

More than one person I interviewed said they weren’t surprised that women would be more likely than men to wear a mask but less likely to get a vaccine. Masks are marketed as tools to help protect others, while the coronavirus vaccine, which may not prevent transmission to others, is perceived as something that helps oneself.

Women might also be more likely than men to question what medical experts say is good for them. “There is a feminist tradition going back to the 1970s that women should be critical when thinking about health care, because of the assumption that medical experience was coming at you from a male perspective,” said Tomes, the historian. Health care was seen as something for men, by men, which ignored or sometimes harmed women.

Just look at early birth control pills, Tomes offers. The first iterations in the 1950s and 1960s were made with much higher hormonal dosages than turned out to be necessary. Women taking these early pills complained of headaches, nausea, dizziness and blood clots and were then dismissed as hysterical. In medical settings, their pain has been discounted and their experiences have been devalued. Heck, it wasn’t until 1993 that the National Institutes of Health became legally required to include women in its studies, as scientists realized that female bodies might react differently to drugs than male bodies, that what worked for a 250-pound man might not work for a 120-pound woman.

“Women,” Tomes told me, “have had many reasons to distrust the pharmaceutical industry.”

And not just women. Black Americans were long victims of hideous government-sponsored medical malfeasance — syphilis experiments conducted on Black men; gynecological procedures forced upon enslaved Black women. In Pew’s coronavirus vaccine survey, Black Americans were less likely than White, Asian or Hispanic Americans to say they planned on getting a vaccine. For any group that has endured centuries worth of systemic abuse and trickery, skepticism and caution can feel like the only reasonable inoculations against a terribly sick society.

And finally — yes. We should mention the online wellness communities. The thin, wealthy Gwyneth Paltrow knockoffs trying to convince their followers that cancer can be cured with juice cleanses, or the thin, wealthy Jenny McCarthy warrior-mom templates, who fear that their children’s autism was caused by vaccines. The kind of women Ben Collins seemed to have had in mind with his original tweet.

“These influencers align vaccines with the idea of chemicals, the idea that they pollute your bodies,” said Kelly McGuire, chair of the gender and women’s studies department at Trent University, who has spent the semester exploring vaccine hesitancy.

When we think of vaccine-hesitant women, McGuire said, the women we immediately picture are privileged peddlers of pseudoscience disguised as secret beauty and wellness hacks. Click over to Facebook and they’re the ones selling leggings and eyelash serum for a multilevel marketing company — while spamming your feed with links to videos about how the coronavirus was part of a huge scheme to scare the world into injecting harmful vaccines.

These extremely free thinkers are the boogeymen (Boogeywomen? Boogeykarens?) whom we imagine standing athwart the public health push necessary to end the pandemic. But, of course, not every woman who listens to Jenny McCarthy necessarily believes that vaccines introduce impurities. And not every person who believes vaccines are impure is a woman.

McGuire urges against making any sweeping inferences about women based on the Pew, National Geographic and Gallups surveys.

“Women are not this homogenous group. We need an intersectional lens to understand how women might decline a vaccine for very different reasons,” she said. “Issues of access, structural reasons. Some of these women may be cynical, or they may be overlooked, or they may be pregnant, or they may have been left out of the conversation.”

What’s up with women and the coronavirus vaccines? might be the wrong question. The right question is, How do we get everyone vaccinated?

What we really need to do, McGuire said, is figure out why microgroups might be hesitant and appeal to those groups rather than trying to solve the issue at the level of “women.”

Perhaps, Ruth Faden suggested, some women will be persuaded by seeing vaccinated friends spending time with their loved ones, up close and free of fear.

Perhaps, Nancy Tomes suggested, we will all again be able to look at vaccines as symbols of caring patriotism, the way Americans once did for polio.

Perhaps, Kelly McGuire suggested, local figures who are respected within their communities could make their vaccination intentions public, signaling to others that it felt safe.

The first New Yorker to receive the vaccine — and potentially the first person in the United States since it was approved — was a Black woman, a nurse named Sandra Lindsay, who oversees five ­critical-care units at the Long Island Jewish Medical Center.

There at the medical center Monday morning, she rolled up her sleeve. As a doctor inserted the needle, Lindsay didn’t flinch. The doctor asked how she felt. “I feel great,” Lindsay said. She talked about hoping that this marked the beginning of the end of a nightmare. She talked about letting her own decisions be guided by science, and hoping others did the same.

“I want to instill public confidence,” she said, “that the vaccine is safe.”

Monica Hesse is a columnist writing about gender and its impact on society. For more visit wapo.st/hesse.

Loading...