The COVID-19 outbreak had severe adverse impacts on the health and the wealth of households in lower-income countries (LICs), and has affected even more severely female-headed households in LICs. Using high-frequency phone surveys in Sierra Leone, we show that female-headed households are likely to rely on cheaper food alternatives (e.g., Cassava) compared to male-headed households and are more food insecure. These effects are more nuanced among the poorest families, owning one or no assets. Furthermore, female-headed households had less access to COVID-19 information and are less likely to adopt preventive measures (e.g., masks and social distancing) at the onset of the pandemic and show greater signs of vaccine hesitancy in the early stages of COVID-19 vaccine campaign.