Many families with immuno-compromised or vulnerable relatives are racing to get vaccines for their 5-to-11-year-olds — and finally experiencing a long-awaited sense of relief.When the pandemic came for Georgia, Lauren Rymer had to make a snap choice: her mother’s safety or what she believed was best for her young child.She locked down her family for the better part of last year, living with her mother, Sharon Mooneyhan, who has multiple sclerosis, and protecting her by keeping her son Jack, 5, out of kindergarten to avoid routine household exposure to Covid. “I didn’t want my mom to miss out on being with her only grandchild,” Ms. Rymer said.So school was scrapped for mushroom hunts in the forest between her work Zoom calls, Legos and an intergenerational exploration of a backyard chicken coop. The upside was that she and her mother would not have to live in fear of a life-ending snuggle at bedtime.Last week Jack, now 6, donned a superhero costume and hit the local CVS in Lawrenceville, Ga., to get a Covid shot, his first step toward a return to school, and a full life beyond their suburban Atlanta home.“This vaccine is much bigger than a shot in the arm,” Ms. Rymer said. “It’s a huge weight off my shoulders.”Millions of American parents have spent the better part of the last two years anxiously viewing their youngest family members through a dual lens: as the small souls crushed by the isolation of lockdowns or periodic quarantines and also as potentially fearsome vectors of infection dwelling in their midst. With another wave of Covid sweeping through parts of the country, the worry has not subsided altogether for so many families.But for some, like the Rymers, finally getting children vaccinated this past month put a major piece of a protection puzzle in place for severely vulnerable adults who are immunocompromised, fighting cancer or coping with other diseases. That sense of relief has intensified with the holiday season here and all the trimmings and trepidation that accompany this year’s family gatherings.Dr. Elizabeth Pietralczyk, who takes drugs that suppress her immune system, fought back tears as she described the terror she felt of becoming ill and trying to hide her fears from her daughter, Sybil, 6.Coloring pages and child-friendly virus information at Lurie Children’s Hospital of Chicago’s pop-up vaccine clinic.Taylor Glascock for The New York Times“The biggest thing for me was that I didn’t want her to get sick and then if something happened to me, have her feel she was responsible,” said Dr. Pietralczyk, a family physician who is the sole wage earner in her household.Sybil got her first shot recently, lifting the canopy of anxiety that hung over the family of four.“I felt like I was letting go of a breath I didn’t know I was holding,” Dr. Pietralczyk said.Parents and children have flocked to vaccination sites after school, lining up outside places like the American Museum of Natural History in New York. According to the Centers for Disease Control and Prevention, nearly 13 percent, or slightly more than 3.5 million of the nation’s 28 million children from ages 5 through 11 had already received their first dose by Tuesday, in the month since that age group was granted eligibility.“Coping with fear and uncertainty, especially over an extended period, is so hard on our brains,” said Lindsey Leininger, a health policy researcher and clinical professor at the Tuck School of Business at Dartmouth. “It’s akin to a major tax on cognitive function. Adults with health issues who have small children have been living with heightened levels of fear and uncertainty for almost two years.”The central goal of vaccinating children against the coronavirus has largely been for their own health and, more broadly, to ease the strain on school and day care systems that are in a perpetual cycle of shutdowns, testing and reopenings as children become infected. For some families with several generations under one roof, or worrying about a family member with a severe illness, the vaccine for young children is a crucial barricade of protection for the most vulnerable adults. It’s a hug recovery program, with giant stakes.“This community has a lot of multigenerational families,” said Nancy Valentin, the director of health equity at the Northwest Center, a nonprofit in Chicago. “If you walk into one single-family home, you’re going to see different folks living there, whether it’s like grandparents or if people are having a hard time paying for rent — they’ll just blend families in one house.”MariCarmen Zavala and her 8-year-old son, Louis Perez, on their way to get him his first shot. “He will help protect the ones who are not,” Ms. Zavala said.Taylor Glascock for The New York TimesThe organization recently ran a vaccine clinic in the heavily Polish and Latino communities, where some have hesitated to get their children vaccinated. MariCarmen Zavala brought her 8-year-old son, Louis Perez.“It’s really important for me to get the vaccine for him so that my son is able to do the activities that he likes to do,” she said. “My two sisters-in-law don’t want to vaccinate their children based on the misinformation they hear. So he will help protect the ones who are not.”In Ely, Minn., two of Michelle Greener’s children, Sophie, 10 and Liv, 11, share a rare disease — Ehlers-Danlos syndrome — with her husband, and she has a 16-year-old she adopted when the girl’s mother, the family babysitter, died in 2019. That child, Emma, is severely disabled and at very high risk for complications from Covid.Ms. Greener, 38, takes care of all three while her husband goes to his manufacturing job. First she was vaccinated, and the outside world belonged largely to her alone. Then, a shot for her husband: another worry down. Next came Emma, who had emergency surgery during the pandemic. Ms. Greener stayed with her in the Twin Cities, and limited contact with her younger children, who at the time were too young to be vaccinated.“The day they approved the vaccine for 12 and up is the very day I drove two hours down to Duluth,” said Ms. Greener, whose house is so distant that she spends nights staring at the northern lights. “I cried all the way in and cried all the way out.” One child had reacted poorly to another vaccine in the past.“That was very emotional, a little stressful not knowing how my younger daughter would handle it,” Ms. Greener said of Liv. “I eat and breathe medical, that’s all I’ve done — all I think about is how I am going to keep these kids alive. Now we have done everything we can do to keep Emma alive. At this point, I am just dependent on the rest of the world.”Michelle Greener, center top, with her children, from left, Sophie, Emma and Liv, and her husband, Troy Greener, in Ely, Minn. Tara Kay PhotographyImmunized children have also become a force shield for families in places where overall vaccination rates are low. “I definitely have my concerns because of the area I am in,” said Lauren Patterson, 36, a government worker in Atlanta with lupus and other medical conditions. She is a single mother to Zora, 5. Only half the state of Georgia is fully vaccinated.