Vaccine hesitancy is a common issue across the world concerning the COVID-19 vaccine. There have been all kinds of misinformation, rumors, and conspiracy theories regarding the efficacy and the safety of the COVID-19 vaccines, ever since the vaccines were made available to the public.
Vaccine hesitancy is a historically well-documented phenomenon. Several factors concerning vaccine hesitancy cut across race, gender, caste, religion, ethnicity, politics, education, age, working status, and income. According to Maya Goldenberg “vaccine hesitancy has less to do with misunderstanding the science and more to do with the general mistrust of scientific institutions and government” (Haelle, 2021). An understanding of vaccine hesitancy is crucial to overcoming the COVID-19 crisis.
In the West, women are getting vaccinated at a far higher rate than men, for instance, 43.3 percent of women got vaccinated compared to 38.5 percent of men as per the recent Centers for Disease Control and Prevention (CDCP) data. Vaccine hesitancy among white men in western society is connected to their toxic masculine behavior such as heavy drinking, smoking, and illicit drug use. Such masculine behaviors cause men not to seek health care and to adopt preventive healthcare measures such as taking vaccines.
Ironically, the situation in India is the opposite with more men getting vaccinated than women. This vaccine disparity implies that for every 1000 men only 867 women have been vaccinated, which is worse than India’s sex ratio.
It is important to understand men’s attitudes and behaviors towards vaccination, which are closely associated with their masculinity. Why are more men getting vaccinated than women in India? Who are these men? And what kind of masculine behaviors do they represent? The construction and reconstruction of hegemonic Hindu (Brahmin-Savarna) masculinities associated with their behaviors and actions are important dimensions to understanding the COVID-19 vaccine apartheid in India.
Masculinity and Vaccine Hesitancy
Generally, masculine behavior and attitudes are important dimensions to understanding the COVID-19 vaccine hesitancy among men. Men who identify themselves as masculine are more likely to hesitate to take vaccines. Taking vaccines makes them non-conforming to their conventional gender roles and norms of men as being physically more resilient, strong, as providers and protectors. Men conforming to conventional masculine gender roles and identity are more skeptical about taking vaccines.
In India, the mainstream discourse about the gender gap in vaccinations conceals more than what it reveals, unless it is seen from the caste perspective. There are multiple dimensions to caste and gender relations and the patterns of inequality. A closer look at each substructure of gender and caste, reveals a pattern of advantages and its associated disadvantages within each category.
Elite affluent men in metropolitan cities, particularly those belonging to the Brahmin-Savarna castes getting early vaccination at a higher rate, are at odds with the conventional masculine behavior of hegemonic men in Western society.
Are all men the same? There are caste and class hierarchies of men. Connell (2011) in her book, “Confronting Equality” argues, “the men who receive most of the benefits, and the men who pay most of the costs, are not the same individuals. On a global scale, the men who benefit from corporate wealth, physical security, and expensive health care are a very different group from the men who dig the fields and the mines of developing countries. Class, race, national, regional and generational differences cross-cut the category ‘men’, spreading the gains and costs of gender relations very unevenly among men.”
In the Indian context, men are neither monolithic nor are they a stable category. Multiple masculinities are being constructed in relation to the dominant caste categories. The Hindu society is based on graded inequality, divided into four castes the Brahmins, Ksatriyas, Vaishyas, and Shudras and then, there are those who fall outside of this system who are called the “untouchables” also known as the Dalits. The caste hierarchy determines men’s social status, privilege, and access to social capital in society. For those lying outside of this caste system, none of the privileges or status exists or even applies. The caste system is constructed such that it confers and gives rights, privileges to the upper castes while authorizing these privileged groups to punish and repress the lower castes. Therefore, based on Connell’s (2005) categorization of masculinities, masculinity of Dalit men can be termed as marginalized masculinity based on their marginalized caste status, while the Brahmin- Savarna men can be categorized as hegemonic masculinity due to their heterosexual, dominant status in the caste hierarchy.
There have been many instances of manifestations of dominant masculinities of Brahmin-Savarna men. During the Second wave of India’s COVID-19 crisis, the Brahmin men expressed their hegemonic masculine behavior by refusing to perform their caste-based duties. Brahmin men deliberately refused to perform the Hindu funeral rites and rituals of the deceased during the pandemic. Consequently, the responsibility of cremating and burying the dead was forced upon the Dalit cremation workers, who undertook the task with no protective gears, at the risk of getting directly exposed to the virus.
Many caste-exclusive vaccination drives were organized for Brahmin-Savarna caste groups in various cities across India. For instance, in Bangalore, an exclusive drive for Brahmin priests was allegedly organized by the state-run BJP government. Moreover, the caste exclusive COVID vaccine drives, home food drives, hotel rooms at a special price for self-isolation, and quarantine for Aggarwala samaj (Savarna community) were organized in Bangalore. Similarly, other metropolitan cities like Hyderabad started exclusive vaccination drives for members of their gated communities and corporate employees. There is no doubt that the largest beneficiaries of these exclusive vaccine drives are men belonging to the Brahmin- Savarna castes.
