Mercuri Mathew, Hackett Kristy, Barnabas Ruanne V, Emerson Claudia I
Institute on Ethics & Policy for Innovation, McMaster University, Hamilton, ON, Canada; Department of Philosophy, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada; Centre for Philosophy of Epidemiology, Medicine, and Public Health, University of Johannesburg, Auckland Park, South Africa.
Institute on Ethics & Policy for Innovation, McMaster University, Hamilton, ON, Canada; Department of Philosophy, McMaster University, Hamilton, ON, Canada; Dalla Lana School of Public Health, Epidemiology Division, University of Toronto, Toronto, ON, Canada.
Lancet Infect Dis. 2024 Oct;24(10):e654-e658. doi: 10.1016/S1473-3099(24)00227-5. Epub 2024 May 8.
Although several countries have adopted a single-dose human papillomavirus (HPV) vaccination strategy, many other countries continue to include multiple doses in their vaccination programmes. There are ethical reasons to transition to a single-dose strategy. We discuss how a single-dose HPV vaccination strategy advances equity in three dimensions: vaccine equity, health equity, and gender equity. Adopting a single-dose strategy eases pressure on vaccine supply, lowers programme costs, and is easier to distribute. This change facilitates vaccine procurement and implementation programmes (contributing to vaccine equity) and reaching hard to reach people or populations (contributing to health equity). A lower number of cases of HPV-related diseases that stem from greater vaccine distribution reduces the burden on women, who are at a higher risk of HPV-related disease or who act as caregivers, which prevents them from accessing opportunities that contribute to their empowerment (contributing to gender equity). Thus, pursuing the single-dose HPV vaccination programme strategy is ethically desirable.
尽管有几个国家已经采用了单剂量人乳头瘤病毒（HPV）疫苗接种策略，但许多其他国家在其疫苗接种计划中仍继续采用多剂次接种。转向单剂量策略有伦理方面的原因。我们将讨论单剂量HPV疫苗接种策略如何在三个层面促进公平：疫苗公平、健康公平和性别公平。采用单剂量策略可减轻疫苗供应压力、降低项目成本，且更易于分发。这一变化有助于疫苗采购和实施计划（促进疫苗公平），并惠及难以触及的人群（促进健康公平）。因疫苗接种范围扩大导致的HPV相关疾病病例数减少，减轻了女性的负担，她们感染HPV相关疾病的风险更高，或担任护理者，这使她们无法获得有助于增强权能的机会（促进性别公平）。因此，从伦理角度来看，推行单剂量HPV疫苗接种计划策略是可取的。
