Throughout history, females have shown a higher tendency for vaccine hesitation . The historical bias against females in the scientific literature can be an integral cause as women are often more sceptical of medicine and the pharmaceutical industries. Expectedly, females had a higher mistrust of the vaccine in our study. In addition, females often exhibit a more heightened responsibility sense for the family’s health as a whole. Hence, they engage in medical research and consultations with experts, but they are also exposed to negative news and social media opinions . Interestingly, it has been previously reported that women comprise most people with anti-vaccination tendencies on social media . Therefore, these factors can interplay, among others, affecting females’ negative attitudes towards vaccinations.
With the recent surge of COVID-19 and the development of vaccines, this trend has proved to be still in effect, with many studies reporting higher levels of COVID-19 vaccine concern among females and lower uptake rates [16–18]. Similarly, our study found that female HCWs have lower vaccine uptake rates than males, which is worrisome considering their substantial role in inpatient care, particularly given the high proportion of female nurses. Consequently, this study used the VAX scale and its sub-items to examine gender differences in attitudes toward vaccine uptake and other associated variables.
Gender-related issues such as infertility and pregnancy were of particular importance debating the difference between genders, while other factors such as profession and parenthood were proposed and reported as significant indicators for vaccine uptake, among others [19, 20]. The myth of infertility persists despite the lack of any evidence to support this notion. A recent study exploring the factors nurturing conspiracy theories regarding COVID-19 and its implication on vaccine uptake has found that 23% of respondents believed the COVID-19 vaccines could lead to infertility . While this specific concern was not addressed in this study, there was an increase in vaccine uptake with increasing age in female HCWs. In males, however, this relationship was reversed; younger males had the vaccine at a higher rate than older males. When this is connected to vaccination attitudes, we can explain this variation in the significant difference in females’ attitudes by the increased concerns about unforeseen future effects.
Many recent studies have reported profession as an essential indicator of vaccination, with physicians having higher vaccination rates [19, 20]. In this study, male physicians are higher than their female counterparts. However, contrary to the recent reports, there was no significant difference in vaccine uptake among females of different professions, with similar vaccine uptake rates between female physicians, nurses, and others. This indicates that working in higher-ranking professions, such as physicians, is not predictive of vaccine uptake but rather that gender plays a significant role. Being a female physician, nurse, or even administrative worker is associated with lower COVID-19 vaccine uptake. Hence, the reluctance of female HCWs to take the vaccine may be due to other reasons, possibly exclusive to females. Likewise, our analysis shows a significant difference between male and female HCWs’ perceived knowledge of COVID-19 and its vaccine; although this gap warrants further investigation to understand its cause, it might play a big factor in driving the negative attitude of females HCWs towards vaccination against the virus.
Other studies have identified having a child as a negative predictive factor for vaccine uptake [19, 22]. Our study results indicate a similar tendency for females. The concerns for local and systemic reactions against the vaccine in most unvaccinated females might make them unsure of their ability to take care of their children under such circumstances. This comes in line with other reports that cited concerns for side effects as a significant barrier in the face of vaccination [17, 23–25].
The overall negative attitude of female HCWs towards the vaccine could be a significant obstacle for healthcare in general and the resolution of the COVID-19 pandemic in particular. To combat this devastating implication, we need to target specific concerns that support this attitude, including components explored in this study, such as worries over unforeseen future effects or concerns about commercial profits.
Despite the significant contributions made by this research, a number of limitations should be addressed. First, the generalizability of this study is limited due to its convenience-sampling approach; however, this is an exploratory study that has provided insight into the current COVID-19 vaccine uptake in HCWs based on their gender. Second, relying on an online survey to collect data may introduce non-response bias, undermining the study’s generalizability. To avoid this bias, we did not require respondents to reveal their identities. Third, some potential confounders associated with female HCW vaccination uptake were not collected, such as being pregnant, planning to become pregnant shortly, or vaccination-related fertility issues. However, the VAX scale measures these issues indirectly through different items.