Gender differences in COVID-19 preventative measures and vaccination rates in the United States: A longitudinal survey analysis

Background: Pandemics present challenges for individuals as they face uncertainties, risks, and decisions which influence their attitudes towards public health interventions. This study investigates gender differences in attitudes towards COVID-19 preventive measures and vaccination intentions in the United States, focusing on the link between risk perception and attitudes towards public health guidelines. Methods: We utilised data from the Understanding America Study, a nationally representative longitudinal survey of U.S. adults from March 2020 to March 2022 to assess how gender differences in health risk perception were associated with attitudes, behaviours, and vaccination intentions, while also evaluating how these gender effects changed over time. We used multilevel logistic regression models to adjust for age, level of education, employment status and income. Results: Women had a higher risk perception of COVID-19 and exhibited greater compliance with preventive measures compared to men. Women also showed higher agreement with COVID-19 restraining public policy measures. However, this contrasted with attitudes towards the COVID-19 vaccine, where men displayed more positive views and a higher intention to receive the vaccine. This gender effect was persistent over time. Conclusions: This seemingly paradoxical outcome suggests that while women's heightened risk perception relative to men's leads to greater adherence to non-pharmaceutical COVID-19 preventative public health interventions, it may also result in more negative views towards the novel COVID-19 vaccine. Understanding the complex interactions between risk perception, behaviour, and gender can inform policymakers and health authorities to tailor interventions that address the diverse needs of the population.