An explosion of community spread that began with a handful of red counties has now turned into a fourth wave of COVID-19 that has seen cases increase in all 50 states for the first time since February. In many states, months of improvements that were generated by a combination of vaccines, masks, and restrictions on businesses have been reversed by a few weeks of casting away all concerns and acting as if the pandemic never happened. And now the nation is caught in a loop where most areas are continuing to lift restrictions at a time when the delta variant is increasing transmissibility and the virus is spreading at an ever-faster rate.

Because of the high basic reproduction number (R0) value for the new variants, even a 70% vaccination rate would not be enough to prevent community spread. But it would sure as hell help. Only America is seemingly stuck at a 48% vaccination rate, with a dozen states below the 40% line and not a single state reaching 70% of the population fully vaccinated. In part, that’s because the FDA has yet to approve vaccinations for those under 12. Because they can’t. Because vaccine providers haven’t yet submitted test data for children. And, since children under 12 account for about 15% of the population, getting to levels of vaccination necessary to stop the spread of delta is almost impossible. 

Still, at this moment, 90% of Democratic adults say they are already vaccinated. That’s about as good as we can do until vaccination for children becomes available. If all adults were vaccinated to that level, we would still be seeing community spread because children would still be acting as a pool of potential cases, but we would not be seeing the wave of cases happening now. 

Only there’s a roadblock: Republicans. And what makes something already difficult to understand even harder is that the biggest part of that roadblock is Republican women.

To see just how contagious the latest variants of COVID-19 really are, the original version of COVID-19 that spread across the United States last spring had an estimated R0 value of 2.7, which is in the range of the common cold. The delta variant has an estimated value of 6. That’s still short of something like chickenpox or polio (both of which have values around 10-15), but it’s much higher than most diseases. At an R0 of 2, a 75% vaccination rate would be enough to halt community spread. At an R0 of 6, it definitely would not. What’s really needed to halt community spread is a vaccination rate of 80% or higher. Everywhere.

That’s a whopper of a challenge. In other diseases, numbers like that have only been obtained because vaccination was in some way mandatory, such as vaccinations required for school or as a condition of employment. However, it is attainable, as the rate among Democratic adults shows.

But of course, all adults are not vaccinated at that level. Without a doubt, there are still some who are being held up by issues like an inability to get to a vaccine site, or concerns about getting time off if a vaccination leads to a day or more of feeling under the weather. Right now Civiqs indicates that 3% of adults still intend to get vaccinated. There is an even higher percentage of kids between 12 and 18 that simply haven’t yet gotten their chance at a jab. Every single one of those who wants the vaccine but hasn’t had an opportunity needs to get it. We need them all.

But to get to the levels necessary, this is a nut that has to be cracked.

Vaccine acceptance among Republicans.

From well before the time vaccines actually became available, over 40% of Republicans said they would not accept a shot even when it was offered. That number fluctuated a bit in early days, but in 2021 it has been remarkably stable. Republicans just don’t want the vaccine, and if they won’t accept the vaccine, it’s not possible to get to the levels of vaccination necessary to halt community spread. And—a letter to the blue states—there is no state so blue that this effect isn’t enough to tip the balance.

Even though 99.2% of COVID-19 deaths in May occurred among the unvaccinated, that shouldn’t make anyone feel safe. First off, there are a lot of problems caused by COVID-19 other than death, including long-term effects that can hit even those who had mild or asymptomatic cases. Second, vaccine breakthroughs do occur, especially among people who are frequently in contact with unvaccinated carriers. Third, the larger the number of cases out there, the more opportunities the virus gets to generate new, even more vaccine-evasive variants.

However, something may have happened in just the last weeks that gives a little hope. As cases have started increasing (again) and headlines have pointed to the rising tide of the delta variant, Republican vaccine resistance may have budged just a little bit. The number of Republicans saying they have been vaccinated ticked slightly up, while the number saying they would not be vaccinated moved slightly down. It will take some time to see if this is a real trend, but in the meantime a few crossed fingers wouldn’t hurt.

While waiting to see if that trend is real, there’s something more buried in these numbers; something that demands some analysis if the nation is going to really get the vaccination levels necessary—and that’s the enormous level of vaccine resistance among Republican women.

Looking at just the latest numbers from Republican men as captured by Civiqs, the number who say they have been vaccinated is 56% and the number who say they won’t be vaccinated is 37%. That “no” number is actually down by five points from the first of the month.

Vaccine resistance among Republican men.

However, when the same question is put to Republican women, the results are markedly different. The number who say they have already been vaccinated is a full 10 points lower, and the number who say they are still willing to be vaccinated is 11 points lower. Over the same period in which Republican men seemed to be moving toward greater acceptance of the vaccine, Republican women didn’t change their positions at all.

