We’re more than a full year into the pandemic and it’s clear: Women are bearing the brunt of it. Not just because women have been forced out of the workplace at disproportionate rates — hitting the lowest level of female participation in the workplace since 1988, or because more than 75 percent of those working in the health sector are women. Indeed, women may be hardwired to experience COVID-19 and the vaccines differently. Data from the Centers for Disease Control and Prevention (CDC) suggests side effects from the vaccines are hitting women harder, as 63 of the total 66 reported cases of anaphylaxis happened in women. Sabra Klein, PhD, a professor at the Johns Hopkins Bloomberg School of Public Health in Baltimore and a codirector of the Center for Women’s Health, Sex, and Gender Research joins us on this episode to explain the biological reasons behind the data. Listen and subscribe on Apple, Stitcher, Spotify, or Google so you don’t miss the next episode. And if you like what you hear, a five-star rating goes a long way in helping us Track the Vax! Serena Marshall: Women and COVID. It’s a big question. And one I feel that we maybe don’t have a whole lot of answers to. But let’s start out with what we do know. I guess, mostly, we know women have been disproportionately affected by the pandemic, forced out of the workforce, childcare, less access to health services. But what about the disease itself? Do women and men react to COVID differently? Sabra Klein: The simple answer is yes, women and men react differently — and by react, I’m going to say our immune responses. How our immune system sees the virus and responds to the virus, absolutely differs. I think all too often, the differences between men and women have gone ignored. Not because women are not studied. We are. But all too often, data is not separated for men and women and analyzed separately to see if we really are responding differently. As you said, we are being disproportionately affected by this pandemic in terms of childcare, occupation, job loss. Some estimates put it at about a decade to get us back to where we were prior to entering into this pandemic. In terms of our biology and who is suffering worse outcomes? When we look at who is being admitted into the intensive care units with severe disease, it is still men. Men are about three times more likely to be admitted into the ICU than are women. Serena Marshall: That’s really a fascinating statistic because you don’t really think about a virus impacting a man and a woman differently. Sabra Klein: I think it’s that we haven’t been able to get this information out to the public in a meaningful way. Because to be honest with you, we have known for decades now that the immune systems of men and women differ and that by and large men are more susceptible to severe outcomes from viral infections. We saw this for others that we call beta coronaviruses, like the SARS-CoV-2 virus that’s causing the pandemic right now. We saw this during the SARS epidemic in 2003. We also have seen this during the MERS epidemic, which is still ongoing in the Middle East. So, you know, even for things like hepatitis viruses, we’ve seen these types of male biases and outcomes. Serena Marshall: When it comes to these vaccines that are being distributed now, are women suffering more adverse events from the vaccinations or fewer? Sabra Klein: It’s such a good question. The data that have been coming out thus far show that 77 percent of the people reporting any adverse events — that can be injection site pain, fatigue, headache, fever — they’re women. So women are experiencing, or at least reporting experiencing more adverse events than males. Serena Marshall: When it comes to that 77 percent who are reporting more adverse reactions, do we know if that’s just because perhaps women report more? They’re more likely to go onto the website, file a complaint, than maybe a man would be? Sabra Klein: Absolutely. You bring up the second point. That there can be this social or what we in the field like to refer to as a gender component. A nonbiological explanation for why we would see these types of numbers. So yes, it turns out that women do report pain and feelings of pain more often than their male counterparts. Women are often more proactive about their health. They tend to utilize healthcare and healthcare services more than men. So just as you said, getting onto a website and reporting just may be higher in women compared with men. I think in the end we’re going to find that it’s the intersection of both the social and cultural norms contributing to why women are more likely to report. Mixed with sometimes when we [women] really don’t feel well, we are more likely to report because we think this is important. I think there’s going to be an intersection between that biology and those social and cultural norms.
