Background

Marginalised communities such as people with disabilities and transgender persons face considerable challenges in accessing COVID-19 vaccines due to inaccessible health facilities, unaffordability and unavailability, historical marginalisation, and entrenched structural inequities. However, this should be viewed in the context of the historical marginalisation and experiences of exclusion of these communities in the health system which the COVID-19 pandemic has exacerbated. Separate vaccination centres created with the help of activists and the intervention of courts have faced poor demand, suggesting lower vaccine confidence. This is highlighted by our ongoing research with the transgender community and the work on disability by our collaborator (TransCare:COVID19 and Disability Inclusive Compassionate Care).

A large segment of the existing scholarship in this field has a narrow framing of ‘vaccine hesitancy’ with focus at the individual level and viewing it as a behavioural and attitudinal issue rather than looking at it structurally through the lens of equity and intersectionality incorporating wider issues such as trust deficit in the public health system, embedded stigma, and exclusion both in practice and clinical trials, which often exclude marginalized communities.