“When I found out they were giving vaccines for 5-to-11-year-olds I immediately started scouring sources to get her an appointment,” she said. “I had always had to tell her this virus could hurt mommy or even kill mommy. So the pain is double when you have to comfort their feels but at the same time reinforce the harsh reality. We couldn’t kiss good night for so long. Having that mom guilt that is prevalent for all of us was so strong.”Dr. Pietralczyk said the issue was much the same in Alaska, where she lives. It has one of the lowest vaccination rates in the nation and its caseloads have risen with the Delta surge. She watched warily when her children wandered across the street to the neighbors.“The whole family came down with Covid,” she said. “I don’t know if they are vaccinated. I didn’t want her to play with them but I also didn’t want it to be a stigma in the relationship by prying into their personal life. That was a stressful two weeks.”For Ms. Rymer, the bottomless patience of her employer became her anchor, and the concentrated time with just her son and mother were gifts.Now, she is happy to leave those days in the rearview mirror.“Our circle has been small enough that we have been the most important people in Jack’s world,” said her mother, Ms. Mooneyhan. “But I know that the maturing and the worldliness you get from other people your age around you outweighs my selfish grandmother ideas.“I am excited about his circle getting wider again.”Ms. Rymer and Jack at home.Nicole Craine for The New York Times

Many who feel they need more coronavirus protection have managed to obtain an extra dose. “I did feel bad about it. But I didn’t feel bad enough,” one woman said.Amy Piccioni is not a doctor or a scientist, but as word of breakthrough coronavirus infections in vaccinated people started spreading this summer, she waded through an array of technical and often contradictory information about the need for coronavirus booster shots. Then she decided for herself: She would not wait for federal regulators to clear them before finding one.“It takes a long time for scientists to admit that some people need a booster,” said Ms. Piccioni, 55, who received the one-dose Johnson & Johnson vaccine last November through a clinical trial and timed her booster around a visit to her father in July, thinking it would protect her on the plane. She walked into her local Walgreens, asked for a Pfizer shot and got it, no questions asked.“All I could think about was how low the vaccination rate is in some areas,” said Ms. Piccioni, who lives near Del Mar, Calif., and is in good health. “Those doses don’t last forever, so I felt no guilt about taking one that probably would have expired.”While tens of millions of Americans continue to decline even a first Covid-19 vaccine, a small but growing number have sought out additional shots even though the Food and Drug Administration has not yet approved them and it remains unclear who precisely needs one and when.Studies in the United States have found that the vaccines continue to provide robust protection against severe Covid-19, especially for those younger than 65, even as evidence grows that their effectiveness against infection wanes over time. A review published on Monday by an international group of scientists, including two from the F.D.A., found that none of the data so far provided credible evidence in support of boosters for the general population.Still, many seeking early boosters fear that breakthrough infections could inconvenience or sicken them — or worse, they say, someone they love. Most do not feel they are taking a dose from someone else, as vaccines are widely available in the United States and a local pharmacy is not in a position to shift shots to nations that need them.The number of Americans who are not immunocompromised but have obtained extra shots is unclear. About 1.8 million people have done so since mid-August, according to the Centers for Disease Control and Prevention, but that count is likely to include many with weakened immune systems. The Food and Drug Administration authorized additional shots for that group last month.Also last month, the Biden administration announced that it hoped to start offering boosters on Sept. 20 to people who had received a second dose of the Pfizer-BioNTech or Moderna vaccine at least eight months before. But the leaders of the F.D.A. and the C.D.C. then said they needed more time to evaluate safety and other data. Janet Woodcock, the acting F.D.A. commissioner, has urged people not to seek booster shots on their own, but to wait for a regulatory ruling that they are safe and necessary.For many Americans — particularly those over 65, who were among the first to be vaccinated — the shifting plans were just another case of inconsistent information from the government about the pandemic.“Frankly, I did not trust the government to act on the science,” said Lynn Hensley, who assigned herself a booster in July, six months after her second shot. “I’m 78 and consider myself at a greater risk. I feel like I can just read what’s out there and make up my own mind.”She went to a temporary county vaccine clinic in the Fox River Valley area of Wisconsin.“They did ask me if it was my first or second shot, and I told them it was my first,” she said. “I did feel bad about it. But I didn’t feel bad enough.”Amy Piccioni at her home in Solana Beach, Calif. She received a booster without being asked questions from a pharmacy.Ariana Drehsler for The New York TimesThe Maryland Department of Health decided to take action ahead of the F.D.A.: It issued an order last week permitting immediate boosters for all residents 65 and older who live in group settings like nursing homes. Michael Ricci, a spokesman for Gov. Larry Hogan, pointed to the C.D.C.’s recommendation last month that “moderately to severely immunocompromised” people should have extra shots.“We are relying on that expansive view to deem the seniors in congregate settings as immunocompromised,” he said. “We are directing those facilities to offer the booster shot to anyone who wants one.”Federal guidance on masks, vaccine mandates, the risk of outdoor transmission and other virus-related issues have shifted often over the course of the pandemic. At times, within both the Trump and Biden administrations, there has been open disagreement among health officials on how to proceed, and confusing guidance that has subsequently been reversed.As a result, Americans across the political spectrum are relying on pieces of information, like an announcement by Israel’s Ministry of Health in July that the effectiveness of the Pfizer-BioNTech vaccine against symptomatic infection — though not against serious illness — waned over time. Others have trusted their intuition, whether that means taking dangerous livestock medications to “cure” the virus or seeking a booster before it is officially recommended.