{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T07:58:23Z","timestamp":1785484703299,"version":"3.56.0"},"reference-count":56,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Alberta Ministry of Health","award":["015486"],"award-info":[{"award-number":["015486"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Human papillomavirus (HPV) vaccination reduces the incidence of high-grade cervical lesions, but its population-level impact on cervical intraepithelial neoplasia grade 2 or worse (CIN2+) may vary by age at vaccination, program coverage, and vaccine type. The extent to which these factors explain variation in CIN2+ outcomes across real-world vaccination programs remains incompletely quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from a prior systematic review of observational studies across HPV-related endpoints, we restricted this meta-analysis to studies reporting histologically confirmed CIN2+. Reported ratio measures were analyzed on the natural log scale using random-effects models fitted by restricted maximum likelihood with Hartung\u2013Knapp\u2013Sidik\u2013Jonkman inference. Prespecified subgroup analyses examined age at vaccination, vaccination coverage, and vaccine type. Exploratory univariable meta-regressions assessed follow-up duration, age-at-vaccination category, study design, and publication year. Sensitivity analyses evaluated the influence of effect-measure type, alternative between-study variance estimation, and trim-and-fill adjustment. A frequentist network meta-analysis (NMA) compared vaccine types versus no vaccination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-two studies were included. HPV vaccination was associated with a pooled ratio estimate of 0.38 (95% CI 0.29\u20130.50), corresponding to an approximate 62% reduction in CIN2+ occurrence. Heterogeneity was very high (I2 = 97.0%), and the 95% prediction interval crossed 1 (0.12\u20131.23), indicating substantial variation in expected effects across real-world vaccination programs. Point estimates were generally protective across subgroup strata, but subgroup differences by age at vaccination, vaccination coverage, and vaccine type were not statistically significant. Sensitivity analyses were directionally consistent with the primary analysis. The NMA suggested lower CIN2+ occurrence for all vaccine-type categories compared with no vaccination; however, all comparisons were indirect through a common no-vaccination comparator, so vaccine-type differences should be interpreted as exploratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HPV vaccination was associated with a substantial average reduction in CIN2+ occurrence across observational studies. However, high heterogeneity, wide prediction intervals, nonsignificant subgroup tests, and indirect network comparisons indicate that subgroup and vaccine-type findings should be interpreted cautiously.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag420","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:22:48Z","timestamp":1782919368000},"source":"Crossref","is-referenced-by-count":0,"title":["Real-world Impact of HPV Vaccination on CIN2+ Reduction: A Meta-analysis of Observational Studies Assessing Variation by Age, Coverage, and Vaccine Type"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5197-1355","authenticated-orcid":false,"given":"Addisu J","family":"Zeleke","sequence":"first","affiliation":[{"name":"Faculty of Nursing, University of Alberta , Edmonton, AB ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0283-9606","authenticated-orcid":false,"given":"Laura","family":"Reifferscheid","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Alberta , Edmonton, AB ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3079-7730","authenticated-orcid":false,"given":"Umar","family":"Yunusa","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Alberta , Edmonton, AB ,","place":["Canada"]},{"name":"Department of Nursing Science, Bayero University , Kano, KN ,","place":["Nigeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Geoffrey and Robyn Sperber Health Sciences Library, University of Alberta , Edmonton, AB ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9985-6452","authenticated-orcid":false,"given":"Manish","family":"Sadarangani","sequence":"additional","affiliation":[{"name":"Vaccine Evaluation Center, BC Children's Hospital Research Institute , Vancouver, Bc ,","place":["Canada"]},{"name":"Department of Pediatrics, University of British Columbia , Vancouver, Bc ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina","family":"Ogilvie","sequence":"additional","affiliation":[{"name":"School of Population and Public Health, University