Study highlights multiple barriers faced by persons with disabilities, transpersons in accessing Covid-19 vaccine

Study on Covid-19 vaccine access barriers for disability, transgender, and gender-diverse communities in India reveals inequities and challenges.

A recent paper that explored structural inequities in the access to, and uptake of, the Covid-19 vaccine among the disability, transgender and gender-diverse communities in India, has flagged several barriers that made it difficult for these communities to get vaccinated. The barriers included information and communication gaps, barriers in vaccine registration, transport and infrastructure among others, pointing to, the paper said, “longstanding and pervasive inequities within health and allied systems.”

”The paper, ‘Understanding structural inequities in Covid-19 vaccine access and uptake among disability, transgender and gender-diverse communities in India’ by Sharin D’souza et al of the Initiative for Health Equity, Advocacy and Research, Bhopal Hub, Sangath, Bhopal, was published in ScienceDirect recently.

A total of 45 individuals were interviewed for the study from the transgender and disabled communities alongside health system representatives and other key stakeholders. 

India had the world’s largest Covid-19 vaccination programme, rolled out in January 2021 and India’s vaccine acceptance rate was higher than that in many developed countries. The study found however, that by May 2021, when approximately 11.7% of the general population was vaccinated, the coverage among trans and gender diverse persons (TG) was only 5.22%. By November 2021, this rate was approximately 0.03% within the disability community.

“In India, the TGD and disability communities, both face a higher risk of neglect, violence and lack of family support. This, combined with stigma and discrimination marginalises both communities socio-economically and within the health system. Both communities have higher rates of unemployment, lack of education and poverty. Many of them are dependent on precarious employments such as begging (in both communities) and sex work (in the TGD community). Combined with poorer immune status linked to their disability, co-existing HIV infections and poorer health in general both communities were at a higher risk of COVID-19-related mortality necessitating early vaccination,” the study pointed out. 

The study highlights four main themes with regard to barriers faced: structural neglect of disability and trans-specific information: how the vaccine would affect those who had medical conditions or those who had transitioned for instance, was a concern, signaling gaps in vaccine research and communication. This was compounded by the communities’ past, sometimes negative experiences with the healthcare system.

Procedural barriers, the second theme, included the digital inaccessibility of the vaccine registration platform CoWIN and the Aarogya Setu app, alongside other issues such as the mandatory requirement of identity documents for the TGD community.