{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:58:33Z","timestamp":1777503513434,"version":"3.51.4"},"reference-count":45,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>Despite widespread promotion of quadrivalent human papillomavirus (qHPV) vaccination for young girls, there is limited information on the vaccine\u2019s real-world effectiveness and none on the effectiveness of qHPV vaccination programs. We assessed the impact of the qHPV vaccine and Ontario\u2019s grade 8 qHPV vaccination program on cervical dysplasia and anogenital warts (AGW).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>By using administrative health databases of Ontario, Canada, we identified a population-based retrospective cohort of girls in grade 8 before (2005\/2006\u20132006\/2007) and after (2007\/2008\u20132008\/2009) program implementation. Vaccine exposure was ascertained in grades 8 to 9 and outcomes in grades 10 to 12. A quasi-experimental approach known as regression discontinuity was used to estimate absolute risk differences (RDs), relative risks (RRs), and 95% confidence intervals (CIs) attributable to vaccination and program eligibility (intention-to-treat analysis).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>The cohort comprised 131\u2009781 ineligible and 128\u2009712 eligible girls (n = 260\u2009493). We identified 2436 cases of dysplasia and 400 cases of AGW. Vaccination significantly reduced the incidence of dysplasia by 5.70 per 1000 girls (95% CI \u22129.91 to \u22121.50), corresponding to a relative reduction of 44% (RR 0.56; 95% CI 0.36 to 0.87). Program eligibility also had a significant protective effect on dysplasia: RD \u22122.32\/1000 (95% CI \u22124.02 to \u22120.61); RR 0.79 (95% CI 0.66 to 0.94). Results suggested decreases in AGW attributable to vaccination (RD \u22120.83\/1000, 95% CI \u22122.54 to 0.88; RR 0.57, 95% CI 0.20 to 1.58) and program eligibility (RD \u22120.34\/1000, 95% CI \u22121.03 to 0.36; RR 0.81, 95% CI 0.52 to 1.25).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>This study provides strong evidence of the early benefits of qHPV vaccination among girls aged 14 to 17 years, offering additional justification for not delaying vaccination.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2014-2961","type":"journal-article","created":{"date-parts":[[2015,4,28]],"date-time":"2015-04-28T00:32:43Z","timestamp":1430181163000},"page":"e1131-e1140","source":"Crossref","is-referenced-by-count":63,"title":["The Early Benefits of Human Papillomavirus Vaccination on Cervical Dysplasia and Anogenital Warts"],"prefix":"10.1542","volume":"135","author":[{"given":"Leah M.","family":"Smith","sequence":"first","affiliation":[{"name":"Departments of Epidemiology, Biostatistics, and Occupational Health, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin C.","family":"Strumpf","sequence":"additional","affiliation":[{"name":"Departments of Epidemiology, Biostatistics, and Occupational Health, and"},{"name":"Economics, McGill University, Montreal, Quebec, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay S.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Departments of Epidemiology, Biostatistics, and Occupational Health, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aisha","family":"Lofters","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, St Michael\u2019s Hospital, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Schwandt","sequence":"additional","affiliation":[{"name":"Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda E.","family":"L\u00e9vesque","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Queen\u2019s University, Kingston, Ontario, Canada; and"},{"name":"Institute for Clinical Evaluative Sciences-Queen's Health Services Research Facility, Kingston, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2015,5,1]]},"reference":[{"key":"2021120907105545800_B1","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.vaccine.2005.09.054","article-title":"The epidemiology of genital human papillomavirus infection.","volume":"24","author":"Trottier","year":"2006","journal-title":"Vaccine"},{"key":"2021120907105545800_B2"},{"issue":"2","key":"2021120907105545800_B3","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1002\/ijc.20244","article-title":"Against which human papillomavirus types shall we vaccinate and screen? 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