of British Columbia , Vancouver, Bc ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4675-4433","authenticated-orcid":false,"given":"Shannon E","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Alberta , Edmonton, AB ,","place":["Canada"]},{"name":"School of Public Health, University of Alberta , Edmonton, AB ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"2026073103113213800_ofag420-B1","author":"World Health Organization"},{"key":"2026073103113213800_ofag420-B2","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/S0140-6736(07)61416-0","article-title":"Human papillomavirus and cervical cancer","volume":"370","author":"Schiffman","year":"2007","journal-title":"Lancet"},{"key":"2026073103113213800_ofag420-B3","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/S1470-2045(08)70103-7","article-title":"Natural history of cervical neoplasia and risk of invasive cancer in women with cervical intraepithelial neoplasia 3: a retrospective cohort study","volume":"9","author":"McCredie","year":"2008","journal-title":"Lancet Oncol"},{"key":"2026073103113213800_ofag420-B4","author":"World Health Organization"},{"key":"2026073103113213800_ofag420-B5","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(19)30298-3","article-title":"Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis","volume":"394","author":"Drolet","year":"2019","journal-title":"Lancet"},{"key":"2026073103113213800_ofag420-B6","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1093\/cid\/ciw354","article-title":"Impact and effectiveness of the quadrivalent human papillomavirus vaccine: a systematic review of 10 years of real-world experience","volume":"63","author":"Garland","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2026073103113213800_ofag420-B7","doi-asserted-by":"crossref","first-page":"5413","DOI":"10.1016\/j.vaccine.2022.06.065","article-title":"Human papillomavirus vaccine effectiveness by number of doses: updated systematic review of data from national immunization programs","volume":"40","author":"Markowitz","year":"2022","journal-title":"Vaccine"},{"key":"2026073103113213800_ofag420-B8","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1056\/NEJMoa1917338","article-title":"HPV vaccination and the risk of invasive cervical cancer","volume":"383","author":"Lei","year":"2020","journal-title":"N Engl J Med"},{"key":"2026073103113213800_ofag420-B9","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/S0140-6736(20)30068-4","article-title":"Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries","volume":"395","author":"Brisson","year":"2020","journal-title":"Lancet"},{"key":"2026073103113213800_ofag420-B10","doi-asserted-by":"crossref","first-page":"2343552","DOI":"10.1080\/21645515.2024.2343552","article-title":"Reduced risk of CIN2+ recurrence in women immunized with a 9-valent HPV vaccine post-excision: retrospective cohort study","volume":"20","author":"Dvo\u0159\u00e1k","year":"2024","journal-title":"Hum Vaccines Immunother"},{"key":"2026073103113213800_ofag420-B11","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/LGT.0000000000000604","article-title":"The natural history of cervical intraepithelial neoplasia grades 1, 2, and 3: a systematic review and meta-analysis","volume":"25","author":"Loopik","year":"2021","journal-title":"J Low Genit Tract Dis"},{"key":"2026073103113213800_ofag420-B12","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1056\/NEJMoa1405044","article-title":"A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women","volume":"372","author":"Joura","year":"2015","journal-title":"N Engl J Med"},{"key":"2026073103113213800_ofag420-B13","author":"World Health Organization"},{"key":"2026073103113213800_ofag420-B14","doi-asserted-by":"crossref","first-page":"2667734","DOI":"10.1080\/14760584.2026.2667734","article-title":"Population-level impact of HPV vaccination: a global systematic review of ecological, cross-sectional, and cohort studies","volume":"25","author":"Zeleke","year":"2026","journal-title":"Expert Rev Vaccines"},{"key":"2026073103113213800_ofag420-B15","doi-asserted-by":"crossref","first-page":"e1003583","DOI":"10.1371\/journal.pmed.1003583","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"18","author":"Page","year":"2021","journal-title":"PLoS Med"},{"key":"2026073103113213800_ofag420-B16","author":"Joanna Briggs Institute"},{"key":"2026073103113213800_ofag420-B17","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1016\/j.vaccine.2015.01.084","article-title":"Reduction in HPV 16\/18-associated high grade cervical lesions following HPV vaccine introduction in the United States \u2013 