Self-Identified Fat Peoples Experiences of COVID-19 Vaccination Centre's in Aotearoa NZ

This study investigates self-identified fat people’s experiences of COVID-19 vaccination centres in Aotearoa NZ. This includes attention to multiple facets of the experience of COVID-19 vaccination centres including the physical environment, interaction with service providers, and knowledge of and access to a long needle in accordance with Ministry of Health vaccination guidelines. The thesis employs a critical realist/contextualist approach, underpinned by the theory of body privilege. Qualitative content analysis is used to analyse open-ended survey responses collected as part of a broader international study. Three main themes are identified from the data set. The first theme, ‘“Crammed in Like Sardines”: Navigating COVID-19 vaccination centre environments’ found mixed experiences and a number of challenges in fat people’s access to and movement through vaccination centres. The second theme, “Thank fuck for fat activists”: The need for COVID-19 vaccination advocacy’ captured the importance that fat people’s advocacy played, both at the individual and community level in ensuring access to COVID-19 vaccinations and in raising awareness about long needle guidelines. The third theme, ‘“I worry about the effectiveness of my vaccine now”: Trust and authority in the vaccination encounter’ identifies the power imbalance within vaccination centres that placed authority with the vaccinator and undermined fat people’s self-advocacy and self-determination for long needle use. I demonstrate the corrosive impact this had on fat people’s confidence that they were protected from COVID-19 and subsequently their trust in the governments COVID-19 responsiveness for fat people. Findings highlight the healthcare inequities experienced by fat people when accessing COVID-19 vaccination that can also be seen reflected in everyday healthcare systems and settings. Vaccination centers were found to privilege thinness at both a structural and interactional level which excluded fat people and disregarded the needs of the fat community as well as other marginalized communities. These inequities ultimately served to undermine public health policies that were meant to protect and provide equitable care to the entire population. The neglect of fat people’s needs led to the requirement of advocacy by fat people to seek accessible and equitable healthcare. Whilst effective in helping promote protection for fat people, public health programmes that rely on community and self-advocacy to ensure responsiveness to marginalized communities is neither a fair solution nor is it sustainable in the long term. Research findings point to important lessons to be learned to ensure the inclusion of and responsiveness to fat people in future pandemic responses and in healthcare systems more generally.