VACCINATION GENDER GAP
B.C. women are getting their COVID-19 shots at higher rates than men
Jennifer Cole had been counting down the days to her COVID-19 vaccination shot like it was Christmas.
Because of health problems, she wanted to wait for the Pfizer or Moderna vaccines instead of AstraZeneca, and had been eagerly anticipating the day the age-based vaccination program would open up for her age group.
“I'm just getting tired of the pandemic,” said the 58-yearold Vancouver woman. “And I don't want to be behind the eight-ball. … The moment my age cohort opened, I was right on there, at 6:30 a.m., waiting for the link.”
Cole is one of the women turning out in droves to get a shot of a COVID-19 vaccine, outnumbering men.
Across Canada, more women are getting COVID-19 vaccines — and getting vaccinated at higher rates — than men, even though men are more likely to contract serious COVID cases and die from the disease.
It's a trend playing out in every province and territory across Canada, except for the Northwest Territories, according to federal figures on vaccination coverage.
In B.C., 1,120,541 women had received at least one shot of a COVID-19 vaccine compared to 924,287 men by May 8, a startling difference of 196,254 even though there's roughly an equal number of men and women in the province.
The gender disparity persists across most age groups in B.C. In cohorts younger than 50, women are getting vaccinated at seven to nine percentage points higher than men as of May 8. That gap is narrower for people age 50 to 69, but doesn't even out until they hit 70.
When asked for updated figures into May, the B.C. Health Ministry said of nearly 1.8 million vaccines administered, 55 per cent were given to women. It was not able to provide a breakdown by age ranges.
Health experts say the trend warrants monitoring, especially since pinpointing what's stopping some men from getting their shot might be crucial if we want to achieve herd immunity and broader community protection.
“I'm curious to see how it unfolds over time,” said Dr. Meena Dewar, who leads immunization work at Vancouver Coastal Health.
For the first 20 weeks in B.C.'s vaccine rollout, vaccines were in limited supply and were allotted by age group and risk, she said. “But now we are getting to a very different speed to our program and opening it up to broader age groups. It's important to monitor who is coming forward and who isn't, and to appropriately tailor the program.”
REASONS FOR THE DISPARITY
So why are men lagging behind women in getting the shot? Some of it could be explained by demographics and how B.C.'s vaccination plan unfolded. Elderly people were the first in the province to be vaccinated, and women make up a larger proportion of that age group.
Among the 80+ group, about 122,500 women have received at least one dose, compared to 92,000 men. However, the data also indicate equal vaccination rates, at about 90 per cent, for both men and women in this age group.
Women may also have got an inadvertent head start because of their jobs. Women are overrepresented in occupations given high priority to get the vaccine because of a higher risk of exposure to COVID-19, such as retail, health care and education.
“It's equally about who has had access (to the vaccines) as much as it is who is seeking out the vaccine,” said Genesa Greening, CEO of the B.C. Women's Health Foundation, noting more women than men work in positions of greater COVID exposure.
Women also carried a disproportionately heavier burden during the pandemic, which may propel them to seek out vaccines sooner, or be more eager once a vaccine is made available to them.
Women were first to be hit by job losses when the pandemic struck, and were more likely to be without a job longer, according to a November report by the B.C. Women's Health Foundation. Women provide more unpaid care, whether for elderly parents or young children. When schools switched to remote learning and daycares temporarily shut their doors, caregiving largely fell to women.
“As caregivers, women could be prioritizing the safety of other people they are taking care of by pursuing vaccines as early as they can get it,” said Greening.
The gender disparity could also reflect the fact men are less likely to use health services compared to women, who tend to seek out preventive care more than men. The avoidance may be linked to masculine ideals of toughness or disliking vulnerability.
Dr. Birinder Narang, a family physician with a practice in Vancouver, said statistics that show a higher uptake among women aren't surprising.
“Men tend to engage less with the health-care system than women do,” he said. “When I see a 20- to 25-yearold male, I know I need to be opportunistic because I might not see them again for two to three years.”
Historically, more women than men got the flu shot, the only other vaccine offered regularly to the general adult population. In the last influenza season, 56 per cent of doses administered by pharmacies were to women, 44 per cent to men, said the Health Ministry.
Women also tend to be the ones arranging medical appointments and health care for their family, and might be more familiar in navigating the system or be more willing to call different pharmacies for a vaccine, for example, or to keep pace with ever-changing news on vaccines and age eligibility.
THE ROLE OF ATTITUDES
Attitudes about the pandemic and vaccines are also a factor.
Research suggests men and women are experiencing the pandemic differently, and their perception of COVID risk also differs.
