These urologists are setting the record straight about penises and COVID

Earlier this month, Green Bay Packers quarterback Aaron Rodgers appeared on The Pat McAfee Show to discuss his decision not to get vaccinated against COVID-19. “I made a decision that was in the best interest of my body,” he said. “The next great chapter in my life, I believe, is being a father, and to my knowledge, there has been zero long-term studies around sterility or fertility issues around the vaccines.” 

When an NFL icon publicly declares that he isn’t taking the vaccine because he’s worried about his fertility, it’s worth paying attention to his reasoning—and not just because he has 4.5 million Twitter followers. He’s also in good company. Online searches for info on the COVID-19 vaccine and fertility increased by up to 710 percent in the 48 days after the vaccine received Emergency Use Authorization from the FDA, according to a study by University of Miami urologists. 

While Rodgers is technically correct that no long-term studies on COVID-19 vaccines and male fertility exist (the vaccines are new, after all), the subject has been investigated, and all evidence suggests there’s no reason to fear. The Johnson & Johnson vaccine, which Rodgers has claimed is the only one he could take due to allergies, has not been examined in this regard—but that’s because it’s not based on new vaccine technology, and should be no riskier to fertility than a flu shot (which is to say, not at all). 

Rodgers is just one of millions of American men who have refused the vaccine. The Centers for Disease Control and Prevention’s most recent data shows that men are slightly less likely to get the jab; 47 percent of the people who’ve been fully vaccinated in the US are men and 53 percent are women. This runs counter to the fact that men are much more likely to die from COVID-19 (globally, they have around 2.4 times the fatality rate in cases) and are also more likely to have severe symptoms. 

Why are men more vaccine-hesitant if they are more at risk? Experts argue that traditional masculinity, which makes men less likely to trust science and protect themselves from viruses, may be the cause. “Men who assert that they’re ‘completely masculine’ are more likely than other men to express skepticism about coronavirus vaccines and are less likely to say that they’ll take the vaccine,” according to a Farleigh Dickinson survey of 6,000 people. 

“Many men think that being tough is part of being masculine,” Dan Cassino, the political scientist who led the survey, said in a press release. “That means not wearing a mask, or getting a vaccine. It means they figure they’ll be tough enough to survive COVID anyway.”

Bribes in the form of hunting and fishing licenses, beer, and shotguns in exchange for a jab have all been offered up in attempts to sway this swath of the population. But to really convince macho men, some experts say, vaccination campaigns should be focusing on the same insecurities that Rodgers alluded to.  

[Related: How to talk to your vaccine-hesitant friends and family]

“What’s more emasculating than losing your ability to get an erection?” says Joshua Gonzalez, a urologist with a practice in Los Angeles.

Enter the creative agency Quality Meats, which was hired by an undisclosed state earlier this year to create a public service announcement encouraging COVID-19 vaccination. While working on a general pro-vax campaign in July, they learned about the work of University of Rome andrology professor Emmanuele A. Jannini. His March 2021 study on nearly 7,000 men found that COVID-19 infection increases the risk of developing erectile dysfunction nearly sixfold. 

Quality Meats co-founder Gordy Sang thought those findings would make perfect fodder for a follow-up PSA. The ad would feature men discussing the prospect of losing their “boners” if they didn’t get a vaccine. The original client was uncomfortable using “government dollars” for an ad that discussed sex, Sang says, especially since Quality Meats’ more generic PSA was “already ruffling feathers” simply for telling residents to get vaccinated. 

Sang considered producing the ad himself, but decided it would have more credibility if it came from professionals. So he began organizing a group to help sound the alarm: the Urologists United for Vaccine Education (UUVE). Now these experts are on a mission to spread the word about erectile dysfunction and COVID-19. 

Rodgers may be right that no long-term studies exist on COVID-19 vaccines—they are, after all, a very recent invention—but his concerns about fertility are almost certainly unfounded. No scientific evidence exists that COVID-19 vaccines cause male infertility, according to the CDC. One small study by David Gonzalez at the University of Miami of 45 men who received mRNA vaccines did not have a decrease in sperm quality, but rather, “showed statistically significant increases in all sperm parameters.” (The authors did note that “the magnitude of change is within normal individual variation” and hypothesized that the sperm increase may have been caused by post-vaccine abstinence.) Another study of 43 men at the Hebrew University of Medicine in Jerusalem also found the vaccine does not negatively affect sperm parameters.

So where did Rodgers get the idea that COVID-19 vaccines cause infertility? According to an October review article in Nature by urologists from University of Utah and University of California San Diego, the worry is “mostly driven by vocal conspiracy theorists.” In May a headline on the UK website “Daily Expose” claimed that vaccines would cause mass male infertility. The myth gained more traction when rapper Nicki Minaj tweeted to her 22.6 million followers that her cousin had become impotent after getting jabbed.

No scientific evidence exists that vaccines cause swollen testicles or impotence, but some research demonstrates a correlation between COVID-19 infection and erectile dysfunction in men. Jannini’s research was the first to show this connection; according to his latest study, which has been accepted for publication in the Sexual Medicine Reviews, the connection between ED and COVID is so strong that erectile dysfunction may indicate that a man has long-haul COVID. 

