Abstract:Background: Cervical cancer remains a leading cause of morbidity and mortality among women in China. New incident cases reached 155,700, with 55,700 deaths annually. In recent years, domestic HPV vaccine development has been prioritized as part of a national strategy to improve vaccine accessibility and reduce health disparities. However, the extent to which this strategy addresses structural health inequities remains underexplored. Objectives: This scoping review aims to explores the implementation and equity impacts of China’s domestic HPV vaccine strategy, focusing on policy milestones, market dynamics, and structural barriers affecting vaccine access. Materials and Methods: Following PRISMA-ScR guidelines, we searched international databases (PubMed, Scopus, Web of Science) and Chinese databases (CNKI, Wanfang) for peer-reviewed articles, policy documents, government reports, and market analyses published between 2015 and 2025. Inclusion criteria targeted literature related to HPV vaccine access, domestic manufacturing, public financing, and equity-related outcomes. Data were charted and thematically synthesized. Results: Key milestones included the 2019 approval of Cecolin® (bivalent), the 2023 National Cervical Cancer Action Plan, and the anticipated 2025 launch of Cecolin 9 (9-valent). Domestic vaccine production improved affordability (e.g., ¥700 800 per dose, compared to ¥1,300-1,500 for imported vaccines. Pilot programs expanded regional coverage, though challenges persist: low national coverage, regional inequities (e.g., Beijing vs. Tibet), exclusion from the national immunization program, and limited public awareness in underserved areas. Conclusions: China’s domestic HPV vaccine strategy shows strong potential to mitigate structural inequities in cervical cancer prevention. However, national-level financing gaps, uneven rollout, and persistent public trust barriers remain. Policy efforts should prioritize cross-sector coordination, tiered pricing models, insurance integration, and the deployment of digital health tools to advance equitable vaccine access nationwide.
Keywords: Health Systems and Universal Health Coverage (UHC), HPV vaccine, Health equity, Cervical cancer prevention, Immunization coverage
