Vaccine rollout ignoring needs of women

As Canada rides yet another wave of the COVID-19 pandemic, vaccine distribution continues to be fragmented, perpetuating inequities for women who have shouldered disproportionate health and societal burdens.

Women have been poorly considered in Canadian vaccine distribution plans, despite facing greater vulnerabilities in terms of job security, employment in higher-risk occupations (i.e., in long-term care homes) and housing stability while balancing personal caregiving responsibilities and facing increased rates of intimate partner violence.

In addition, gendered norms that are culturally, institutionally and societally perpetuated have influenced women’s willingness to engage with vaccination (i.e., the role of vaccines in influencing reproduction). A study published in January outlines that among 1041 individuals (n=537 identifying as female) residing in Ireland and 2025 individuals (n=1047 identifying as female) residing in the U.K., 35 and 31 per cent respectively had increased likelihood of hesitancy toward COVID-19 vaccines because of distrust of the health-care system, limited knowledge surrounding vaccine efficacy and fears surrounding safety of the vaccine. In both groups, the vaccine hesitant were more likely to identify as female than male. Yet, few conversations have taken place on how to best meet the vaccine information and access gaps.

Lack of data on vaccine safety and immunogenicity contributes to uncertainty, especially among women of childbearing age, the group demonstrating the greatest proportions of vaccine hesitancy. COVID-19 vaccine efficacy remains unknown for pregnant women because they have not been included and followed in the research despite the fact that a large portion of public-facing workers in health care are women of childbearing age. This information gap means that many in high-risk health-care settings are unwilling to be vaccinated. And while late-stage clinical trials often include children and even infants to determine safety and immunogenicity, this practice was skipped for COVID-19. Thus, women are doubly burdened – worrying about how to protect themselves, if pregnant or breastfeeding, and how to protect their children if they are already mothers. As well, many essential workers or workers with low levels of workplace protections are women from racialized communities with documented histories of mistreatment by the health-care system.  

Governments have failed to ensure gender parity in evidence on vaccine efficacy. There is a vicious cycle of gaps in research evidence for women’s health conditions, fewer research dollars going to conditions impacting women, fewer and poorer treatment options for major conditions affecting women and a greater sense of distrust of the health sector by women. Vaccine hesitancy is rooted in this distrust and misinformation.

Despite Canadian equity frameworks that acknowledge the role of building trust with historically affected populations and “a deliberate questioning of assumptions” by those in power to ensure justice for all populations, a gender-blind approach to communications about vaccine safety and rollout has been implemented. To effectively address current disparities faced by women, an approach that redistributes resources to ensure gendered needs are met must be integrated within vaccine distribution plans, programs and policies across Canada.

Without this approach, there is an increased risk that thousands of women will go unvaccinated or will delay vaccination, further weakening overall mitigation responses and contributing to preventable COVID-19 related morbidity and mortality.

Will we take the opportunity that COVID-19 has presented us to take off the blindfold and tailor our vaccine strategies to the unique needs of each gender or will we continue to ignore the needs of women across society?