{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T07:00:11Z","timestamp":1784098811846,"version":"3.55.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T00:00:00Z","timestamp":1566518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["FDN-143339"],"award-info":[{"award-number":["FDN-143339"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>To understand real-world human papillomavirus (HPV) vaccine impact, continuous evaluation using population-based data is critical. We evaluated the early impact of the school-based HPV immunization program on cervical dysplasia in women in British Columbia, Canada.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data linkage was performed using records from provincial cervical screening and immunization registries. Precancerous outcomes were compared between unvaccinated and HPV-vaccinated women born 1994\u20132005. Incidence rate, relative rate (RR), and vaccine effectiveness (VE), using unadjusted and adjusted Poisson regression of cytology (HSIL) and histopathology (CIN2, CIN3, and CIN2+) outcomes, were compared across vaccination status groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Women who received a complete series of vaccine on schedule between age 9 and 14 years had an adjusted RR = 0.42 (95% confidence interval [CI], 0.31\u20130.57) for CIN2+ over 7 years of follow-up compared to unvaccinated women, resulting in a VE of 57.9% (95% CI, 43.2%\u201369.0%). Adjusted RR for HSIL was 0.53 (95% CI, .43\u2013.64), resulting in a VE of 47.1% (95% CI, 35.6%\u201356.7%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Women vaccinated against HPV have a lower incidence of cervical dysplasia compared to unvaccinated women. Immunization between 9 and 14 years of age should be encouraged. Continued program evaluation is important for measuring long-term population impact.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiz422","type":"journal-article","created":{"date-parts":[[2019,8,16]],"date-time":"2019-08-16T07:18:11Z","timestamp":1565939891000},"page":"81-90","source":"Crossref","is-referenced-by-count":26,"title":["Cervical Intraepithelial Neoplasia Rates in British Columbia Women: A Population-Level Data Linkage Evaluation of the School-Based HPV Immunization Program"],"prefix":"10.1093","volume":"221","author":[{"given":"C Sarai","family":"Racey","sequence":"first","affiliation":[{"name":"University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada"},{"name":"Women\u2019s Health Research Institute, BC Women\u2019s Hospital and Health Service, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianne","family":"Albert","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Research Institute, BC Women\u2019s Hospital and Health Service, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robine","family":"Donken","sequence":"additional","affiliation":[{"name":"University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada"},{"name":"Women\u2019s Health Research Institute, BC Women\u2019s Hospital and Health Service, Vancouver, British Columbia, Canada"},{"name":"Vaccine Evaluation Centre, BC Children\u2019s Hospital Research Institute, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie","family":"Smith","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Research Institute, BC Women\u2019s Hospital and Health Service, Vancouver, British Columbia, Canada"},{"name":"BC Cancer, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J","family":"Spinelli","sequence":"additional","affiliation":[{"name":"University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada"},{"name":"BC Cancer, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Pedersen","sequence":"additional","affiliation":[{"name":"University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada"},{"name":"Women\u2019s Health Research Institute, BC Women\u2019s Hospital and Health Service, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"de Bruin","sequence":"additional","affiliation":[{"name":"Communicable Disease Prevention and Immunization Program, Interior Health Authority, Sicamous, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Masaro","sequence":"additional","affiliation":[{"name":"Vancouver Costal Health Authority, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheona","family":"Mitchell-Foster","sequence":"additional","affiliation":[{"name":"University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada"},{"name":"University of Northern British Columbia, Prince George, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish","family":"Sadarangani","sequence":"additional","affiliation":[{"name":"University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada"},{"name":"Vancouver Costal Health Authority, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meena","family":"Dawar","sequence":"additional","affiliation":[{"name":"University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada"},{"name":"Vancouver Costal Health Authority, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mel","family":"Krajden","sequence":"additional","affiliation":[{"name":"University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada"},{"name":"BC Centre for Disease Control, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Naus","sequence":"additional","affiliation":[{"name":"University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada"},{"name":"BC Centre for Disease Control, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"van Niekerk","sequence":"additional","affiliation":[{"name":"University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada"},{"name":"BC Cancer, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina","family":"Ogilvie","sequence":"additional","affiliation":[{"name":"University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada"},{"name":"Women\u2019s Health Research Institute, BC Women\u2019s Hospital and Health Service, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,23]]},"reference":[{"key":"2019121321383493500_CIT0001","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1128\/CVI.00591-14","article-title":"Efficacy of human papillomavirus 16 and 18 (HPV-16\/18) AS04-adjuvanted vaccine 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