2008\u20132012","volume":"33","author":"Hariri","year":"2015","journal-title":"Vaccine"},{"key":"2026073103113213800_ofag420-B18","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1093\/cid\/cix455","article-title":"Declines in human papillomavirus (HPV)\u2013associated high-grade cervical lesions after Introduction of HPV vaccines in Connecticut, United States, 2008\u20132015","volume":"65","author":"Niccolai","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2026073103113213800_ofag420-B19","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1002\/ijc.34231","article-title":"HPV type-specific trends in cervical precancers in the United States, 2008 to 2016","volume":"152","author":"Gargano","year":"2023","journal-title":"Int J Cancer"},{"key":"2026073103113213800_ofag420-B20","doi-asserted-by":"crossref","first-page":"1656","DOI":"10.1002\/cncr.32700","article-title":"Comparison of the long-term impact and clinical outcomes of fewer doses and standard doses of human papillomavirus vaccine in the United States: a database study","volume":"126","author":"Rodriguez","year":"2020","journal-title":"Cancer"},{"key":"2026073103113213800_ofag420-B21","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1002\/ijc.33513","article-title":"Declining rates of cervical intraepithelial neoplasia in British Columbia, Canada: an ecological analysis on the effects of the school-based human papillomavirus vaccination program","volume":"149","author":"Donken","year":"2021","journal-title":"Int J Cancer"},{"key":"2026073103113213800_ofag420-B22","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1093\/infdis\/jiz422","article-title":"Cervical intraepithelial neoplasia rates in British Columbia women: a population-level data linkage evaluation of the school-based HPV immunization program","volume":"221","author":"Racey","year":"2020","journal-title":"J Infect Dis"},{"key":"2026073103113213800_ofag420-B23","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1002\/ijc.29508","article-title":"Reduction in cervical intraepithelial neoplasia in young women in B ritish C olumbia after introduction of the HPV vaccine: an ecological analysis","volume":"137","author":"Ogilvie","year":"2015","journal-title":"Int J Cancer"},{"key":"2026073103113213800_ofag420-B24","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.pvr.2015.05.005","article-title":"Effectiveness of less than three doses of quadrivalent human papillomavirus vaccine against cervical intraepithelial neoplasia when administered using a standard dose spacing schedule: observational cohort of young women in Australia","volume":"1","author":"Brotherton","year":"2015","journal-title":"Papillomavirus Res"},{"key":"2026073103113213800_ofag420-B25","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1186\/1741-7015-11-227","article-title":"Impact of a population-based HPV vaccination program on cervical abnormalities: a data linkage study","volume":"11","author":"Gertig","year":"2013","journal-title":"BMC Med"},{"key":"2026073103113213800_ofag420-B26","doi-asserted-by":"crossref","first-page":"2639","DOI":"10.1007\/s00404-024-07692-y","article-title":"The impact of Germany's human papillomavirus immunization program on HPV-related anogenital diseases: a retrospective analysis of claims data from statutory health insurances","volume":"310","author":"Goodman","year":"2024","journal-title":"Arch Gynecol Obstet"},{"key":"2026073103113213800_ofag420-B27","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1186\/s12885-022-10214-1","article-title":"HPV vaccination leads to decrease of anogenital warts and precancerous lesions of the cervix uteri in young women with low vaccination rates: a retrospective cohort analysis","volume":"22","author":"Osmani","year":"2022","journal-title":"BMC Cancer"},{"key":"2026073103113213800_ofag420-B28","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1002\/ijc.34489","article-title":"Real-world effectiveness of HPV vaccination against cervical neoplasia among birth cohorts ineligible for routine vaccination","volume":"153","author":"Dong","year":"2023","journal-title":"Int J Cancer"},{"key":"2026073103113213800_ofag420-B29","doi-asserted-by":"crossref","first-page":"421","DOI":"10.3390\/vaccines12040421","article-title":"Impact of HPV vaccination on the incidence of high-grade cervical intraepithelial neoplasia (CIN2+) in women aged 20\u201325 in the northern part of Norway: a 15-year study","volume":"12","author":"Mikalsen","year":"2024","journal-title":"Vaccines (Basel)"},{"key":"2026073103113213800_ofag420-B30","doi-asserted-by":"crossref","first-page":"l1161","DOI":"10.1136\/bmj.l1161","article-title":"Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12-13 in Scotland: retrospective population