“This is a result of poor risk communication and lack of political and scientific transparency over the last 18 months,” said Rachael Piltch-Loeb, a researcher and fellow in public health emergency preparedness and response at the Harvard School of Public Health. “It is also a reflection of people feeling a total lack of control of what is happening in society at this point. One of the things that can do to protect themselves is to take science into their own hands.”.css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-3btd0c{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-3btd0c{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-3btd0c strong{font-weight:600;}.css-3btd0c em{font-style:italic;}.css-w739ur{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-family:nyt-cheltenham,georgia,’times new roman’,times,serif;font-weight:700;font-size:1.375rem;line-height:1.625rem;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-size:1.6875rem;line-height:1.875rem;}}@media 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a:hover{-webkit-text-decoration:none;text-decoration:none;}For vaccinated people living in areas where many have shunned shots and masks, proactively grabbing a booster feels like buying insurance on a rental car: They might not need it, but it makes them feel more secure.Many have found willing partners in pharmacies and health care providers.Bruni Baeza, 83, walked into a CVS in Miami, flashed the white vaccine card that showed seven months had passed since her last shot and was immediately given a booster, she said in an email from her birthday cruise — the impetus, she said, to get the third shot.Pharmacies deny that they are knowingly letting people flout the guidelines. “Patients are asked to attest that all information provided, including health status, is truthful and accurate while scheduling a vaccination appointment on CVS.com and when they receive their vaccination,” said Ethan Slavin, a spokesman for the company. “Mr. Slavin said that “we can’t speak to anecdotal reports” that CVS is giving boosters to customers like Ms. Baeza, who shared a record of her third dose with a reporter.Public health experts generally take a dim view of booster self-selection. Like vaccine refusal, they say, it does not take into consideration the broader fight against the pandemic, which they believe should be focused on vaccinating the 25 percent of Americans who are eligible but unvaccinated, or on vaccinating people in poor nations.“This flies in the face of what is required in a pandemic,” said Dr. Kirsten Bibbins-Domingo, an epidemiologist at the University of California, San Francisco. “The challenge is, particularly in a pandemic, individual choice is important but the entire strategy has to do with our collective choices and responsibility.”Isabella, an healthy 18-year-old freshman at Colorado College, decided to get a second Moderna vaccine in order to protect immune-compromised friends and others.“I feel like I can’t put the responsibility of being safe on anyone else,” said Isabella, who asked to be identified only by her first name because she had been dishonest about her health status, telling a pharmacist that she was immunocompromised. “I don’t want to contribute to illness in my community. Maintaining my immunity status is something I can do to protect my peers and myself, across all political views, so the legality of my booster shot isn’t important to me.”Dr. Bibbins-Domingo saw another downside in this method: “With everyone out there lying about being immunocompromised, lying about their status, this will just wreak havoc with the data. We want public health decisions to be based on good data. It is a disserve to treat medicine like a restaurant where we go in and order from a menu.”Still, people like Ms. Piccioni, the California woman who supplemented her Johnson & Johnson vaccination with a Pfizer one, feel it is better to be safe than sorry, even if the evidence has been mixed. “I was nervous,” she said, but concluded, “For someone like myself, someone who had an old vaccine, it was OK to boost with two.”She got her second Pfizer shot last month.

Tossing their masks, jumping on side-by-side treadmills, sharing peanuts next to fellow sports fans, the vaccinated find special freedoms await.At Fort Bragg, soldiers who have gotten their coronavirus vaccines can go to a gym where no masks are required, with no limits on who can work out together. Treadmills are on and zipping, unlike those in 13 other gyms where unvaccinated troops can’t use the machines, everyone must mask up and restrictions remain on how many can bench-press at one time.Inside Dodgers Stadium in Los Angeles, where lines not long ago snaked for miles with people seeking coronavirus vaccines, a special seating area allows those who are fully inoculated to enjoy games side by side with other fans.When Bill Dugan reopens Madam’s Organ, his legendary blues bar in Washington, D.C., people will not be allowed in to work, drink or play music unless they can prove they have had their shots. “I have a saxophone player who is among the best in the world. He was in the other day, and I said, ‘Walter, take a good look around because you’re not walking in here again unless you get vaccinated.’”Evite and Paperless Post are seeing a big increase in hosts requesting that their guests be vaccinated.As the United States nudges against the soft ceiling of those who will willingly take the vaccine, governments, businesses and schools have been extending carrots — actually doughnuts, beers and cheesecake — to prod laggards along. Some have even offered cold hard cash: In Ohio, Gov. Mike DeWine this week went so far as to say that the state would give five vaccinated people $1 million each as part of a weekly lottery program.On Thursday, federal health officials offered the ultimate incentive for many when they advised that fully vaccinated Americans may stop wearing masks.Now, private employers, restaurants and entertainment venues are looking for ways to make those who are vaccinated feel like V.I.P.s, both to protect workers and guests, and to possibly entice those not yet on board.Come summer, the nation may become increasingly bifurcated between those who are permitted to watch sports, take classes, get their hair cut and eat barbecue with others, and those who are left behind the spike protein curtain.Soldiers at Fort Bragg in North Carolina have access to a dedicated gym where the vaccinated can work out maskless and in unlimited numbers.Travis Dove for The New York TimesAccess and privilege among the vaccinated may rule for the near future, in public and private spaces.