Men lag women in coronavirus vaccinations, especially in Black communities

When his wife got vaccinated in March, the pressure mounted.

"It is creating that separation in the house," he said during a forum he hosted with doctors. "Like: 'OK, baby, I'm vaccinated. What you going to do?' I'm like: 'Ugh. Jesus Christ.'"

Across the country, more women than men have been getting vaccinated, data shows, even though more men have been hospitalized for or died of covid-19. In the D.C. area, the gap appears especially wide among Black residents.

Local and state officials largely point to early eligibility guidelines that prioritized senior citizens and health-care workers, who are disproportionately female. Public health experts and community advocates say that perspective overlooks the important ways gender can intersect with race and income to drive vaccine hesitancy. Outreach efforts are failing to reach men of color, they say, particularly those who are poor or unemployed. A Washington Post analysis shows that the gender gap in D.C., Maryland and Virginia stayed consistent from March through early April, even as more adults became eligible.

"You got the hesitancy, you got the inconvenience, you got the misinformation and you got the machismo," said the Rev. Derrick DeWitt of First Mount Calvary Baptist Church in West Baltimore, who has interceded on behalf of several female congregants struggling to get their husbands vaccinated. He said it has been especially challenging to engage older Black men, who are closer to the memory of the decades-long Tuskegee experiment, when government-financed doctors allowed syphilis to run unchecked through Black test subjects despite knowing that penicillin would cure them.

In Virginia, where the male-female divide is about 50-50, Black women are being vaccinated at nearly twice the rate of Black men, with a 26-point gap. Among White residents, in contrast, 58 percent of doses are going to women and 42 percent to men, a 16-point gap. Some diverse, dense communities in Northern Virginia, including Prince William County and Alexandria, have markedly larger gender disparities than more-rural localities in the southern and western parts of the state.

Maryland and D.C. said they did not have data cross-referencing gender and race. But in Maryland, which also has a fairly even split between men and women, there is a statewide gap between vaccinated men and women of 13 percentage points. In majority-Black Prince George's and Baltimore City, the gaps are 17 and 16 percentage points.

"It boils down to trust, and trust is not something that is built easily in someone who has been wronged by the system," said Quicksilva's doctor, Fernando Porter.

Quicksilva, who hosts a daily show on 93.9 WKYS and travels frequently for work, said he was eventually persuaded to get his first dose of the Pfizer-BioNTech vaccine in late March. But now, disturbed by news that the Pfizer vaccine will probably require booster shots, he is wavering about his second dose.

"When you look at all the injustices, at the top of the totem pole are Black and Brown men," said Quicksilva, 40. "The distrust has been there for so long."

Porter said this point of view is common among the Black and Latino men he treats at his family practice in Silver Spring, with many wary of both the health-care system and the government.

"You have this double whammy of health care and government saying 'Do this,'" Porter said. "For a lot of them it comes down to fear."

Annapolis residents Mo Lloyd, 22, and Deonte Ward, 32, say they do not intend to get vaccinated. Ward said his wariness comes from incidents such as Tuskegee; Lloyd said he does not trust the three pharmaceutical companies producing the vaccines. "They've done some sketchy things in the past," said Lloyd, citing reports from 2018 that Johnson & Johnson knowingly sold baby powder that contained small amounts of asbestos.

The only people in their families who have gotten vaccinated are women, the two men said. For Ward, it's his aunt; for Lloyd, his mother.

Officials from D.C., Maryland and Virginia, along with those from nine local jurisdictions in the Washington metro area, said that aside from some targeted ads, they have not taken specific steps to increase vaccine turnout among men.

"The data that is used by us doesn't take into particular account gender," said Lt. Col. Andrew Collins, deputy chair of Maryland's vaccine equity task force.

Elyn Garrett-Jones, a spokeswoman for the Baltimore County Department of Health, said that "while we are pushing for communities of color in general to get vaccinated, we have not singled out men as part of this effort."

Gloria Addo-Ayensu, Fairfax County health director, said that "it is still too early in the mass vaccination process to draw firm conclusions about gender disparities."

In Prince William, officials have not studied the intersection of race and gender in vaccine hesitancy, said health director Alison Ansher. She acknowledged that the gap is concerning, however, given that men constitute 57 percent of the covid-19 deaths in the county.

Derek M. Griffith, director for the Center for Research on Men's Health at Vanderbilt University, said that "if governments notice (the gender gap), they're certainly not paying attention to it nor incorporating it into their rollout."

Theories have emerged to explain the disparity - including that women traditionally take on family caregiving roles, which drives them to seek out vaccinations earlier than men. But Griffith said it is difficult to ascertain whether those theories are accurate, because research is scarce.

"There are huge racial differences in who gets vaccinated, and we know that," Griffith said. "What I haven't seen done well is a crossing of the race, ethnicity and gender patterns."

Locally, Prince George's is one of the few counties where officials are directly targeting the gender gap, including plans for a 24-hour vaccine-a-thon in mid-May focused on men. Members of the county's Commission for Fathers, Men and Boys say they are volunteering at mobile vaccine clinics and planning public service announcements because they realize it is helpful for men to see people who look like them vouching for the shot.

Euniesha Davis, director of the county's office of community relations, proposed the vaccine-a-thon after health department officials pointed out the gender divide in early data. She wants to partner with local go-go artists and make the event accessible by having appointments throughout the day. It will be open to everyone, but the emphasis is on drawing men.

"We are going to encourage wives to bring husbands, mothers to bring sons, sisters to bring brothers," she said. "The message is: It's not about you - it's about the community."

More efforts to bridge the gender gap are happening at the grass-roots level - doctors coaxing patients, barbers fielding questions from clients, pastors taking calls from exasperated wives.

Stephen B. Thomas, head of the Maryland Center for Health Equity at the University of Maryland, said he has heard numerous stories of "discordant households" split by the vaccine - and he is not surprised.

"Who runs the health in your house? My wife runs it in my house," he said, adding that he has been disappointed not to see a more concerted government focus on gender. The key to such an effort, he said, is not to "shame" men but to "meet them where they are."

Mike Brown, a Hyattsville, Md., barber who works with Thomas to promote men's health, estimated that about 40 percent of his clients do not want to get vaccinated, and many baseless vaccine theories that he tries to debunk. Brown, who works in a Zip code with one of the highest coronavirus case rates in the state, started promoting men's health a decade ago, after his father died of colorectal cancer that Brown believes could have been prevented with a healthier lifestyle.

He frames the decision to get vaccinated as a matter of personal responsibility. "If the coronavirus vaccination is Plan A, then what is your Plan B to stop this from ravaging our communities?" he asks the men who sit in his chair. "They can't answer that question."

Sherry Johnson-Miller, 46, is one of the women who pleaded with DeWitt to counsel her husband. As a certified nursing assistant at a Baltimore nursing home, Johnson-Miller was fully vaccinated by January. She has tried since then to persuade husband Joseph Miller, 50, to join her in the world of the immune.

She set up appointments, to no avail. Now, her 29-year-old son is also eligible but wavering.

"I'm the only vaccinated one. That's what I'm dealing with," she said during her lunch break Thursday.

With each passing week, Johnson-Miller said, she gets more frustrated with her husband for interfering with her plans to go to Las Vegas for their wedding anniversary in August. She will not travel with anyone who is not vaccinated, she said, not after seeing what the virus did to the residents at her nursing home. If Miller does not change his mind soon, she said, she will make plans to go on a "girls trip" instead. Her sister and most of her friends are fully inoculated.

"I'll be gone in Vegas and having fun, and he'll be stuck here," she said, half-laughing. "See how he feels then."