study","volume":"365","author":"Palmer","year":"2019","journal-title":"BMJ"},{"key":"2026073103113213800_ofag420-B31","doi-asserted-by":"crossref","first-page":"1824","DOI":"10.1038\/bjc.2014.479","article-title":"Reduction of low- and high-grade cervical abnormalities associated with high uptake of the HPV bivalent vaccine in Scotland","volume":"111","author":"Pollock","year":"2014","journal-title":"Br J Cancer"},{"key":"2026073103113213800_ofag420-B32","doi-asserted-by":"crossref","first-page":"101178","DOI":"10.1016\/j.lanepe.2024.101178","article-title":"Effectiveness of quadrivalent human papillomavirus vaccination against high-grade cervical lesions by age and doses: a population-based cohort study","volume":"49","author":"Wu","year":"2025","journal-title":"Lancet Reg Health Eur"},{"key":"2026073103113213800_ofag420-B33","doi-asserted-by":"crossref","first-page":"2867","DOI":"10.1002\/ijc.30035","article-title":"Quadrivalent HPV vaccine effectiveness against high-grade cervical lesions by age at vaccination: a population-based study","volume":"138","author":"Herweijer","year":"2016","journal-title":"Int J Cancer"},{"key":"2026073103113213800_ofag420-B34","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1158\/1055-9965.EPI-21-0895","article-title":"Impact of a human papillomavirus vaccination program within organized cervical cancer screening: cohort study","volume":"31","author":"Martellucci","year":"2022","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2026073103113213800_ofag420-B35","doi-asserted-by":"crossref","first-page":"6373","DOI":"10.1016\/j.vaccine.2018.09.011","article-title":"Effectiveness of varying number of doses and timing between doses of quadrivalent HPV vaccine against severe cervical lesions","volume":"36","author":"Dehlendorff","year":"2018","journal-title":"Vaccine"},{"key":"2026073103113213800_ofag420-B36","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1111\/aogs.13935","article-title":"High-grade cervical lesions after vaccination against human papillomavirus: a Danish cohort study","volume":"99","author":"Thamsborg","year":"2020","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2026073103113213800_ofag420-B37","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1186\/s12879-020-05513-6","article-title":"Effectiveness of HPV vaccination against the development of high-grade cervical lesions in young Japanese women","volume":"20","author":"Shiko","year":"2020","journal-title":"BMC Infect Dis"},{"key":"2026073103113213800_ofag420-B38","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1111\/j.0006-341X.2000.00455.x","article-title":"Trim and fill: a simple funnel-plot\u2013based method of testing and adjusting for publication bias in meta-analysis","volume":"56","author":"Duval","year":"2000","journal-title":"Biometrics"},{"key":"2026073103113213800_ofag420-B39","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1111\/j.1467-985X.2008.00552.x","article-title":"A re-evaluation of random-effects meta-analysis","volume":"172","author":"Higgins","year":"2009","journal-title":"J R Stat Soc Ser A Stat Soc"},{"key":"2026073103113213800_ofag420-B40","doi-asserted-by":"crossref","first-page":"e010247","DOI":"10.1136\/bmjopen-2015-010247","article-title":"Plea for routinely presenting prediction intervals in meta-analysis","volume":"6","author":"IntHout","year":"2016","journal-title":"BMJ Open"},{"key":"2026073103113213800_ofag420-B41","first-page":"CD009069","article-title":"Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors","volume":"5","author":"Arbyn","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"2026073103113213800_ofag420-B42","doi-asserted-by":"crossref","first-page":"2084","DOI":"10.1016\/S0140-6736(21)02178-4","article-title":"The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study","volume":"398","author":"Falcaro","year":"2021","journal-title":"Lancet"},{"key":"2026073103113213800_ofag420-B43","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1056\/NEJMcp2108502","article-title":"Human papillomavirus vaccination","volume":"388","author":"Markowitz","year":"2023","journal-title":"N Engl J Med"},{"key":"2026073103113213800_ofag420-B44","volume-title":"Current HPV vaccination recommendations (HCP page)","author":"CDC\/ACIP","year":"2024"},{"key":"2026073103113213800_ofag420-B45","doi-asserted-by":"crossref","first-page":"96","DOI":"10.15585\/mmwr.mm7406a4","article-title":"Trends in cervical precancers identified through population-based surveillance\u2014human papillomavirus vaccine impact monitoring project, five sites, United States, 2008\u20132022","volume":"74","author":"Gargano","year":"2025","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026073103113213800_ofag420-B46","first-page":"CD015364","article-title":"Human