“The bottom line is this interesting question of the conception of our society,” said Dr. Tom Frieden, a former head of the Centers for Disease Control and Prevention and the architect of a smoking ban and a tuberculosis control program in New York City, both of which included forms of mandates. “Are we in some important way connected or not?”A vaccine requirement to attend school or participate in the military is not a novel concept. But because the three Covid vaccines offered in the United States have yet to receive full approvals by the Food and Drug Administration, the military has declined to insist on inoculation. For their part, public school districts cannot consider mandates until the vaccines are available to most children. The F.D.A. just granted emergency use authorization to Pfizer this week for children ages 12 to 16.But even without a mandate, a nudge can feel like a shove. The military has been strongly encouraging vaccines among the troops. Acceptance has been low in some branches, like the Marines, with only 40 percent having gotten one or more shots. At Fort Bragg, one of the largest military installations in the country and among the first to offer the vaccine, just under 70 percent have been jabbed.A Paperless Post design for  for post-pandemic parties: vaccinated only please RSVP.Paperless PostA podcast designed to knock down misinformation — a common misbelief is that the vaccines affect fertility — plays around the base. In addition to their freedom gym, vaccinated soldiers may now eat in groups as they please, while the unvaccinated look on as they grab their grub and go.With soldiers, experts “talk up to decliners versus talk down,” said Col. Joseph Buccino, a spokesman at Fort Bragg.Still, holdouts pose obstacles. For a recent mission to Europe, a handful of unvaccinated troops had to be replaced with those who had gotten shots, because of quarantine rules in countries there. “What we need to do is restore readiness,” Col. Buccino said.Segregating the unvaccinated and limiting access to gyms and dining areas were not measures aimed specifically at getting soldiers vaccinated, he said, “but there is an enticement.”The private sector, sometimes with the encouragement of government, is also trying to make life a bit nicer for the vaccinated, emphasizing the privileges — rather than perceived infringements on freedom — bestowed by the protection of the vaccines.It’s baseball season, and fans have clamored to get back to normal, to a place where the wave used to mean something other than the next surge of the coronavirus. Major League Baseball is heavily promoting inoculations, and stadiums have become a new line of demarcation, where vaccinated sections are highlighted as perks akin to V.I.P. skyboxes.In Washington, Gov. Jay Inslee recently announced that sporting venues and churches would be able to increase their capacity by adding sections for the vaccinated.Some businesses — like gyms and restaurants — where the coronavirus was known to spread easily are also embracing a reward system. Even though many gyms have reopened around the country, some still haven’t allowed large classes to resume.Others are inclined to follow the lead of gyms like Solid Core in Washington, D.C., which seeks proof of inoculation to enroll in classes listed as “Vaccine Required: Full Body.” “Our teams are now actively evaluating where else we think there will be client demand and will be potentially introducing it to other markets in the weeks ahead,” said Bryan Myers, president of the national gym chain, in an email.At Dragon’s Den in New Orleans, customers were induced to get vaccinated on site.Emily Kask for The New York TimesThe Bayou, a restaurant in Salt Lake City, will open its doors only to those who have had their shots, according to Mark Alston, one of the owners.“It was entirely driven by the fact that I work at the Bayou seven days a week,” he said. “I do not work from a comfy office and send staff off to work in unsafe conditions, but work there alongside them.”The “vaxxed-only” policy has flooded his voice mail with rancorous messages. “One in particular accuses us of running some kind of pedophile beer cult,” he said. “It’s a bit unhinged.”Even private citizens are deploying the practice in their homes. A spokesperson for Evite said 548,420 guests had received online invitations to events mentioning “fully vaccinated” or using other vaccinated-related terms since March 1, 2021, and invitations with the exact term “fully vaccinated” had been sent to 103,507 people. A similar company, Paperless Post, has created specific invitation designs with the inoculated in mind, vaccinated only please RSVP.Not everyone endorses this type of exclusion as good public policy. “I worry about the operational feasibility,” said Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Coronavirus Resource Center. “In the U.S., we don’t yet have a standard way to prove vaccination status. I hope we’ll see by fall such low levels of infection in the U.S. that our level of concern about the virus will be very low.”But few dispute that it is legal. “Having dedicated spaces at events reserved for vaccinated people is both lawful and ethical,” said Lawrence O. Gostin, an expert in health law at Georgetown Law School. “Businesses have a major economic incentive to create safer environments for their customers, who would otherwise be reluctant to attend crowded events. Government recommendations about vaccinated-only sections will encourage businesses and can help us back to more normal.”The gym for vaccinated soldiers at Fort Bragg. The perks of vaccination don’t stop there: For a recent mission to Europe, a handful of unvaccinated troops were replaced with those who had gotten shots.Travis Dove for The New York TimesLarge employers with a few notable exceptions have been reluctant so far to impose vaccine mandates for workers, especially in a tight labor market. “Our association came out in favor of masks,” said Emily Williams Knight, president of the Texas Restaurant Association. “We probably will not be taking a position on mandates, which are incredibly divisive.”But some companies are moving that way. Norwegian Cruise Line is threatening to keep its ships out of Florida ports if the state stands by a law prohibiting businesses from requiring vaccines in exchange for services.Public health mandates — from smoking bans to seatbelt laws to containing tuberculosis outbreaks by requiring TB patients to take their medicines while observed — have a long history in the United States.“They fall into a cluster of things in which someone is essentially making the argument that what I do is only my business,” said Dr. Frieden, who is now chief executive of Resolve to Save Lives, a program designed to prevent epidemics and cardiovascular disease. “A lot of times that’s true, unless what you do might kill someone else.”Dr. Frieden was the main official who pushed for a smoking ban in bars and restaurants in 2003 when he was the New York City health commissioner under former Mayor Michael R. Bloomberg. Other senior aides at the time felt certain the ban would cost Mr. Bloomberg a second term. “When I was fighting for that, a City Council member who was against the ban said of bars, ‘That is my place of entertainment.’ And I said, ‘Well, that’s someone’s place of employment.’ It did have impact.”Mr. Dugan, the bar owner in Washington, said protecting his workers and patrons are of a piece. “As we hit a plateau with vaccines, I don’t think we can sit and wait for all the nonbelievers,” he said. “If we are going to convince them, it’s going to be through them not being able to do the things that vaccinated people are able to do.”

