We call for an intersectional approach to COVID-19 research and vaccination programmes to better serve people. Socially, gender, race, ethnicity, disability, class and geography are key mediators of exposure to SARS-CoV-2, access to care and the impact of lockdowns. Biologically, age, male sex, obesity and co-morbidities are important risk factors for severe disease and mortality. More investigation is needed on how these factors interact to affect health and vaccination.
For example, mild to moderate adverse events following messenger RNA COVID-19 vaccines (such as fatigue and pain) are more likely to be reported by women than men (CDC COVID Response Team, Food and Drug Administration. MMWR Morb. Mortal. Wkly Rep. 70, 125–129; 2021). Meanwhile, fewer women, younger adults and Black individuals intend to get a COVID-19 vaccine (K. H. Nguyen et al. MMWR Morb. Mortal. Wkly Rep. 70, 217–222; 2021). Clearly, intersectionality is key in studying and communicating the risks and benefits of vaccination.
Despite interest in how the pandemic differentially affects people, biomedical and social scientists have siloed variables to focus on one group or risk factor. Instead, we need models that evaluate, for example, how the impact of age on COVID-19 outcomes differs by sex, race, gender, co-morbidities or frailty. Such approaches have borne fruit in flu vaccine development.