These men use their caste networks and their economic privileges to get vaccines from private hospitals at a price double the actual price when the whole country is reeling under an acute shortage of vaccines. This is a sign of toxic and passively violent behavior of Brahmin-Savarna men towards marginalized sections of society. This behavior perpetuates the idea of domination and the unequal power relation with men and women from other marginalized castes.
R Srivatsan (2015) in his article, Reflections on discrimination and health in India argues that discrimination as a phenomenon in India is interconnected with political power, economic capability, and social (caste) dominance. Discrimination and its various forms is a strategy used by elite caste Hindus to guarantee control and seize the benefits of the developments of a capitalist economy driven by privatization. It is through these discriminatory practices and strategies that the elite dominant castes maintain their privileges. He also argues that discrimination more specifically caste discrimination is an undeniable fact and has always been a means of control, dominance, and exercising of power in Hindu society. This form of liberal capitalist thinking coupled with caste Hindu elitism, magnifying and disguising the caste Hindu’s intolerance for equality keeps large sections of the underprivileged, so-called lower caste or marginalized people deprived of access to resources (Srivatsan, 2015).
Hence, from the perspective of caste discrimination, it can be argued that the Brahmin-Savarna men getting early vaccination is deeply connected to their caste dominance, supremacy, and masculine ego. These men are self-centered, exclusive, and disinterested in the welfare of ‘others,’ particularly those they consider to be a ‘threat’ or morally inferior or marginal. These men lack basic human values and moral reasoning that vaccines should be first provided to the high-risk groups such as the elderly, transgender, women, sanitation worker, cremation workers, frontline health workers, and other day-to-day service providers.
History of Vaccine Hesitancy
‘Vaccine Hesitancy’ and resistance among people is a universal problem that can be greatly reduced and overcome through massive awareness campaigns and literacy about vaccines. History has shown that vaccine hesitancy and popular resistance were common during earlier pandemics like cholera (1817-1920), plague (1894-1920), and influenza (1918-1920). Vaccine hesitancy was huge in the late 19th century which was overcome through massive public communication (Tumbe, 2020). But it took a period of three decades for the mind-shift to change as people realized the worth of the vaccine. This change in mindset is captured by the Haffkine medical institutes report (1930), which remarks, “where riots were liable to occur when inoculation was pressed, recently a riot was threatened because the supply of vaccine ran short”. Moreover, the massive loss of lives during the second wave of the COVID-19 crisis made people realize the importance of vaccines (Tumbe, 2020).
Role of Mainstream Media in racializing Dalits and Minorities
Moreover, there is an urgent need to critically examine mainstream media’s role in racializing the poor and the marginalized sections. Instead of holding the government responsible and accountable to address the issue of vaccine hesitancy through massive awareness programs, the mainstream media has been selectively targeting and racializing the most marginalized and vulnerable sections of society. In India, the mainstream both regional and the national media’s reporting on the COVID-19 vaccine hesitancy particularly among the backward areas dominated by the Dalit-Adivasi, and minority communities have been sexist, casteist, and Islamophobic so say the least. Some of these phrases are given below:
“….the hesitancy is higher among Dalits, who are at the bottom of a deeply discriminatory Hindu caste hierarchy.”
The mainstream media blaming Dalits, Adivasi, Minorities, and women in rural areas for being vaccine hesitant is selective and reductionist. So, rather than vaguely portraying “vaccine deprivation” as “vaccine hesitancy” among the poor and marginalized people, the mainstream media should ask the following questions:
- Has the government launched any massive health awareness program to address vaccine hesitancy among people?
- Does everyone have equal access to the COVID-19 vaccine?
- Is the government able to provide free and universal vaccines to all?
- Shouldn’t the “Right to Free Vaccines” be included under the “Right to Life and Personal Liberty” of Article-21 of the Indian Constitution?
- What is the gender, caste, and class composition of about 5% of India’s population who got vaccinated?
The access to privatized healthcare services in India is limited to those who can afford it, which implies that only the hegemonic Hindu (Brahmin-Savarna) men would be the early beneficiaries of the vaccines, while the Dalit-Adivasi, minorities, women, and other marginalized groups will be systematically excluded from getting vaccinated and from all other public health care services.
The elite caste Hindus in the last few decades have moved away from public to private hospitals, which is largely both inaccessible and unaffordable to the poor who mostly belong to the lower castes. The notion of “well-being” in the Indian context is not a universal to which everyone is entitled to, but rather “well-being” is an exclusive value and property which is accessible to only those who already have caste privilege (Srivatsan, 2015). This then leaves out the marginalized, lower castes, and the poor outside the domain of development and access to resources, such as education and healthcare.
In conclusion, the early vaccination of upper-caste men, the privatization, and deprivation of vaccines to the marginalized or high-risk groups are linked to the casteist-masculine behaviors and actions of the dominant Brahmin-Savarna men. It has been affecting the uniform distribution of the limited COVID-19 vaccines in India. The masculine actions and casteist behaviors of Brahmin-Savarna men are a major obstacle to the universalization of the COVID-19 vaccines and other basic healthcare facilities. The public health system is a cooperative enterprise, where everyone should have an equal stake. The COVID-19 pandemic can only be dealt with through collective effort. To address the vaccine apartheid and to ensure equal distribution of the COVID-19 vaccines, the casteist and toxic masculine behaviors of the Brahmin-Savarna men have to be deconstructed and dismantled.