Why the issue of gender gap in vaccination is a community problem

By Simi Mehta, Sakshi Sharda, Swati Solanki, Mahima Kapoor, Arjun Kumar
The need to address the vaccination gap through a gendered lens is imperative. COVID-19 is an issue that is being tackled globally, however, the need to address discrepancies in the same has been absolutely pivotal.
IMPRI Gender Impact Studies Center (GISC), IMPRI Impact and Policy Research Institute, New Delhi hosted a special talk on The Gender Gap in Vaccination with Prof Vina Vaswani as a part of The State of Gender Equality – #GenderGaps series.
Professor Vina Vaswani, Director, Centre for Ethics, and Professor, Department of Forensic Medicine and Toxicology, Yenepoya (Deemed to be) University, Mangalore was the eminent speaker of the session. Professor Vibhuti Patel, Former Professor, Tata Institute of Social Sciences (TISS), Mumbai chaired the session. Dr. Mala Ramanathan, Working Editor, Indian Journal of Medical Ethics (IJME) and Dr. Medha Rajappa, Professor of Biochemistry and Associate Dean (Research), JIPMER, Pondicherry joined in as discussants. The discussion aimed to address several important points of gender sensitization, tackling fake news, marginalised communities and responsible dissemination of news and vaccines.

Addressing the issues with vaccines

Professor Vibhuti Patel steered the discussion into discussing the statistics of the vaccinated population in India. Around 47% of the women had received vaccinations while 52.5% of men have been able to avail the vaccination along with a negligible and almost minimal number of people from the trans community has been able to get vaccinated. This data opened a plethora of questions for the panel to discuss. Namely, how this gap is supposed to be addressed along with the socio-cultural connotations for the same. Also, the discussion should focus on how the regional disparity along with the gender disparity played an important role when places like Himachal Pradesh and Chattisgarh are still lacking to cope up with the vaccine gap. It is also necessary to address the state-led initiative to cover this gap and make it effective, so as to how it is dealt with on a macro aspect along with the contribution of the private players.

A gendered approach to vaccination

Prof Vina Vaswani opened the floor for discussion by bringing forth a data-driven approach along with her own experience during her initial days of working with the community on the field to address the issue of ‘hesitancy’ and the perpetual lack of vaccinations amongst women. She spoke of how the notion of ‘contraception’ which was something to be exercised by the woman as it pertains to her autonomy and agency is more often than not exercised by her husband or her family which highlights the very core structural problem of Indian society. This opened avenues of thought regarding how the issue of vaccination is often a community problem than an individual problem.
The next most important take on the issue was discussing the role of women during clinical trials. Very often, pregnant, lactating, or chronically ill women have been excluded from vaccination trials without proper research being conducted into their well-being and also ensuring adequate consent if they have been included in any. This discrimination persists in the field of the COVID-19 vaccination and continues to pose a problem. “Religious and minority groups, why do they feel so secluded? It is because we are making them feel so,” asked Professor Vaswani while explaining how the preconceived judgments, notions and lack of awareness also contribute to the gap and the growing skepticism of certain groups from not being vaccinated.
Lastly, she also touched on the transgender community which faces constant discrimination at the hands of the government authorities while producing identity proof regarding vaccines and often hesitate from participating in vaccination drives due to the lack of respect shown towards them. Thus to overcome these issues the need for a social contract-based approach to immunization should take place along with universalization of the drive which will promote the welfare of the citizens.

Busting myths of the COVID-19 vaccines

Dr Rajappa drawing from pointers introduced by the previous speaker emphasised specifically on the preconceived ideas which the society has regarding the COVID-19 vaccine and the inhibitions that prevent them from getting vaccinated. She specifically focussed on the news spread by the ‘Whatsapp University’ which often seemed to regurgitate old knowledge and give them a spin to prevent the public or cause anxiety or panic regarding how vaccinating can be apparently ‘dangerous’ for people. She spoke of how the marginalisation also takes place and the universalisation of the vaccine is important as the fees often become a factor of hindrance.
“There needs to be intensified drives to dispel the propaganda by the Whatsapp Universities and wrong information about the vaccine,” she iterated by pointing out that there needs to be a multi-pronged approach to overcome this problem much like the polio campaign. Some solutions proposed were the promotion of communication advocacy, organising flash mobs, programmes and encouraging youth participation along with greater accessibility to information to dispel the myths of vaccination. An effective engagement can be carried out with the help of anganwadi workers who are the focal point for communication with women specifically in many areas.

Data gap and gender gap

Dr Ramanathan discussed the issue by bringing forth the point of a larger data gap in the information about which the discussion was taking place. The lack of a comprehensive database is often a tool which hinders a wholesome comprehension of the larger issue in place which needs to be looked into. “The exclusion of women from trials has been an issue which persists from 1977 and still persists,” she said, pointing out the medical implications of the trial. By analysing the projected population data she showed how some of the leading states of India are nowhere near achieving a sense of parity between men and women being vaccinated which raises several issues of concern.
She discussed how lactating and pregnant women may not have been vaccinated thus contributing to the gap till it was deemed suitable for them to get vaccinated and thus contributed to the backlog. She proposed that larger groups of women must be mobilised especially the ASHA workers who have been working at the frontline with them especially focussing on elderly women. Need for addressing vulnerable groups and inter state gaps and language barriers should also be a primary focus as it pushes several people into the marginalised section preventing them from accessing better healthcare.
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Acknowledgement: Srimoyee Biswas, a Research Intern at IMPRI