Holly Elgison and Len Schillaci are a mixed vaxxed couple, and they are far from alone.“I was always going to get the vaccine, 100 percent,” said Ms. Elgison, a medical claims auditor in Valrico, Fla.Her husband, a disaster insurance adjuster, said he will pass. “To be honest with you, I think that the worst of Covid is behind us,” Mr. Schillaci said. “I’m good.”As the Biden administration seeks to get 80 percent of adult Americans immunized by summer, the continuing reluctance of men to get a shot could impede that goal.Women are getting vaccinated at a far higher rate — about 10 percentage points — than men, even though the male-female divide is roughly even in the nation’s overall population. The trend is worrisome to many, especially as vaccination rates have dipped a bit recently.The reasons for the U.S. gender gap are many, reflecting the role of women in specific occupations that received early vaccine priority, political and cultural differences and long standing patterns of women embracing preventive care more often generally than men.The gap exists even as Covid-19 deaths worldwide have been about 2.4 times higher for men than among women. And the division elucidates the reality of women’s disproportionate role in caring for others in American society.“It could matter to localized herd immunity,” said Alison Buttenheim, an associate professor of nursing at the University of Pennsylvania and expert on vaccine hesitancy. “While most experts are fretting about larger gaps by race, political party, religion and occupational group,” she said, many of which overlap with the gender disparities, “I haven’t heard of any specific initiatives to target men.”In Los Angeles County, where 44 percent of women over 16 have gotten their first shot — compared with 30 percent of men — officials are scrambling to figure out how to do just that.“We are very concerned about it and are planning to embark on some targeted outreach among men,” said Dr. Paul Simon, the chief science officer at the Los Angeles County Department of Public Health, who said that the disparities are of particular concern for Black and Latino men. Only 19 percent of Black males in Los Angeles County and 17 percent of Latino males have received at least one dose of the vaccine, compared with 35 percent of Asian men and 32 percent of white men, according to the most recent data available from early this month.“We don’t fully understand it,” Dr. Simon said. “One of our messaging strategies will be that the vaccine is not only important for you but, in addition, is a means of protecting others in your family.”In Los Angeles County, 44 percent of women over 16 had gotten their first shot — compared with about 30 percent of men.Frederic J. Brown/Agence France-Presse — Getty ImagesThe early divisions in vaccine rates by gender could largely be explained by demographics. Americans over 70 got the first sets of doses, and women make up a larger proportion of that age group. In many states, health care workers and schoolteachers were also given vaccine priority: Women account for three-quarters of full-time health care workers and over 75 percent of public schoolteachers in the United States are female.The disparities show both where women do the paid and unpaid labor of life. For instance, women lost the majority of the earliest jobs in food services, retail businesses, health care and government jobs. The mothers among them have done most of the work in the shift to remote schooling and caring for parents and sick relatives.The combination may have increased their vaccine motivation in two ways: They are seeking to protect the rest of their family and they are desperate to get back in the work force. Indeed, just as women drove the job losses last year, they are leading the economic recovery now; roughly half a million women joined the labor force in March, in part because in-person schooling has resumed across much of the country.“In addition to women being disproportionately represented in several essential jobs,” said Pilar Gonalons-Pons, an assistant professor of sociology at the University of Pennsylvania who specializes in gender issues, “they are also disproportionately represented as unpaid caregivers for older adults in their families and communities, and this can also be an additional motivation for getting the vaccine.”In many ways, the pattern with vaccines reflects longstanding gender differences when it comes to preventive health care. Women are on average more likely to get annual physicals than men, even when adjusted for pre-existing health conditions and other factors, and are more likely than men to get preventive care.Men are more likely than women to engage in behaviors that hurt their health — like heavy drinking, smoking and illicit drug use — and are more overweight compared to women. Men are less likely to visit doctors regularly and go to the emergency room in a crisis and to get basic dental care, according to federal data. Vaccines are no exception: Historically, influenza vaccination is much higher among females — about 63 percent compared to 53 percent — though the gap narrows in Americans over 75 years old.The coronavirus vaccine “is the latest expression of the tried-and-true gender gap we’ve long witnessed in preventive health care seeking patterns,” said Lindsey Leininger, a health policy researcher and clinical professor at Tuck School of Business at Dartmouth College.But experts say that even in the context of general male health care recalcitrance, there may be some factors that are specific to this vaccine that are preventing more male shots in arms. Because the sign up has been cumbersome and confusing, men may have had less patience in navigating the system, which has largely taken place online, a process that women might find easier since they tend to get more of their health care information online.“We have to figure out if disparities are about access, if men are having more difficulty navigating the appointment systems,” Mr. Simon of Los Angeles said.Further, when it comes to the coronavirus — which has been the subject of rampant misinformation, evolving medical advice and politicization — other dynamics may be at work.“Some men have a sense that they are not necessarily susceptible,” Mr. Simon said health care workers have told officials. “They have weathered this for more than a year and have a sense of omnipotence.”Public health and academic experts have been long concerned with the “macho” effect that prevents men from getting all sorts of health care, and fear that it might be exacerbated with this vaccine. (Notably, in the most male service branch of the military, the Marines, about 40 percent of those who were offered the vaccine by the Defense Department have turned it down.)A selfie after receiving a Covid shot at the First Baptist Church of Glenarden in Upper Marlboro, Md., last month.Erin Schaff/The New York Times“This avoidance has been linked to masculinity ideals of men being strong, invincible and not asking for help,” said Kristen W. Springer, an associate professor in the Department of Sociology at Rutgers University in New Jersey who has done research on this trait.“In other words, these cultural ideals lead men to avoid important health care in order to act masculine,” she said. “Now that the vaccine is available to everyone, it will be interesting to watch male-female differences in vaccine uptake, because these will more likely reflect social and cultural ideas about gender and health, such as the cultural idea that ‘real men’ don’t need preventive health care.”At this stage, U.S. health authorities have not released data on nonbinary adults and vaccination.There may also be political connections. Women are far more likely than men to register as Democrats, and polls demonstrate that Republicans across the country have been far less likely than Democrats to embrace the vaccine.So who will men listen to? Not their wives and female friends or doctors, it seems. For their recent preprint study, Leah Witus and Erik Larson, professors at Macalester College in Saint Paul, Minn., watched videos with men and women that featured identical information about the vaccine. Among the 1,184 Americans who watched them, most were positively influenced by the male narrator while the female narrator got a far more mixed response.“The male-narrated version of the video increased vaccination intention in viewers,” said Ms. Witus, “but the female-narrated had mixed associations with vaccine propensity, and in some viewers, those that identified as conservative, actually decreased vaccination intention.”This may spell victory for Mr. Schillaci as he and his wife subtly joust for influence over their 20-year-old son’s vaccination decision. Mr. Schillaci has been sharing his views with his son, whom his wife is prodding to take a shot.“I would rather he got the shot, and I hope that he’ll consider it,” said Ms. Elgison.But Ms. Elgison’s own decision may benefit her son, even if he decides against the vaccine.As often happens in life, men may find their gaps covered by women. “To the extent most people live and socialize in a mixed-gender setting, the men will benefit from the higher coverage among women,” Ms. Buttenheim said.Ms. Elgison, however, still has a trump card she hopes might work. “I would like my son to get it so we can all travel together,” she said. “I explained to him that it’s possible that we could protect his dad.”

