Source: Wikimedia Commons; Image only for representational purpose
Due to the low availability of vaccines in India, the question of who should get the limited supply, and in what order, has triggered heated public debate. Persons with disabilities are among those who are in crucial need of the vaccine, and paradoxically, they have the most difficulty in procuring it, due to problems accessing registration portals, travelling to vaccine sites etc.
Firstly, persons with disabilities are at a higher risk of contracting COVID-19. They already face existing barriers to healthcare and healthcare information and COVID-19 has just exacerbated this divide. The World Health Organisation, in a report titled Disability considerations during the COVID-19 outbreak has determined that due to mental or physical disability, they may find it more difficult to practice proper sanitation, such as frequent washing of hands or refraining from touching surfaces. Those with a visual disability may rely on touch to move around, others may require physical support. A caregiver may help them with their day-to-day activities, which increases the risk of transmission and may make social distancing difficult. Caregivers, likewise, also need to be vaccinated on priority in order to be able to perform their functions, as caregivers could also be a vector.
Secondly, care after contracting COVID-19 can be doubly difficult for a person with a disability. Testing centres must be equipped with ramps and have staff who know how to assist persons with disabilities. Underlying health concerns such as autoimmune diseases could cause COVID-19 to be much more fatal than it would be for others. There is also the issue of self-isolation as persons with intellectual impairments cannot cope with the mental strain of self-isolation. The need for a caregiver will also risk exposing others to the virus.
Section 25(1) of the Right of Persons with Disabilities Act, 2016 provides that the Government has to take necessary measures to provide free healthcare in the vicinity of PwDs, especially in rural areas; barrier-free access in all parts of Government and private hospitals and other healthcare institutions and centres; and most importantly, priority in attendance and treatment. With the magnitude of the COVID crisis, this provision needs to be given effect immediately.
Regarding vaccination of persons with disabilities, the World Health Organisation published a policy report which advises governments to consider persons with disabilities when considering different demographics for vaccine priority. It has also advised state officials to provide information about the vaccine, vaccination prioritization and registration, in a range of accessible formats and languages, including sign languages so that it can reach the target group. The vaccine policy of the United Kingdom and the CDC guidelines for vaccinations of the United States have also aimed at vaccinating persons with disabilities and have made them a part of priority lists. However, the challenges of vaccinating a population of 1.3 billion are greater and require a great deal of planning and strategizing.
In India, currently, vaccine registration is only done through the Cowin site or the Aarogya Setu app, both of which are not user-friendly for persons with disabilities. Section 42 of the Right of Persons with Disabilities Act, 2016 also puts the onus on the Government to make sure that content is more easily accessible. Different methods should be used for registration, such as through a telephone helpline or forms which are screen‐reader accessible. The Government should provide options for telephone registration, video relay, national sign language interpretation, and COVID-safe in-person registration.
The needs of persons with disabilities ought to be considered and prioritised, now more than ever, as they are significantly more impacted than the average citizen by COVID. Law-makers at the centre and the states should look to international norms in framing vaccine policy.