The impact of vaccination on gender equity: conceptual framework and human papillomavirus (HPV) vaccine case study

Presenter: Samantha Clark

Co-authors: Allison Portnoy, Sachiko Ozawa, Mark Jit

Poster file: [download]
Background: Although the beneficial effects of vaccines by socioeconomic status and geography are increasingly well-documented, little has been done to extend these analyses to examine the linkage between vaccination and gender equity. In this study, evidence from the published literature is used to develop a conceptual framework demonstrating the potential impact of vaccination on measures of gender equity. This framework is then applied to the example of HPV vaccine introduction in three countries with different economic and disease burden profiles to establish proof of concept in a variety of contexts. Methods: An initial literature review was conducted to inform development of the conceptual framework. Output from the Papillomavirus Rapid Interface for Modelling and Economics (PRIME) model was then used to generate cervical cancer cases and deaths due to HPV types 16/18 by age in each country. We estimated labor force participation and fertility effects from improvements in health and converted these into inputs consistent with those used to calculate the United Nations Gender Inequality Index (GII) (0-1 scale with lower scores associated with greater gender equity) to assess gender equity impact. Findings: Overall, HPV vaccination is expected to decrease cervical cancer cases and deaths by approximately 80% in Tanzania, India, and the United Kingdom based on PRIME projections. This mortality reduction is associated with labor force participation improvements corresponding to 10,600 years of employment gained and an additional $46.7 million dollars (in US$2015) in economic productivity. These cases and deaths averted were also associated with a decrease in maternal mortality and GII score. Interpretation: This proof of concept model is a starting point to inform future health and economic analyses that might incorporate gender equity considerations as an additional impact of vaccination in improving the health and well-being of populations under study.