As states open vaccines and restaurants to all, wait staff and food service workers are often left behind. Some chefs have even opened pop-up spots to get their employees shots more quickly.Over the course of the pandemic, some of the most dangerous activities were those many Americans dearly missed: scarfing up nachos, canoodling with a date or yelling sports scores at a group of friends at a crowded, sticky bar inside a restaurant.Now, as more states loosen restrictions on indoor dining and expand access to vaccines, restaurant — who have morphed from cheerful facilitators of everyone’s fun to embattled frontline workers — are scrambling to protect themselves against the new slosh of business.“It’s been really stressful,” said Julia Piscioniere, a server at Butcher & Bee in Charleston. “People are OK with masks, but it is not like it was before. I think people take restaurants and their workers for granted. It’s taken a toll.”The return to economic vitality in the United States is led by places to eat and drink, which also suffered among the highest losses in the last year. Balancing the financial benefits of a return to regular hours with worker safety, particularly in states where theoretical vaccine access outstrips actual supply, is the industry’s latest hurdle.In many states, workers are still unable to get shots, especially in regions where they were not included in priority groups this spring. Immigrants, who make up a large segment of the restaurant work force, are often fearful of signing up, worrying that the process will legally entangle them.Some states have dropped mask mandates and capacity limits inside establishments — which the Centers for Disease Control and Prevention still deem a potentially risky setting — further endangering employees.“It is critical for food and beverage workers to have access to the vaccine, especially as patrons who come have no guarantee that they will be vaccinated and obviously will not be masked when eating or drinking,” said Dr. Alex Jahangir, the chairman of a coronavirus task force in Nashville. “This has been a major concern for me as we balance the competing interests of vaccinating everyone as soon as possible before more and more restrictions are lifted.”Servers in Texas are dealing with all of the above. The state strictly limited early eligibility for shots, but last week opened access to all residents 16 and over, creating an overwhelming demand for slots. The governor recently dropped the state’s loosely enforced mask mandate, and allowed restaurants to go forth and serve all comers, with zero limitations.“Texas is in a unique position because we have all these things going on,” said Anna Tauzin, the chief revenue and innovation officer of the Texas Restaurant Association.Michael Shemtov, owner of Butcher and Bee in Charleston, S.C., spoke to a television reporter during a vaccination drive at his restaurant. “If people can’t get appointments, let’s bring them to them,” he said.Ben ChrismanThe trade group is pairing with a health care provider to set aside days at mass vaccines sites in the state’s four biggest cities to target industry workers.The industry has taken matters in its own hands in other places, too.In Charleston, Michael Shemtov, who owns several spots, turned a food hall into a restaurant worker vaccine site on a recent Tuesday with the help of a local clinic. (The post-shot observation seating was at the sushi place; celebratory beers were tipped at an adjoining pizzeria.) Ms. Piscioniere and her partner eagerly availed themselves. “I am super relieved,” she said. “It’s been so hard to get appointments.”In Houston, Legacy Restaurants — which owns the Original Ninfa’s and Antone’s Famous Po’ Boys — is running two vaccine drives for all staff members and their spouses, moves the owners believe will protect workers and assure customers.Some cities and counties are also tackling the problem. Last month, Los Angeles County set aside the majority of appointments for five mass sites two days a week for the estimated 500,000 workers in the food and agriculture industries — half of whom are restaurant staff. In Nashville, the health department has opted to set aside 500 spots daily for the next week specifically for people in the food and hospitality industries. It is possible that restaurants will be able to require their workers be vaccinated in the future.Many business sectors were battered by the coronavirus pandemic, but there is broad agreement that hospitality was hardest hit and that low wage workers sustained some of the biggest blows. In February 2020, for instance, restaurant worker hours were up 2 percent over a previously strong period the year before; two months later those hours were cut by more than half.While hours and wages have recovered somewhat, the industry remains hobbled by rules that most other businesses — including airlines and retail stores — have not had to face. The reasons point to a sadly unfortunate reality that never changed: indoor dining, by nature of its actual existence, helped spread the virus.Tyler Cahill, 29, received his first Pfizer vaccine shot at Workshop, a food court in Charleston.Ben ChrismanA recent report by the C.D.C. found that after mask and other restrictions were lifted, on-premise restaurants led to daily increase in cases and death rates between 40 and 100 days later. Although other settings have turned into super-spreading events — funerals, wedding and large indoor events — many community outbreaks have found their roots in restaurants and bars.“Masks would normally help to protect people in indoor settings but because people remove masks when dining,” said Christine K. Johnson, professor of epidemiology and ecosystem health at the University of California, Davis, “there are no barriers to prevent transmission.”Not all governments have viewed restaurant workers as “essential,” even as restaurants have been a very active part of the American food chains — from half-open sites to takeout operations to cooking for those in need — during the entire pandemic. The National Restaurant Association helped push the C.D.C. to recommend that food service workers be included in priority groups of workers to get vaccines although not all states followed the guidelines.Almost every state in the nation has accelerated its vaccination program, targeting nearly all adult populations.“Most people in our government have considered restaurants nonessential luxuries,” said Rick Bayless, the well-known Chicago restaurateur, whose staff scoured all vaccines sites for weeks to get workers shots. “I think that’s shortsighted. The human race is at its core social and when we deny that aspect of our nature, we do harm to ourselves. Restaurants provide that very essential service. It can be done safely, but to minimize the risk for our staff, we should be prioritized for vaccination.”Texas did not designate as early vaccine recipients any workers beyond those in the health care and education sectors, but is now open to all.