Gender equity impact of HPV vaccination

Portnoy, A., Clark, S., Ozawa, S., Jit, M. The impact of vaccination on gender equity: conceptual framework and human papillomavirus (HPV) vaccine case study. Int J Equity Health 19, 10 (2020). https://doi.org/10.1186/s12939-019-1090-3

We conducted a literature review examining evidence on the linkage between health outcomes and dimensions of gender equity. We utilized the Papillomavirus Rapid Interface for Modelling and Economics (PRIME) model to estimate cervical cancer incidence 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 to assess gender equity (Figure 1).

Figure 1. Conceptual flow diagram.

Note: [1] Feikin, et al., 2016. [2] Bloom, et al., 2016. [3] United Nations Development Programme, 2018.

In our case study, we found that HPV vaccination among girls could help narrow socioeconomic gender disparities by quantifying the main pathways by which HPV vaccination improves health, which enables improvement in gender equity indicators such as labor force participation and maternal mortality ratios (Table 1). While these improvements are small when averaged over the entire population, the components measured – labor force participation and maternal mortality ratio – account for 50% of the index scores.

Table 1. Years of life saved and years of employment gained and maternal deaths averted among women with averted cervical cancer in Tanzania, India, and the United Kingdom.

This proof of concept model is a starting point to inform future health and economic analyses that might incorporate the impact of gender equity as an additional impact of vaccination in improving the health and well-being of the population.

Allison Portnoy 
Harvard TH Chan School of Public Health 
Postdoctoral Fellow 
aportnoy@mail.harvard.edu