Stakeholders Engagement in the Assessment of Ethical, Legal, Social and Health System Impact (ELSHI) of the Use of 9valent Human Papilloma Virus (9vHPV) Vaccine
Author(s)
Imelda G. Peña, Doctor of Public Health (major in Epidemiology), Frances Lois Ngo, BS, MS, Yolanda Robles, BS, PhD.
Professor, University of the Philippines Manila, Manila, Philippines.
Professor, University of the Philippines Manila, Manila, Philippines.
OBJECTIVES: Stakeholders in the use of 9valent HPV (9vHPV) vaccine are important in assessing the impact of this health technology in the local setting. This study aims to assess the ethical, legal, social and health system impact of the use of 9vHPV vaccine based on the experiences and expertise of the stakeholders.
METHODS: Qualitative research with primary data collection was done through focus group discussions and interviews. Methods were guided by scoping review of relevant evidences on ELSHI as well as HTA documents to ensure validity of captured local data. Three FGDs were conducted with 53 invited representatives. Eight key opinion leaders were invited for interview.
RESULTS: Twelve participants for FGDs and four for KIIs agreed to participate. Each FGD represents a sector: government; practitioners and researchers; advocates and patients. Opinion leaders for KII represent private and government organizations. Ethical concerns include unaffordability of the vaccine, lack of awareness on the disease and the vaccine, access to the vaccine to ensure equity, local burden of disease as well as age before sexual debut of 9 year old, females, are important in allocating resources in the National Immunization Program; Legal considerations include inclusion of the vaccine in the Philippine National Formulary for government procurement; Social impact include diminished productivity due to the disease, stigma, system barriers in releasing the results, unaffordable cost for minimum wage earners, for vaccine preference, government participants prefer 4vHPV vaccine, while clinicians and patients prefer the 9vHPV vaccine. Health system concerns include educating the policymakers on the value of the vaccine as guide in decision-making, HPV vaccination is not priority program of the health system.
CONCLUSIONS: Interactions with stakeholders revealed various ELSHI concerns. For population-based vaccination, 4vHPV vaccine is preferred due to its cost-effectiveness, while for individual vaccination, 9vHPV vaccine is preferred due to its broader spectrum.
METHODS: Qualitative research with primary data collection was done through focus group discussions and interviews. Methods were guided by scoping review of relevant evidences on ELSHI as well as HTA documents to ensure validity of captured local data. Three FGDs were conducted with 53 invited representatives. Eight key opinion leaders were invited for interview.
RESULTS: Twelve participants for FGDs and four for KIIs agreed to participate. Each FGD represents a sector: government; practitioners and researchers; advocates and patients. Opinion leaders for KII represent private and government organizations. Ethical concerns include unaffordability of the vaccine, lack of awareness on the disease and the vaccine, access to the vaccine to ensure equity, local burden of disease as well as age before sexual debut of 9 year old, females, are important in allocating resources in the National Immunization Program; Legal considerations include inclusion of the vaccine in the Philippine National Formulary for government procurement; Social impact include diminished productivity due to the disease, stigma, system barriers in releasing the results, unaffordable cost for minimum wage earners, for vaccine preference, government participants prefer 4vHPV vaccine, while clinicians and patients prefer the 9vHPV vaccine. Health system concerns include educating the policymakers on the value of the vaccine as guide in decision-making, HPV vaccination is not priority program of the health system.
CONCLUSIONS: Interactions with stakeholders revealed various ELSHI concerns. For population-based vaccination, 4vHPV vaccine is preferred due to its cost-effectiveness, while for individual vaccination, 9vHPV vaccine is preferred due to its broader spectrum.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD167
Topic Subcategory
Data Protection, Integrity, & Quality Assurance
Disease
STA: Vaccines