ArticleBMC public health2014
Individual- and regional-level determinants of human papillomavirus (HPV) vaccine refusal: the Ontario Grade 8 HPV vaccine cohort study.
Article in BMC public health, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Are there any sociodemographic factors associated with non-uptake of HPV vaccination of girls in high-income countries with school-based vaccination programmes? A systematic review.Journal of epidemiology and community health · 2025Pooled it
- HPV vaccination coverage and barriers for people with disability: A scoping review.Human vaccines & immunotherapeutics · 2026Review
- Validating sociodemographic disparities in HPV vaccine uptake in a universal, publicly funded, low barrier, school-based immunisation program in the Vancouver Coastal Health region of British Columbia, Canada: A cross-sectional study.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- Cervical Cancer Screening and Prevention Uptake in Females with Autism Spectrum Disorder.Journal of autism and developmental disorders · 2026Article
- Socioeconomic/health-related factors associated with HPV vaccination initiation/completion among females of paediatric age: A systematic review with meta-analysis.Public health in practice (Oxford, England) · 2025Review
- Estimates and determinants of HPV non-vaccination in 14-year-old Canadians: Results from the childhood national immunization coverage survey, 2019.Human vaccines & immunotherapeutics · 2024Article
- Mental health and lower adolescent HPV vaccine coverage.The Lancet. Public health · 2024Article
- Individual and Geospatial Determinants of Health Associated With School-Based Human Papillomavirus Immunization in Alberta: Population-Based Cohort Study.JMIR public health and surveillance · 2024Article
- Corona virus vaccine hesitancy among higher education students in Adama City, Oromia, Ethiopia.Frontiers in public health · 2024Article
- Barriers and facilitators in uptake of human papillomavirus vaccine across English Canada: A review.Human vaccines & immunotherapeutics · 2023Review
- Factors influencing human papillomavirus school-based immunization in Alberta: A mixed-methods study protocol.PloS one · 2022Article
- Observational
- Human Papillomavirus (HPV) Health Savings as an Alternative Solution: HPV Vaccination Behavior in Adolescents.Asian Pacific journal of cancer prevention : APJCP · 2021Article
- Article
- Article
- Vaccination in people with disability: a review.Human vaccines & immunotherapeutics · 2020Review
- Determinants of vaccine hesitancy in Quebec: a large population-based survey.Human vaccines & immunotherapeutics · 2019Article
- Quadrivalent human papillomavirus vaccination in girls and the risk of autoimmune disorders: the Ontario Grade 8 HPV Vaccine Cohort Study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018Article
- Discrepancies in the evaluation of the safety of the human papillomavirus vaccine.Memorias do Instituto Oswaldo Cruz · 2018Article
- Pharmacotherapeutic Considerations for Individuals with Down Syndrome.Pharmacotherapy · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStudies on the determinants of human papillomavirus (HPV) vaccine use have generally focused on individual-level characteristics, despite the potentially important influence of regional-level characteristics. Therefore, we undertook a population-based, retrospective cohort study to identify individual- and regional-level determinants of HPV vaccine refusal (non-receipt) in Ontario's (Canada) Grade 8 HPV Immunization Program.
methodsOntario's administrative health and immunization databases were used to identify girls eligible for free HPV vaccination in 2007-2011 and to ascertain individual-level characteristics of cohort members (socio-demographics, vaccination history, health care utilization, medical history). The social and material characteristics of the girl's region (health unit) were derived from the 2006 Canadian Census. Generalized estimating equations (binomial distribution, logit link) were used to estimate the population-average effects of individual- and regional-level characteristics on HPV vaccine refusal.
resultsOur cohort consisted of 144,047 girls, 49.3% of whom refused HPV vaccination. Factors associated with refusal included a previous diagnosis of Down's syndrome (OR = 1.37, 95% CI 1.16-1.63) or autism (OR = 1.60, 95% CI 1.34-1.90), few physician visits (OR = 1.45, 95% CI 1.35-1.55), and previous refusal of mandatory (OR = 2.23, 95% CI 2.07-2.40) and optional (OR = 3.96, 95% CI 3.87-4.05) vaccines. Refusal was highest among the lowest and highest income levels. Finally, a previous diagnosis of obesity and living in an area of high deprivation were associated with lower refusal (OR = 0.87, 95% CI 0.83-0.92 and OR = 0.82 95%, CI 0.79-0.86, respectively).
conclusionsStudies on HPV vaccine determinants should consider regional-level factors. Efforts to increase HPV vaccine acceptance should include vulnerable populations (such as girls of low income) and girls with limited contact with the healthcare system.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.