Other research by Eliyahu Kresch and his team at University of Miami has shown that COVID-19 remains detectable in penile tissue nine months after infection, and that some men’s post-virus ED has been so severe that they’ve sought out penile implants. 

COVID-19 binds to penile tissue for the same reason it binds to lung tissue: Penises, like lungs, are highly vascular organs, and the virus latches on to the endothelial cells that line blood vessels. The disease might also affect the scrotum, which could decrease testosterone production and hinder erections, according to Rena Malik, a urologist at the University of Maryland. Fertility may also be impacted. “In the short term, any sort of infection can really plummet sperm production,” Malik says. “We don’t know yet if that’s going to affect [men] long term. But there’s certainly concerns.” 

Malik tweeted as much when she saw Minaj’s viral missive this fall. “The COVID virus is actually much more dangerous than the vaccine. It has been linked with increased risks of erectile dysfunction,” she says, summarizing her arguments. In her post, she linked to a video from her YouTube channel addressing similar claims. After Sang watched it, he asked Malik to join UUVE. 

Between a growing body of published evidence and anecdotal reports of more young men complaining of ED post-COVID, Sang hoped that the fear of penis malfunction could win over some vaccine-hesitant men. “If we could get people to lower the temperature, get people laughing … get more guys vaccinated, then we feel good about that,” he says. 

On September 16, the same day he contacted Malik, Sang also reached out to Amy Perlmann, the men’s health program director of urology at the University of Iowa, as well as Mathias Hofer, a urologist with a practice in San Antonio. All three agreed to sign on to UUVE. Soon more experts joined the organization, including doctors from Weill Cornell Medicine and Northwestern University. Sang and his team storyboarded the video, solidified the boner-centric concept, and got F Is for Family director Brad Morris on board. Morris convinced Saturday Night Live alum Tim Meadows to make a cameo.

And on October 7, Quality Meats shot the PSA in Chicago, with three urologists from UUVE (some of whom happened to be at a Midwest urology conference at the time of the Chicago shoot). But the clip doesn’t begin with them. It starts with random men perched on stools talking about where they got their first erections. “Nicole Greenbaum’s bat mitzvah,” one says. “1996 Olympics,” says another. “It’s the only thing I give a damn about,” says 74-year-old Steve Zacharias, writer of Revenge of the Nerds. Then a bespectacled, goateed Meadows pipes in. “If I couldn’t have one, it would be kind of devastating and kind of boring.”

The PSA eventually cuts to Laurence Levine, a world-renowned expert on erection conditions at the Rush University Medical Center in Chicago, accompanied by two fellow members of UUVE. “Men who have had COVID are six times more likely to get erectile dysfunction,” Levine says. “I’m sorry, what?” Meadows replies. “What are you guys doing? Go get the vaccine … I would cut off my own dick to protect my future boners.” Levine, in his baritone, intones: “Do it for your penis.”

The relentless gags didn’t dissuade other urologists from joining UUVE, which now counts 41 members. “How seriously can you take yourself when you’re dealing with genitalia all day?” Malik jokes. 

While it’s impossible to know if the PSA has actually convinced men to get vaccinated, it has been watched more than 200,000 times. The response was mostly positive—at first. “Soy Lefties Claim Covid Causes Erectile Dysfunction in Bizarre Jab Ad,” reads the title on a YouTube post by vlogger Salty Cracker that has been watched nearly as much as the PSA itself. Throughout the comments, men insist that the science must be wrong—because they’ve had COVID and can still get erections. “I can still get my flag up the pole with no problem,” one commented. “It’s like the Eifell [sic] tower. Stiff as ever,” added one viewer. 

And wasn’t just YouTube comments. Recently, Sang opened up his email to find this rant from a 63-year-old man. “I’m not getting the experimental toxic gene therapy jabs, and I have no fear of ‘covid’, whatever it really is, robbing me of my ability to f*ck,” he wrote. “Your video is a f*cking disgrace.” 

[Related: Eating soy doesn’t make men grow boobs]

But Malik has hope for the get-vaccinated-for-your-boner campaign. While some folks won’t listen to reason, she maintains that many young men with genuine anxiety about the COVID shots are capable of being convinced by good data. “Research suggests that exposure to detailed messages debunking misinformation can be effective,” a recent National Institute of Health report on the subject concludes. And young men do have a strong motivation to listen. “Losing your sexual function is something that men are very scared about,” Malik says. 

In the meantime, research on the vaccines and male fertility remains ongoing. “Future studies should further examine the long-term effects of COVID-19 and its vaccines on men’s health and sexual function as well as the impacts it may have on their offspring,” a recent article in Nature noted. And while Rodgers claims to be doing his own digging, as do many skeptics, Malik wishes they would listen to the experts instead. “We have no financial vested interest in you getting vaccinated,” she says. “We just want everyone to be out of the pandemic and to be safe.”