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Time for action: towards an intersectional gender approach to COVID-19 vaccine development and deployment that leaves no one behind

Countries
World
Sources
BMJ
Publication date
Origin
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Shirin Heidari, David N Durrheim, Ruth Faden, Sonali Kochhar, Noni MacDonald, Folake Olayinka, Tracey S Goodman

Correspondence to Dr Shirin Heidari; heidaris@who.int

Summary box

  • The COVID-19 pandemic has revealed persistent gender inequalities that exacerbate health inequities.

  • Sex and gender intersect with other variables such as age, race and ethnicity, and other health conditions, resulting in differential risks and outcomes of COVID-19.

  • Importantly, well-documented sex differences in vaccine-induced immune response and adverse events, alongside gendered factors related to vaccination programmes, may influence vaccine acceptance, access and uptake, further worsening inequities.

  • It is thus imperative that an intersectional gender lens be systematically applied to development and deployment of COVID-19 vaccines.

  • Integral to this approach is meaningful engagement of women at all levels to ensure that scientific, policymaking and programmatic decision-making processes benefit from their leadership, expertise and perspectives.

  • This article presents a rationale and recommended actions for incorporating sex and gender dimensions in current and future COVID-19 vaccine development and deployment efforts to fast-track an end to the pandemic in an equitable way.

Introduction

The COVID-19 pandemic has exposed once again how gender and other inequalities are inter-related with and worsen health disparities. Gender shapes risk of infection, vulnerability to disease and experience of ill health, and socioeconomic disparities. Important interplays between biological sex and gender, as a social construct, and other variables such as age, race and ethnicity, and other health conditions, have demonstrated differential risks of COVID-19 exposure, acquisition and outcomes. Sex-based differences in vaccine-induced immune response and adverse events are well documented, and may influence vaccine acceptance, access and uptake, which are also highly gendered. Hence, it is imperative that sex and gender be meaningfully considered alongside other intersecting dimensions when developing and deploying COVID-19 vaccines. Inherent in this is the need for meaningful engagement of the expertise and leadership of women in all scientific research, policymaking and programmatic decision-making processes at global, national and local levels.

This article provides a critical review of the role of sex and gender dimensions from vaccine development to delivery (figure 1). It offers six recommended actions for incorporating an intersectional gender lens in COVID-19 vaccine development and deployment efforts to fast-track and end the pandemic in an equitable way (table 1). The proposed actions are also applicable and necessary for future vaccine research and programmes.