papillomavirus (HPV) vaccination for the prevention of cervical cancer and other HPV-related diseases: a network meta-analysis","volume":"11","author":"Bergman","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"key":"2026073103113213800_ofag420-B47","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1016\/S1473-3099(12)70187-1","article-title":"Cross-protective efficacy of two human papillomavirus vaccines: a systematic review and meta-analysis","volume":"12","author":"Malag\u00f3n","year":"2012","journal-title":"Lancet Infect Dis"},{"key":"2026073103113213800_ofag420-B48","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1016\/S1473-3099(17)30468-1","article-title":"Changes in the prevalence of human papillomavirus following a national bivalent human papillomavirus vaccination programme in Scotland: a 7-year cross-sectional study","volume":"17","author":"Kavanagh","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"2026073103113213800_ofag420-B49","doi-asserted-by":"crossref","first-page":"1437704","DOI":"10.3389\/fcimb.2024.1437704","article-title":"Head-to-head comparison of two human papillomavirus vaccines for efficacy against cervical intraepithelial neoplasia grade 3 and adenocarcinoma in situ\u2014population-based follow-up of two cluster-randomized trials","volume":"14","author":"Lehtinen","year":"2024","journal-title":"Front Cell Infect Microbiol"},{"key":"2026073103113213800_ofag420-B50","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.vaccine.2021.11.041","article-title":"Rationale and design of a double-blind randomized non-inferiority clinical trial to evaluate one or two doses of vaccine against human papillomavirus including an epidemiologic survey to estimate vaccine efficacy: the Costa Rica ESCUDDO trial","volume":"40","author":"Porras","year":"2022","journal-title":"Vaccine"},{"key":"2026073103113213800_ofag420-B51","volume-title":"Background document and report to SAGE: potential contribution of HPV vaccines and immunization towards cervical cancer elimination","author":"Strategic Advisory Group of Experts (SAGE) Working Group on Potential Contribution of HPV Vaccines and Immunization towards Cervical Cancer Elimination","year":"2022"},{"key":"2026073103113213800_ofag420-B52","doi-asserted-by":"crossref","first-page":"37","DOI":"10.3947\/ic.2023.0064","article-title":"Comparative effects of bivalent, quadrivalent, and nonavalent human papillomavirus vaccines in the prevention of genotype-specific infection: a systematic review and network meta-analysis","volume":"56","author":"Kim","year":"2024","journal-title":"Infect Chemother"},{"key":"2026073103113213800_ofag420-B53","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.1016\/j.vaccine.2022.02.074","article-title":"HPV vaccine introduction and implementation in low- and middle-income countries","volume":"40 Suppl 1","author":"Denny","year":"2022","journal-title":"Vaccine"},{"key":"2026073103113213800_ofag420-B54","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/S1470-2045(20)30729-4","article-title":"WHO launches strategy to accelerate elimination of cervical cancer","volume":"22","author":"Das","year":"2021","journal-title":"Lancet Oncol"},{"key":"2026073103113213800_ofag420-B55","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1097\/AOG.0000000000004000","article-title":"Human papillomavirus vaccination: ACOG committee opinion, number 809","volume":"136","author":"American College of Obstetricians and Gynecologists' Committee on Adolescent Health Care, American College of Obstetricians and Gynecologists' Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group","year":"2020","journal-title":"Obstet Gynecol"},{"key":"2026073103113213800_ofag420-B56","doi-asserted-by":"crossref","first-page":"3786","DOI":"10.1016\/j.vaccine.2013.06.060","article-title":"Cost-effectiveness of human papillomavirus vaccination in low and middle income countries: a systematic review","volume":"31","author":"Fesenfeld","year":"2013","journal-title":"Vaccine"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofag420\/68691901\/ofag420.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/7\/ofag420\/68691901\/ofag420.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/7\/ofag420\/68691901\/ofag420.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T07:11:44Z","timestamp":1785481904000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofag420\/8724189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":56,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofag420","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,7,1]]},"article-number":"ofag420"}}