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Patriarchal Society Leading to Fluctuating Vaccination Drive

Campaigners and scholars have cautioned that deep-seated structural inequities and patriarchal beliefs are responsible for India's alarming Covid vaccination gender gap.

According to Cowin, India's official statistics site, 143 million Covid vaccine doses have been provided to women since January 2021, compared to approximately 167 million doses given to males - a ratio of 856 doses given to women for every 1,000 doses given to men. 

India's gender imbalance of 924 women to 1,000 males does not account for the disparity. Uttar Pradesh, India's most populated state with the highest proportion of rural residents, has given out 29 million vaccinations. 


Women received 42 percent of this total, which includes both the first and second doses. West Bengal, the fourth most populous state, is also falling behind, with 44% of dosages given to women. Dadra and Nagar Haveli, a largely rural union territory in western India, has one of the most severe disparities: women received just 30% of vaccinations. Other regions with poor performance include Daman and Diu, Delhi, and Jammu & Kashmir. Women have received more doses than males in a few places, including Kerala and Andhra Pradesh.


Data on transgender individuals, nonbinary people, and people of other marginalized genders, have been inaccurately tracked, with all categories lumped together as "other."


“Women are not valued as integral members of the family, community, or society. [The vaccination gender gap] reflects the gender inequity that exists in India, and even globally,” said Bhagyashri Dengle, Plan International's executive director of Asia Pacific and gender transformational policy and practice.

Sofia Imad, a junior scholar at the Mumbai-based think tank IDFC Institute, studied vaccination attitudes among Mumbai and Pune's urban poor. She said that there were different reasons why women were unable or unwilling to receive the vaccination.


“There is apprehension due to rumors regarding adverse effects and how the vaccination impacts fertility and menstruation,” Imad explained. “However, there are additional reasons, such as women not having access to the technology required to register for it, not knowing where the centers are located, or not being allowed to visit the centers alone.

“Women frequently require their husbands' consent to be immunized. Even if women receive it, if their spouses are unable to join them, they will be unable to participate.”


Mumbai street art shows attempts to curb the spread of Covid. Many immunization clinics are inaccessible to women because they are not within walking distance of their homes. Photograph courtesy of Reuters/Francis Mascarenhas

“I didn't even realize we had to register on the phone,” Ram Kumari, 26, of Gurugram, Haryana, said. I do not have access to a smartphone. My spouse owns one, but I have no idea how to operate it.”


“I want to get the vaccination, and I was thinking about going to the government hospital, but it's too far to walk,” she continued. I do not know how I'm going to get there, especially alone.”

A reasonable number of digital gender differences were shown, in the fifth National Family Health Survey, which was performed in 2019–20. In the poll, 58 percent of women said they had never used the internet, while 38 percent of males said they had.


“Most men do not think it necessary to register their wives on the Cowin app,” said Julie Thekkudan, a women's rights and gender justice specialist with over 18 years of expertise. Their health is not a priority, and they are not considered in danger if they do not work outside the home.”

“Mobility also becomes an issue,” she noted. What can working-class women do if public transportation is scarce and [the immunization center] is inaccessible by foot?”


According to anecdotal evidence, in many mixed-gender homes, males are given precedence for immunization. “My husband believed it was proper for him to get vaccinated first,” Neerja Sharma, 46, of Jaipur, Rajasthan, said. He required me to look after him while he was unwell due to the potential adverse effects of Covishield. And who would cook and look after the house and our boy if I get sick with him?”


On June 25, 2021, people gathered outside a Hindu temple in Hyderabad to get vaccinated. Many women are also concerned that information about side effects and how to deal with them is not readily available in a language or format that they can understand. There are also arguable concerns that the vaccination could induce infertility or disrupt menstrual cycles, especially in rural areas.


“Women get a lot of information through WhatsApp, which isn't necessarily reliable,” Imad noted. Women are concerned about two things: the first is that they would be unable to get the vaccine while menstruating, and the second is that vaccination will affect their future cycles. Accredited social health advocates have not been educated about the Covid-19 vaccines, and they have not been given any communication materials. To alleviate concerns at the grassroots level, they require tools for community health workers.”


Getting immunized has become a priority for employees as firms prepare to return to in-person working. 

According to a Covid-19 vaccine, trends study performed in India in April of this year, more than half of employers intend to enable vaccination for their employees and dependents, 


However, according to research released in March by Korea University in Andhra Pradesh, 93 percent of rural women and 77 percent of urban women work in informal jobs, where most employers do not believe they should guarantee that their employees get vaccinated.


The ministry of health and family welfare said earlier this month that anybody can come into a vaccination center without first registering on the app, making it more accessible to women.

However, Thekkudan believes that more has to be done to close the gender gap in immunization. “We need to promote walk-ins and make vaccines more accessible to people at their homes. We also need to develop public health education materials that are translated into regional languages and graphically depicted. It's critical to turn this vaccine campaign into a mission.”


Plan International's Dangle said that it was not only a matter of access. “We must address the societal norms and fundamental reasons that have resulted in this disparity. And it must begin at an early age: are we instilling preconceptions in our children, such as that women belong in the kitchen? An inclusive curriculum is only one of the ways we may begin to address the gender inequity that contributes to such disparities in the wider scheme of things.”


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