(This was first published on 4 June 2021. It has been republished from The Quint's archives over prevailing gender gap in COVID-19 vaccination in India.)
Four and a half months after India began its inoculation drive against COVID-19, the country has vaccinated over 1.2 crore more men than women with at least one dose of vaccine – exposing a gender gap in the vaccination programme.
As of 2 June, over 17 crore Indian adults have received at least one dose of the vaccine. Of this, 9.29 crore are men and 8.04 crore women. This means that of those who have received a single dose of vaccine – 53.61 percent are men.
In other words, for every 1,000 men receiving the jab, only 870 women are getting vaccinated – which is lower than India’s already skewed sex ratio.
But, why are more men getting vaccinated than women?
“Vaccination-related gender disparity cannot be viewed in isolation,” says Dr Sanghamitra Singh, a health scientist and senior manager, Knowledge Management and Partnerships at Population Foundation of India. “If we look at historic trends around women’s health in India, we will notice that women’s health has never really been given as much priority in families or by women themselves.”
“There is enough data to show that women are taken to hospitals only when they are in critical condition – when they are seriously ill or when they are pregnant.”Sanghamitra Singh
What makes matters worse is women’s lack of freedom of movement.
As per the fourth National Family Health Survey, 2015-16, only 40 percent women are allowed to go out alone, including to a health facility. “The differential vaccination trends between men and women are an extension of these pre-existing challenges,” Singh explains.
Further, the digital-first approach, especially for vaccination of the 18-44 cohort, and vaccine hesitancy among women could be among the contributing factors.
Speaking to The Quint, Anushree Jairath, Program Coordinator, Gender Justice, Oxfam India, said:
“There are gaps in terms of both access to mobile phones and use of mobile phones. Less than 20 percent of women in India own a mobile phone. In rural settings, most families have one shared phone – which is usually a brick phone. In this case, you don’t have access to Co-WIN platform or the kind of information others have. Our entire vaccination process is driven by technology and women are simply not a part of that.”
The fifth National Family Health Survey, released in December 2020, revealed that more than 60 percent women across 12 states have never used the internet. Less than 3 out of 10 women in rural India and 4 out of 10 in urban India have only ever used the internet.
“Families think that if a woman has access to internet, she will engage in ‘galat kaam’ or ‘our daughters will be exposed to bad things.’ There are multiple studies that show that women do not use internet or have access to it because families will not approve of it. It is not an individual decision. But how families and societies look at women who use internet.”Anushree Jairath
Increased Vaccine Hesitancy?
In a survey conducted by Videologue and The Quint, where almost 50 percent of respondents were women – it was revealed that women are more suspicious of the vaccine with 61 percent of women expressing fear of the vaccine compared to 49 percent of the men.
The survey done across Uttar Pradesh, Madhya Pradesh and Bihar with over 1,700 respondents also indicated that 46 percent of women did not want to get vaccinated as compared to 39 percent men.
The hesitancy could have stemmed from misinformation about the vaccine. From unfound rumours about vaccine disrupting women’s menstruation cycle, and other claims about the jab causing sterilisation – these are likely to have made a significant dent in women’s vaccine hesitancy, especially in semi-urban areas.
“Misinformation is a key factor in the low vaccination turnout, and this impacts women more. This is again tied to issues around access to technology to enable registering for vaccination, lower decision-making power in families, and lower priority given to women and their health needs within families.”Dr Anant Bhan, Adjunct Professor & Researcher in Bioethics at Mangaluru’s Yenepoya University
But, what is the solution then?
“The government should invest greatly in social and behaviour communication campaigns to address the misconceptions around vaccination, especially among pregnant, lactating and menstruating women. We must remember that as new information is available around COVID-19, the advisories from health experts are also changing, and not everyone is capable to constantly update themselves with verified information,” Population Foundation of India’s Singh tells The Quint.
Oxfam’s Jairath adds that the vaccination drive needs to be taken to women.
“For example, involving ASHA and anganwadi workers – especially to dispel misinformation fears and to take them through the process. I realise that these frontline workers are overburdened, but it will be an effective method. Organising drives near their homes will help more women get vaccinated. Even use local community leaders – like women panchayat,” she adds.
The Best & The Worst Performing States
As per Co-WIN data, only three states in India have vaccinated a higher percentage of women than men.
Kerala, which has the best sex ration in the country – 967 women to 1,000 men – is also the state that has best ensured that female population gets their jab. In terms of population, for every 1,000 men vaccinated, 1,125 women got their jabs.
In Chhattisgarh, 1,045 women have received the vaccine for every 1,000 men who got theirs. Although a minuscule difference, Himachal Pradesh too has 1,003 women receiving immunisation for 1,000 men.
The widest, biggest gender disparity in the vaccination drive was found in Jammu and Kashmir, Nagaland and Delhi, followed by Punjab, Uttar Pradesh and Tamil Nadu.
In J&K, for every 1,000 men receiving the jab, only about 709 women are – way below the national average.
In Nagaland, where over 1.3 lakh men have received their jab, only 94,000 women have.
The picture is dismal in India's national capital as well. While the sex ratio in the city is 869 women to 1,000 men – only 725 women are receiving the jab for every 1,000 men getting the same.