“The state leadership decided to ignore our industry as a whole as well as grocery workers,” said Michael Fojtasek, the owner of Olamaie in Austin. “Now because our state leadership has decided to lift a mask mandate while not giving us an opportunity to be vaccinated, it has created this really challenging access issue.” He has switched to a takeout sandwich business for now, and won’t reopen until every worker gets a shot, he said.Jade Fletcher, a server at the County Line in Austin. “I think it is important for them to be vaccinated,” Don Miller, the owner, said of his staff.Ilana Panich-Linsman for The New York TimesMany restaurant owners, however, said that they are going their own way with the rules, and customers often lead them there. “There is a lot of shaming that goes on if you open up and you don’t have your tables six feet apart,” said Don Miller, the owner of the County Line, a small chain in Texas and New Mexico.Moreover, his places continue to require masks and keep them at the hostess station for anyone who “forgets.” Most of his young work force, however, will likely wait a long time for a jab. “I think it is important for them to be vaccinated,” he said. “It hasn’t resonated with them as it hasn’t been available to that age group.”The restaurant industry has many more Latino immigrant workers than most other businesses, and some fear registration for the vaccine is complicating reopenings. Many workers at Danielle Leoni’s Phoenix restaurant, the Breadfruit and Rum Bar, declined unemployment insurance, and have shied from signing up for a shot. “Before you can even make an appointment you have to put in your name and date of birth and email,” Ms. Leoni said. “Those are questions that are deterrents for people trying to keep a low profile.”In Charleston, Mr. Shemtov was inspired by accounts of the immunization program in Israel, which was considered successful in part because the government took vaccines to job sites. “If people can’t get appointments, let’s bring them to them.”Other restaurants are devoting hours to making sure workers know how to sign up, locating leftover shots and networking with their peers. Some offer time off for a shot and the recovery period for side effects.“We don’t want them to have to choose between an hour or pay of a vaccine,” said Katie Button, the owner of Curate and La Bodega in Asheville, N.C.Still, some owners are not taking chances. “If we go out of business because we are one of the few restaurants in Arizona that won’t reopen, so be it,” Ms. Leoni said. “Nothing is more important than someone else’s health or safety.”

Bobby Stuckey flipped through receipts this month, surprised to see a huge increase in cocktail sales, the highest in the 17-year history of his restaurant, even though the bar section has been closed. The septuagenarians are back.“Every night we are seeing another couple or a pair of couples in the dining room, and they feel so much relief,” said Mr. Stuckey, the owner of Frasca Food and Wine in Boulder, Colo. “Covid was hard on everybody, but you can’t even think of the emotional toll in this group. They haven’t gone out. They want to have the complete experience. It is just joyful to see them again.”Older people, who represent the vast majority of Americans who are fully vaccinated against the coronavirus, are emerging this spring with the daffodils, tilting their faces to the sunlight outdoors. They are filling restaurants, hugging grandchildren and booking flights.Marcia Bosseler is back to playing Ping-Pong — and beating all the men, she says — at her apartment complex in Coral Gables, Fla.Randy and Rochelle Forester went out to eat with another couple for the first time in a year, and Ms. Forester celebrated the pleasure of being “out of sweats, to put on some pretty earrings and lipstick and be back in the world a little bit.” Fully vaccinated, Louis Manus Jr., an 82-year-old Navy veteran in Rapid City, S.D., is getting ready for his first vintage car club meeting in a year.Diners at Frasca Food and Wine in Boulder, Colo. “Every night we are seeing another couple or a pair of couples in the dining room, and they feel so much relief,” said Bobby Stuckey, the owner.Eliza Earle for The New York TimesRandy and Rochelle Forester, right, out to eat with longtime friends Phyllis and Sheldon Schwartz in Detroit. Ms. Forester celebrated being “out of sweats, to put on some pretty earrings and lipstick and be back in the world a little bit.”Cydni Elledge for The New York TimesThe upside-down world in which older Americans are drinking more martinis inside restaurants at a far greater rate than millennials will be short-lived.It’s a fleeting Covid-era interregnum in which the elders celebrate while their younger counterparts lurk in grocery stores in search of leftover shots or rage on social media, envious of those who have received a vaccine. In a few months, all that will most likely be over, and vaccines will be available to all who want them.For now, about two-thirds of Americans over 65 have started the vaccination process and nearly 38 percent are fully vaccinated, compared with 12 percent of the overall population, giving the rest of the nation a glimpse into the after times.“I am just enjoying my life,” said Robbie Bell, 75, who recently went out with two friends for a birthday celebration in Miami — one of whom was hospitalized last year with a dangerous case of Covid — and even hit the dance floor.“This is my just due,” Ms. Bell said. “Seniors gave up more than anybody else.”From left, Loretta McNeir, 68, Robbie Bell, 75, and Anita McGruder, 72, dance to the restaurant’s music as they left after dinner in Miami.Scott McIntyre for The New York TimesMs. Bell, left, and Ms. McNeir, surprised by a friend while out to dinner. “This is my just due,” Ms. Bell said. “Seniors gave up more than anybody else.”Scott McIntyre for The New York TimesMrs. Bosseler, who is 85, is thrilled to go back to live games of Ping-Pong and mahjong at The Palace in Coral Gables.“This is very exciting for me,” she said in a telephone interview.She is happiest to get back to “relationship with friends,” she said.“What was difficult was losing that intimacy of walking together and talking face-to-face. I missed not shaking a hand, or putting a hand on a shoulder.”Her neighbor Modesto Maidique, who is 80, has tiptoed out into the world, grabbing his sandwich indoors. But his central goal, like many older people, is to see his grandchildren.