Heather Owen, vice-president of polling group Leger, said their surveys have found women are more afraid of catching COVID-19 than men (67 per cent compared to 55 per cent) and are more likely to feel pandemic burnout (66 per cent compared to 57 per cent).
An Insights West survey looking into vaccine hesitancy found men were more likely to express hesitation about COVID-19 vaccines than women (18 per cent versus 11 per cent).
Men were significantly more likely, about 10 percentage points more, to say they are taking enough precautions and don't need the vaccine or to believe they won't suffer serious complications from the virus or to say COVID isn't a serious disease.
A separate survey also found men are more susceptible to conspiracy theories than women, and with the pandemic resulting in a wide array of conspiracies, this could fuel hesitancy.
For instance, more men than women (37 per cent versus 25 per cent) believe COVID-19 was created as a biological weapon in a lab or that vaccines include a chip used to track individuals (11 per cent versus seven per cent). Seventeen per cent of men believe the pharmaceutical industry was involved in the spread of COVID-19, compared to 13 per cent of women.
“If you believe Big Pharma was involved in the spread, why would you inject yourself purposefully with the vaccine if you think they're doing this for profit?” said Steve Mossop, president of Insights West.
Heidi Tworek, a University of B.C. public policy professor, said misinformation and conspiracy theories flourish in a vacuum of information, which is why it is crucial people are able to access accurate information about the vaccines as early as possible before the “misinformation narrative” takes hold.
However, she cautioned the gender disparity might not be due to vaccine hesitancy or anti-vaccination attitudes, but could boil down to something more basic.
“What is in that differential group of men? Maybe they can't be bothered, maybe they're hesitant. Is it a question of access? We have to figure out if the disparity is about access, and ensure people have the information on how to register and get the vaccine.”
B.C.'s parallel vaccination streams, at health-authority-run sites, pharmacies, work sites, and pop-up clinics, could create confusion, said Tworek. Last month, poor communication around pop-up clinics at Fraser Health prompted an apology from health officials. Some of those pop-up clinics, which weren't officially announced by Fraser Health yet drew long lines, fed into suspicions some people may have that the system is arbitrary and rumour-based rather than something that is well set up and smoothly run, she added.
GAP MAY CLOSE AS VACCINATIONS CONTINUE
It is still early days in B.C.'s vaccination rollout for the general population. But as more people become eligible for the vaccine — vaccine appointments are expected to open for every British Columbian adult starting Sunday — experts say the gender gap might close.
A Women's Health Research Institute study has found men are more likely to say they “intend” to get vaccinated than women. And in the U.S., in some states that are further along in their vaccination programs, gender gaps have started to narrow, although they remain high compared to Canada.
For now, the gender differential raises questions about whether there needs to be messaging aimed at getting more men vaccinated.
“Absolutely,” said Tworek. “There isn't one silver bullet. There will be multiple approaches we need to take.”
Penny Norman is a Vancouver-based communications strategist who led a hack-athon organized by her industry group to tackle COVID-19 vaccine hesitancy.
She said men tend to respond differently to health communications. Rational arguments work more than an emotional appeal. If it's the latter, it has to connect with them personally.
“Guys like to figure it out on their own,” said Norman. “They like to do their own reading, and they like taking an independent approach. When you give them the data in a way that means something to them, and you do it from a source they can trust, that's key.”
The trusted source doesn't have to be Health Canada or the World Health Organization, she said. It could be a religious leader they respect, a magazine they love to read, a guy on a Harley-Davidson.
“One size fits all coming from the government does not always work,” said Norman.
Earlier this month, Premier John Horgan mounted a campaign enlisting the help of community leaders to try to get more people to register. A national grassroots campaign called This is our Shot also harnesses the power of influencers to encourage people to get shots in their arms.
Celebrities like Ryan Reynolds and Michael Bublé, Olympian Hayley Wickenheiser, Defence Minister Harjit Sajjan, and former astronaut Chris Hadfield were on board.
The message: “If Deadpool is getting vaccinated, then we probably should too,” quipped Narang, one of the physicians involved in the campaign.
Narang said he'll be keeping an eye on vaccine uptake among younger cohorts to see whether the gender gap closes in the next few weeks.
“Even though it might be an aberrancy, we need to keep a close eye on it,” he said. “If it persists … we need to look at it on a broader level, a provincial level on how to tackle this, or perhaps even national, depending on what's happening.”
About two weeks ago, Cole finally got her first Pfizer shot at the Vancouver Convention Centre. She's grateful and glad. Getting the vaccine, she said, made her feel more secure.
“Things can expand. It gives me some confidence,” she said. “If I'm vaccinated, I'm protected and I know it sounds very cliché, but it's for everybody's good.”
Guys like to figure it out on their own. They like to do their own reading, and ... taking an independent approach.”