ArticleArchives of public health = Archives belges de sante publique2025
Is the HPV vaccine lottery system equitable under constrained vaccine supply? A cross-sectional study in China.
Article in Archives of public health = Archives belges de sante publique, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLimited supply has led to poor accessibility of high-priced imported human papillomavirus (HPV) vaccines, resulting in a vaccine lottery system in China. Few studies explore the inequities of vaccine lottery based on real-world environments, leaving uncertainty about whether the lottery actually achieved equal distribution in practical application. This study aims to take the HPV vaccine lottery system in China as an example to investigate the potential factors associated with participation in HPV vaccine lottery and the association between participation in HPV vaccine lottery and HPV vaccination.
methodsA cross-sectional study was conducted in a developed county that have piloted the HPV vaccine lottery system between April and June 2024. The study respondents were mothers of 7th grade students and the primary outcome variables were mothers' participation in vaccine lottery and HPV vaccination status. Logistic regression models were used for analysis.
resultsAmong the 2436 mothers of 7th grade students, mothers with high school, bachelor's degree or higher educational level, a monthly household income exceeding 20,000 RMB (US$2752) and better critical health literacy were more likely to have ever participated in the vaccine lottery. The above significant disparities still existed in the subgroups of medical education background, residence and functional health literacy. Mothers who used to participate in the vaccine lottery were 5.54 times more likely to have received the HPV vaccine.
conclusionsEducational attainment, household income, and health literacy are key determinants of both HPV vaccine lottery participation and vaccination. Our results suggested potential inequities generated by the vaccine lottery system, indicating that consideration should be given to further optimizing the vaccine lottery and combining it with vaccine subsidies, improving the health literacy of the population, and enhancing the accessibility and comprehensibility of vaccine-related information.
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