“I am about ready to jump in a plane and fly, and the sooner the better,” Mr. Maidique said. He also teaches a course on “lessons in life, love and leadership” at Florida International University in Miami and “dreaded the thought of people being online and my not having the ability to interact with others,” he said.His tentative plan is to hold a normal class in September.Other older Americans still in the work force are finding their way back into that world before many of the rest of us, too. Ms. Bell, a real estate broker, spent the last year driving around Miami in a car separate from clients, once giving a tour by speakerphone and pointing out landmarks. The clients would then go inside houses by themselves. “That is how I had to function,” she said. “For the first time last week, someone came who had her shots, too. I picked her up and I did my showings.”Modesto Maidique, 80, is excited to see his grandchildren. “I am about ready to jump in a plane and fly, and the sooner the better,” Mr. Maidique said.Scott McIntyre for The New York TimesMs. Bosseler, back at the Ping-Pong table, is eager to reestablish friendships. “I missed not shaking a hand, or putting a hand on a shoulder,” she said.Scott McIntyre for The New York TimesMs. Bell also dared to go out with two girlfriends for a birthday celebration. She and one of the friends are members of a ski club that suffered three Covid deaths related to a trip to Sun Valley, Idaho, early in the pandemic, and one of her two dinner companions also became sick enough to be hospitalized. Their first dinner out was so jubilant that Ms. Bell made her way to the dance floor, where an older gentleman tried to grab her hand and dance. (For that, she was not ready, and she said she swatted him away.) She and her pals “were talking about how great we felt and how nice it was even to be in each other’s company and talk and laugh,” she said.Ms. Bell said she tries not to dwell on the losses and the pain of the last year. “I am not going there,” she said, preferring to focus on the cheerful now. But when she talked about her grandchildren, she began to weep. “Do you know how bad it was not to hug your grandchild?” she asked. “I try not to think about it, it’s so hurtful.”Marsha Henderson, a former commissioner for women’s health with the Food and Drug Administration, also got inoculated and then began helping her friends and neighbors find vaccine appointments in Washington, D.C. As she and her friends crawl out, she said, they are beginning to look at shaking up some of their routes.“The Book Club Sisters will meet in April for the first time since Covid,” she said. “The pandemic has encouraged us to look to a new genre, not our usual biographies or politics. We are trying to look to the future, Afro Futuristic short stories. No more Zoom. It will be a hoot!”Marsha Henderson looks forward to her book club meeting in person. “We are trying to look to the future, Afro Futuristic short stories,” she said. “No more Zoom. It will be a hoot!”Michael A. McCoy for The New York TimesMany of those fully vaccinated — older and younger — are still as cautious , more like those crocuses that bloom in the day only to fold quietly back into their stems at night. “I would say that we are less afraid, but not fear-free,” said John Barkin, 76, who lives with his wife, Chris, 70, in Chestertown, Md. “There are so many stories about mutations, etc., and so many yet-to-be-vaccinated people seem to be acting more and more irresponsibly. Both of us feel that we have invested a year of being careful, so to continue on conservatively seems the way to go.”Their vigilance stems from the spread of some more contagious variants of the virus and from uncertainty over whether those who are vaccinated can still spread it. Lindsey J. Leininger, a health policy researcher and a clinical professor at the Tuck School of Business at Dartmouth in Hanover, N.H., said that the public health messaging has been “overcautious” at times.“But I suspect there’s something much deeper at play,” she said.“We’re biologically wired to avoid viral threats and abhor uncertainty,” Dr. Leininger continued. “Sadly, the variants inject some serious uncertainty, although we’re hopeful about emerging data suggesting our vaccines remain protective and that effective boosters can be produced. Some people cope with uncertainty by saying ‘To heck with it!’ and avoid all precaution, while others become super-cautious.”Paul Einbund, owner of The Morris, a restaurant in San Francisco, is seeing the adventurers out again. “We are getting more of our older clientele coming back,” he said. “Normally these are people who if I hadn’t seen in a year it would be so weird I would call them to see if they were OK.” One man who told him before the pandemic that he had a terminal illness came in the other night, to his great shock. “He was dining with three businessmen, and they went big and ordered this incredible chartreuse,” Mr. Einbund said. “That table gave me so much energy that night.”Cocktail sales this month at Frasca Food and Wine in Boulder were the highest in the restaurant’s 17-year history, thanks to older patrons. “It is just joyful to see them again,” said Mr. Stuckey, the owner.Eliza Earle for The New York TimesThe Foresters, right, and their friends, the Schwartzes, toasted the 80th birthday of Phyllis, left, and retirement for Sheldon, right.Cydni Elledge for The New York TimesNancy Arcadipone, 71, who splits time between Chicago and Kalamazoo, Mich., is planning her first trip to the Southwest in 45 years, and plotting when she can next enjoy eggplant parmigiana at La Scarola and a margarita next to a couple of tacos at Frontera Grill, both in Chicago, and live music performances. All within tantalizing reach.Still, her elation is tempered by the generational reversal of vaccine fortunes.“I feel the worst for the younger generation,” Ms. Arcadipone said. “My generation really got to live, experience and experiment. I feel sad for younger people. I find it kind of strange that our generation gets to be socially free first after a year of isolation.”Andrea Westberg, 73, sees it through all lenses, having missed out on a customized tour of Italy last summer with her teenage grandchildren. She and her husband, Gary, 74, moved to an active adult community in Roseville, Calif., two months before the world locked down and immediately longed for the incipient community pickleball, wine club get-togethers, potlucks and seeing new neighbors.“We were so disappointed,” Ms. Westberg said. “We kept busy decorating a new home, but not being able to share it with guests, including our sons and families, was very sad and lonely.”At last, she is together with family again.“I am hopeful for the future but cautious,” she said. “I grieve for those lives lost and hope that science and truth prevail in the years to come.”