Health outreach workers drove past Lama Mballow’s village carrying a megaphone and handed out T-shirts with the words “I GOT MY COPID-19 VACCINE!”

Sare Gibel’s women had already heard about the social media rumors: The vaccines can make your blood stop working or cause miscarriage. It would prevent women from getting pregnant again.

Lama Mballow’s sister-in-law Fatoumata Mballow never made the 3.4-mile (5.5 km) trip to town for their vaccinations. However, the family kept the shirt. The lettering on the shirt is worn from washing but the women have not lost their resolve. They share many responsibilities, including meal preparation, child care, trips with plastic jugs to the well, and their outlook about the vaccine.

Lama Mballow (24), who has a 4-year old son and another child, said that she needs a lot of children. She also plans to get vaccinated once the baby is born. Fatoumata, 29, is struggling to get pregnant in a village that has as many as 10 children. She insists, “I don’t want to make things worse and destroy my body.”

Health officials across Africa and Gambia have faced resistance from women of childbearing age to get vaccinated. Many women fear that their current and future pregnancies may be endangered. In Africa, the success or failure of a woman’s marriage depends on how many children she has. Others women feel more scared of the vaccine than of the virus. They are breadwinners and cannot miss a day of work, even if they experience side effects like fatigue or fever.

These fears are not uncommon in Africa, where less than 4% of the population has been immunized. Experts believe that vaccine distribution data is not available for Africa, but experts are seeing a rise in the number of African women who have been denied vaccines. Officials already lament the uneven distribution of vaccines between poor and rich countries, but they fear that this stark gender gap will lead to African women being the least vaccinated in the world.

This is the first in a series of stories that will cover the impact of the pandemic on women in Africa. It is the most severe in the least-developed countries. The European Journalism Centre’s European Development Journalism Grants program supports AP’s series. All content is under the control of AP.

“We are seeing that women are being left behind even though COVID vaccines have arrived in Africa after a long delay,” stated Dr. Abdahalah Ziraba of the African Population and Health Research Center. This could lead to a greater number of deaths during the pandemic.

Officials claim that the gender gap is due in large part to misinformation about vaccines. Officials claim that misinformation flourished because of delays in getting vaccines to poor countries. This is even true in remote villages, where very few people have smart phones. Because of the difficulty in obtaining vaccines for women in Africa, they have relied on word-of-mouth information.

Despite widespread concerns about fertility and pregnancy, there is no evidence to suggest that vaccines can affect a woman’s chances of becoming pregnant. The U.S. Centers for Disease Control and Prevention compared the outcomes of tens of thousands vaccinated women and found no differences in their pregnancies. Because pregnant women are at greater risk for severe diseases and death, the CDC, World Health Organization and other agencies recommend that they get vaccinated.

AstraZeneca, like many African countries in Africa, was the first vaccine that was available in Gambia. The widespread publicity about the link between AstraZeneca and rare blood clots among women in Europe during a slow rollout of vaccines set back vaccination efforts. Gambians believed that the shot would stop blood flow, owing to poor translations of news into local languages.

Officials were also faced with deep distrust of government and the belief that Africans were being given shots they don’t want. Rumours circulated that the vaccine was intended to reduce Africa’s birthrate.

Since then, health officials have made great strides to get Gambian women vaccinated. They now account for about 53% of all those who have had the jabs. This is a significant increase from just a few short months ago. However, there has been a delay in vaccinating women of child bearing age, despite the fact that they are regularly in touch with maternity clinic workers.

Across Africa, officials report similar trends despite lacking wider data. Women comprised less than 30% of the people who received at least one dose during the initial stages of COVID-19 immunization campaigns in South Sudan, Gabon, and Somalia.

These countries, as well as other parts of the world, are home to many women who have difficulty accessing vaccines. Others need permission from their husbands, lack the technology to schedule appointments, or are not included on vaccine priority lists.

Assistant professor at Georgetown University Medical Center Dr. Roopa Datt said that it is not surprising that African women are being left behind. However, the urgency of addressing this problem is clear. She stated that if they are not vaccinated at the rate of men, they will be a pocket for COVID-19 and it will make the pandemic more difficult to end.

Gambia has many women who start their day by lighting a fire for breakfast. Lucy Jarju wakes up and walks to the river to finish her morning chores. In search of dinner, she and others spend hours paddling small boats across the open water. They will sell the oysters, crabs and small fish left unattended, which makes up the majority of their household income.

Jarju, 53 years old, won’t be willing to get vaccinated for COVID-19 if that means she has to miss a day of work. Jarju’s husband passed away a decade ago leaving her to care for her seven children, and her three grandchildren.

“Everyday I’m running up and down just to survive. Jarju said, “If I go to the vaccine, it’ll be a problem.” Jarju often makes it home before dark and then goes to wash dishes before heading to bed. The next day, Jarju will repeat the same routine. “If my arm becomes heavy and I cannot go to the water, then who will feed my children?”

Jarju stated that she has received other vaccines but has not yet made the 25-minute walk to the nearest clinic to get her COVID-19 shot.