Vaccine resistance among Republican women.

So … why? Last December, a poll by NPR/PBS seemed to show an even greater gap, with NPR reporting: “Just 34% of Republican women say they would take a vaccine when it comes available, compared with 61% of Republican men.” However, this does not seem to align with the actual poll results. And those results are decidedly odd.

NPR / PBS / Maris poll (Mar 8, 2021)

	
		
        Yes, Will
        ALready 
        Vaccinated
        No, Won’t
        Unsure
	


	
        Democratic Men
        65%
        27%
        6%
        2%
	
	
        Democratic Women
        53%
        30%
        14%
        3%
	
	
        Republican Men
        30%
        20%
        49%
        1%
	
	
        Republican Women
        35%
        27%
        34%
        4%

This poll data is not only so different from current results, but so different from the way that NPR itself reported the results that it’s hard to know what to think of it. For what it’s worth, Civiqs has 88% of Democratic women reporting that they would accept the vaccine, with just 4% saying no. At the time of the NPR/PBS/Marist poll, that was slightly higher, but only 6%.

In April, Pew did an extensive write-up on the need to build an outreach to “rural, Republican men, 35% of whom don’t want to get a vaccine.” That article is notable because it proposes exactly the sort of “on-the-ground” outreach from “local pastors, doctors and families” that President Biden has proposed, and which Republicans have been attacking. The article is also notable because the word “women” does not appear in it a single time. 

In June, 538.com noted a gender gap among men and women on vaccination, in the sense that more women than men have been vaccinated overall, and proposed a whole series of reasons there should be an outreach to men … while ignoring the fact that the difference in vaccination rates is only 2% and that in the most vaccinated group—Americans over 65—there are just 84 men for every 100 women. With 89% of the over-65 age cohort receiving at least one shot compared to just 56% of the total population, that simple difference in life expectancy more than explains the difference in total vaccinations. And that’s before bringing in how early vaccinations were made available to those involved in health care positions where women are present in greater numbers. So, no, there’s not a need to make an outreach to men or explain how vaccines are “masculine.” 

The best clue to why Republican women might be still holding out against the vaccine, even as Republican men seem to be slowly sliding toward acceptance, might come from a Politico article from back in March. The focus of that article was on a rumor that has been consistently spread since even before the vaccines became available. 

That myth is still being pushed by the anti-vax sources who dominate a lot of the online rumor mill. As Open Access Government reported, Google searches for connections between infertility and the COVID-19 vaccines “increased by 34,900%” following the publication of that online petition.

Claims about infertility, about how mRNA vaccines could lead to “mutations” or “birth defects,” and about how even associating with vaccinated people could cause potential harm to pregnant women or their children are right at the top of the false claims made about COVID-19 vaccines. So are associated claims that an mRNA vaccine can “change your DNA.”

From the time these rumors first appeared, medical authorities have attempted to knock them down. And knock them down again. And again.  But that message is clearly not breaking through to Republican women—and even among Democratic women, there is a 4% gap in those saying they have been vaccinated. 

So again … why? A big part of the “why Republicans” is clearly related to how the anti-vax community has shifted to the right, with just 12 scam artists feeding massive amounts of false information through social media at every level. Some of these disinformation campaigns are well-organized and well-funded, giving an appearance of professionalism that draws from decades of experience in building confusion over the opinion of genuine experts.

And when it comes to “why women?” there’s not just the way in which concerns over COVID-19 vaccines have been attached to pregnancy and children. There’s also a longstanding issue—in fact, a semi-eternal issue—in which women don’t feel like doctors or other medical experts are looking out for their concerns. As The New York Times reported back in 2018, “Health care providers may have implicit biases that affect the way women are heard, understood and treated.”

To give a personal example, my wife went to her doctor repeatedly complaining of pains in her back and shoulders, exhaustion, difficulty sleeping, and an inability to keep up her level of exercise. Her doctor chuckled at her and said, “You sound like a woman who’s upset about turning 50.” He recommended she see a therapist to decrease her anxiety. What she had was not anxiety. It was a two-liter tumor in her chest that had collapsed her left lung, was crushing her heart, and which within days of that visit came very close to killing her. That experience may be extreme, but it’s sadly not all that unfamiliar to way too many women.

Fixing the longstanding and well-earned distrust that many women have for medical experts may be too much to ask as a step in getting us to where we need to be when it comes to COVID-19 vaccinations. But shooting down the disinformation that is generating enough concern to generate a 10-point gap among Republican women and men is something that deserves more attention, and a better approach.