Evidence map›Paper›PMID 25487660›Full record

ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2015

Effect of human papillomavirus (HPV) vaccination on clinical indicators of sexual behaviour among adolescent girls: the Ontario Grade 8 HPV Vaccine Cohort Study.

Leah M Smith, Jay S Kaufman, Erin C Strumpf, Linda E Lévesque

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Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

53 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Leah M SmithDepartment of Epidemiology, Biostatistics, and Occupational Health (Smith, Kaufman, Strumpf), McGill University, Montréal, Que.; Department of Public Health Sciences (Lévesque), Queen's University, Kingston, Ont. leah.smith3@mail.mcgill.ca.
Jay S KaufmanDepartment of Epidemiology, Biostatistics, and Occupational Health (Smith, Kaufman, Strumpf), McGill University, Montréal, Que.; Department of Public Health Sciences (Lévesque), Queen's University, Kingston, Ont.
Erin C StrumpfDepartment of Epidemiology, Biostatistics, and Occupational Health (Smith, Kaufman, Strumpf), McGill University, Montréal, Que.; Department of Public Health Sciences (Lévesque), Queen's University, Kingston, Ont.
Linda E LévesqueDepartment of Epidemiology, Biostatistics, and Occupational Health (Smith, Kaufman, Strumpf), McGill University, Montréal, Que.; Department of Public Health Sciences (Lévesque), Queen's University, Kingston, Ont.

Funding

Canadian Institutes of Health Research MOP 130339
6 · The paper itself

Abstract

backgroundSuboptimal human papillomavirus (HPV) vaccine coverage in some jurisdictions is partly attributed to fears that vaccination may increase risky sexual behaviour. We assessed the effect of HPV vaccination on clinical indicators of sexual behaviour among adolescent girls in Ontario.

methodsUsing Ontario's administrative health databases, we identified a population-based cohort of girls in grade 8 in the 2 years before (2005/06 and 2006/07) and after (2007/08 and 2008/09) implementation of Ontario's grade 8 HPV vaccination program. For each girl, we then obtained data on vaccine receipt in grades 8 and 9 and data on indicators of sexual behaviour (pregnancy and non-HPV-related sexually transmitted infections) in grades 10-12. Using a quasi-experimental method known as regression discontinuity, we estimated, for each outcome, the risk difference (RD) and relative risk (RR) attributable to vaccination and to program eligibility.

resultsThe cohort comprised 260 493 girls, of whom 131 781 were ineligible for the program and 128 712 were eligible. We identified 15 441 (5.9%) cases of pregnancy and sexually transmitted infection and found no evidence that vaccination increased the risk of this composite outcome: RD per 1000 girls -0.61 (95% confidence interval [CI] -10.71 to 9.49) and RR 0.96 (95% CI 0.81 to 1.14). Similarly, we found no discernible effect of program eligibility: RD per 1000 girls -0.25 (95% CI -4.35 to 3.85) and RR 0.99 (95% CI 0.93 to 1.06). The findings were similar when outcomes were assessed separately.

interpretationWe present strong evidence that HPV vaccination does not have any significant effect on clinical indicators of sexual behaviour among adolescent girls. These results suggest that concerns over increased promiscuity following HPV vaccination are unwarranted and should not deter from vaccinating at a young age.

Indexed as

Adolescent BehaviorPapillomavirus VaccinesSexual BehaviorAdolescentCohort StudiesFemaleHumansIncidenceOntarioPapillomavirus InfectionsPatient Acceptance of Health CarePregnancyPregnancy in AdolescenceSexually Transmitted DiseasesVaccinationPapillomavirus Vaccines

Identifiers

PMID25487660
PMCPMC4312170

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Registered trials

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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.