She muttered, “Maybe later”, and headed off to cook dinner with her catch of the day.

According to University College London, only half of the 200 countries and regions in the world have reported COVID-19 vaccination data by gender. Experts fear for the well-being of women in poor countries, as similar scenes are seen across this country with 2.2 million inhabitants and its neighbouring nations.

Sarah Hawkes, UCL’s Centre for Gender and Global Health director, stated that “in most countries around the world, there just aren’t the data to tell if there is an COVID-19 female divide.” “But we have a few numbers to suggest it’s a problem.”

Gambia’s fate is intertwined to that of Senegal, its larger West African neighbor. Senegal completely engulfed the small enclave of nation with the exception of the coast. The majority of foreigners arriving by land are required to show proof of negative COVID-19 results. This allowed the virus’s spread, and Senegal was hit with a third wave.

The pandemic has also ravaged the Gambian economy. It is supported by tourists from Europe as well as money sent home by Gambians from abroad. Gambians are now more dependent on farming and fishing than ever before. To escape Gambia, increasing numbers are taking to the rickety boats. This country emerged from over two decades of dictatorship in 2017.

Hawkes expressed hope that the initial COVID-19 immunization rates differences between men and women will continue to level out in Gambia once there are stable vaccine supplies. There is almost a even split in the number of women and men getting immunized in most countries with vaccines readily available, including Britain, Canada and Germany.

It’s especially difficult to get vaccines into areas where there haven’t been severe outbreaks of the virus like South Sudan and Gambia.

Anger Ater, a nurse who is involved in immunization campaigns for South Sudan, said that “Women here are concerned their children will get malaria or pneumonia.” They aren’t worried about COVID-19.

Remote villages are not the only ones who resist getting the coronavirus vaccination. The Bundung hospital in Serrekunda is on the outskirts Gambia’s capital. Chief executive officer Kebba Maneh, who has been there for over 20 years, finds the situation a bit bizarre.

Manneh recently asked a group dozens of expectant moms in the hospital’s maternity clinic how many had been vaccinated for COVID-19. Only one woman raised her hand.

Other women, just a few steps away, brought their children and grandchildren in for routine immunizations, including diphtheria, measles and tetanus.

“You must take your child to the doctor for vaccinations. Manneh wanted to know what was so special about this particular one. Manneh was shown a video by a pregnant woman who pulled out her smartphone to show him the clip. It showed that a person’s body had become magnetic following the COVID-19 shot. A spoon was stuck to one arm.

Initial confusion was caused by advice against vaccinations for many women, Marielle Bouyou-Akotet, the coordinator of the COVID-19 immunization program in Gabon, explained.

Bouyou Akotet from the University of Health Sciences, Libreville, stated that “we didn’t know the effects of the vaccine on pregnant and breastfeeding women or women who wish to have a child in the next six month,”

This recommendation was revised after several months. However, many women in Gabon have decided to skip vaccinations altogether.

Mariama Sonko is an infection control specialist at Bundung hospital. “We tell them that the research has shown it has nothing to do.

Many women prefer stories to research. Women hear stories about women who have miscarried after getting their vaccinations at 11 weeks. The fear spreads even though it is common to lose a pregnancy in the first trimester.

Binta Balde (29), a married woman who has struggled with conceiving for two years, said that “What makes me fear is what I heard from social media.” “That you won’t get pregnant if you take that shot.”

She visited the local hospital and a traditional spiritual healer. They advised her to swallow small pieces of paper with Quranic verses on them and to drink herbal tea to increase fertility.

She said, “When you get married and move to your husband’s home, you must have a child.” He could leave you or divorce you if you don’t have a child. He might say, “She cannot give me children, so I should find another.”

In Somalia and Gambia, which are predominantly Muslim countries, the rumors regarding fertility and COVID-19 have been particularly concerning. Polygamy is a common practice.

Abdikadir Ore Ahmed is a health specialist at CARE. “It means a lot for Somali women.” It’s important to be able to have more children in order to keep a family together and to continue to live with your spouse. Acceptance is more if you have more children.

Gambia requires husbands to give their wives permission for medical procedures. Many women will tell their spouses that they won’t consent to the COVID-19 vaccination unless they are consented to by their husbands. Few husbands attend prenatal visits. Only about half of them even attend the Bundung hospital’s childbirth.

Manneh explained the effectiveness of the vaccine at a recent information session held by the hospital for fathers.

He explained to the men that all the women who are pregnant come here don’t get the vaccine because their husbands haven’t authorized them. “Two have already died. While we aren’t forcing anyone, many vaccines will soon expire.

Fatoumata Nyabally is a security officer, which puts her at greater risk of contracting COVID-19. She has not been vaccinated. Manneh did not meet her husband, even though she is seven months pregnant. He has already refused to consent to his wife being vaccinated.

Nyabally refused the Johnson & Johnson vaccine and told workers, “He’s head of the family. So I have to follow him in everything we do.”

Only nine of the 100 women who came to the hospital that day agreed to be vaccinated.