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G !AUFzx R# v,6yX`Z>/QϦre󶳾䰿n<%qBh7*cT_u{5xЁ^ di]#Y#U&rp~ q&rT7TOU1l%4R( 2XCtV{ |HmURHHjN}HJ{R̢ V-.ΚNC]#u\U*x~u++oG ѭ8{t+ MM쵫e2=Nʣ[ͭٓ[Ջ[[-yqHC^*rŭbdyeiΘ(3xD%qUaPԇ|`뫕Y@풷ږّpc(0NW[_f.z})uey!w$ arz$A =mڬ&YM38' _v`r kCt/yuھgɲDIQ5OhK] 1a}qU7dWI(d),8g޿8 "BXiO5ͤT$B2"LkMU~ֆĈ)].&}v.VI똣 Q&ىvTFטI}2:f_ZS6iU)o9ɺ݇&wAa`8lȑ| t} 9~e:Rp'-B_CU?1ؐ)oa!wJ,dI%Ц*DCH#,=¦D&KԐWD$*%1N o3P(5y )҉; fձX`5[ˊXxlT<N'FūRaqV#lF#al wQæ9J/bo{Mďh#@;ďI(+Wj2)#t\+Q#כ{Z(3uMQ Q=՗ev̧,VqRE_%x՘*ZU胏 ܹ-qe]TL 2|_4oqMݫ Z#$`.0L;]C_o>e1IfJ}a.%o!sk#C~gwT) ^cΏH-=)@97Mp;\/>fG0s}yX`^m˸r)[n\PXI^`ɔٳ]&$ĜٳI(06;6^7RYBЂ|S]Ʈ5a|%7Ä Γ. qR;~4h'Q!fCSqWߠht> wv*G@sP&M~F{uvхB[(fݷRJ.>h ڳ]… 1+ #,aέY>W sflw'@xt#i)1l`Y,|×Ts]p֥=( ҥF̐s+Ybx336i`yn݀ EIfMdVw:o@.N b0ocxav] E nn"L'0~a=B3c LgYZ E+)qΆcs1T즴g\4k;3λpSW$wqJqѺgǧ}b_t uϘ=ħf3;&%"Jhog*,ZZSoђO~˔a`/:JaCVQ K %a!;^$Xw=:e6U}1⥶cQ|j|sr)~EZ uPa `J^M6 'E^~9)cՋN^aD-*y7FᥢJKO5}<;CTB[|,rt!(:!]N(Ax  endstream endobj 64 0 obj << /Type /StructElem /S /Part /P 14 0 R /Pg 10 0 R /K [71 0 R 69 0 R 72 0 R 70 0 R 68 0 R 73 0 R 74 0 R 75 0 R] >> endobj 65 0 obj << /Type /StructElem /S /Part /P 14 0 R /Pg 11 0 R /K [80 0 R 93 0 R 82 0 R 83 0 R 94 0 R 242 0 R 85 0 R 86 0 R 243 0 R 95 0 R 79 0 R 96 0 R 78 0 R 97 0 R 92 0 R 76 0 R 98 0 R 91 0 R 77 0 R 81 0 R 99 0 R] >> endobj 66 0 obj << /Type /StructElem /S /Part /P 14 0 R /Pg 12 0 R /K [110 0 R 114 0 R 104 0 R 105 0 R 115 0 R 244 0 R 116 0 R 113 0 R 117 0 R 103 0 R 118 0 R 100 0 R 102 0 R 112 0 R 101 0 R 111 0 R 119 0 R] >> endobj 67 0 obj << /Type /StructElem /S /Part /P 14 0 R /Pg 13 0 R /K [143 0 R 145 0 R 132 0 R 137 0 R 146 0 R 245 0 R 141 0 R 147 0 R 246 0 R 142 0 R 148 0 R 135 0 R 149 0 R 150 0 R 144 0 R] >> endobj 68 0 obj << /Type /StructElem /S /P /P 64 0 R /E (April 2026) /Pg 10 0 R /K [0] >> endobj 69 0 obj << /Type /StructElem /S /H1 /P 64 0 R /T (HUMAN PAPILLOMAVIRUS \(HPV\) DATA BRIEF) /E (HUMAN PAPILLOMAVIRUS \(HPV\) DATA BRIEF) /Pg 10 0 R /K [1] >> endobj 70 0 obj << /Type /StructElem /S /P /P 64 0 R /E (Vaccine Preventable Disease Program) /Pg 10 0 R /K [2] >> endobj 71 0 obj << /Type /StructElem /S /Figure /P 64 0 R /Pg 10 0 R /A [247 0 R 0] /K [3] >> endobj 72 0 obj << /Type /StructElem /S /Figure /P 64 0 R /Pg 10 0 R /A [248 0 R 0] /K [4] >> endobj 73 0 obj << /Type /StructElem /S /Figure /P 64 0 R /Pg 10 0 R /A [249 0 R 0] /K [5] >> endobj 74 0 obj << /Type /StructElem /S /Figure /P 64 0 R /Pg 10 0 R /A [250 0 R 0] /K [6] >> endobj 75 0 obj << /Type /StructElem /S /Figure /P 64 0 R /Pg 10 0 R /A [251 0 R 0] /K [7] >> endobj 76 0 obj << /Type /StructElem /S /Figure /P 65 0 R /Pg 11 0 R /A [252 0 R 0] /K [0] >> endobj 77 0 obj << /Type /StructElem /S /Figure /P 65 0 R /Pg 11 0 R /A [253 0 R 0] /K [1] >> endobj 78 0 obj << /Type /StructElem /S /H3 /P 65 0 R /T (Assigned Male at Birth) /E (Assigned Male at Birth) /Pg 11 0 R /K [2] >> endobj 79 0 obj << /Type /StructElem /S /H2 /P 65 0 R /T (Key Findings) /E (Key Findings) /Pg 11 0 R /K [3] >> endobj 80 0 obj << /Type /StructElem /S /H1 /P 65 0 R /T (HPV ASSOCIATED CANCERS) /E (HPV ASSOCIATED CANCERS) /Pg 11 0 R /K [4] >> endobj 81 0 obj << /Type /StructElem /S /P /P 65 0 R /E (02) /Pg 11 0 R /K [5] >> endobj 82 0 obj << /Type /StructElem /S /P /P 65 0 R /E (Human Papillomavirus, or HPV, is a common virus with more than 200 types. Some types can cause warts \(papillomas\), while others can lead to cancer.1 All genders can be affected by HPV-related cancers, which include the mouth \(oral cavity\), throat \(pharynx\), and anus \(including anal canal and anorectum\). HPV can also cause penile, cervical, vaginal, and vulvar cancer. Fortunately, a vaccine is available that can prevent infection with the types of HPV that most commonly cause cancer. ) /Pg 11 0 R /K [6 8 7] >> endobj 83 0 obj << /Type /StructElem /S /P /P 65 0 R /E (The graphs below illustrate the distribution of HPV-associated cancer types by race and ethnicity among individuals, based on sex assigned at birth.) /Pg 11 0 R /K [9] >> endobj 84 0 obj << /Type /StructElem /S /P /P 254 0 R /E (The rate of HPV-associated oral cavity and pharynx cancers is highest among White) /Pg 11 0 R /K [10] >> endobj 85 0 obj << /Type /StructElem /S /P /P 65 0 R /E ( \(18.8 per 100,000\) individuals assigned male at birth compared to all races ) /Pg 11 0 R /K [11] >> endobj 86 0 obj << /Type /StructElem /S /P /P 65 0 R /E ( \(16.7 per 100,000\). ) /Pg 11 0 R /K [12] >> endobj 87 0 obj << /Type /StructElem /S /P /P 255 0 R /E (The rate of anus, anal canal, and anorectum cancer is highest among Black \(2.3 per 100,000\) individuals assigned male at birth.) /Pg 11 0 R /K [13] >> endobj 88 0 obj << /Type /StructElem /S /P /P 256 0 R /E (White individuals assigned female at birth have a higher incidence rate of oral cavity and pharynx, anus, anal canal, and anorectum, and vulva cancers compared to other races.) /Pg 11 0 R /K [14] >> endobj 89 0 obj << /Type /StructElem /S /P /P 257 0 R /E (The rate of cervical \(cervix uteri\) cancer was highest in Hispanic and Black individuals assigned female at birth. ) /Pg 11 0 R /K [15] >> endobj 90 0 obj << /Type /StructElem /S /P /P 258 0 R /E (The rate of vaginal cancer is highest among Black individuals assigned female at birth.) /Pg 11 0 R /K [16] >> endobj 91 0 obj << /Type /StructElem /S /P /P 65 0 R /E (*Persons of Hispanic ethnicity may be any race or combination of races.) /Pg 11 0 R /K [17] >> endobj 92 0 obj << /Type /StructElem /S /H3 /P 65 0 R /T (Assigned Female at Birth) /E (Assigned Female at Birth) /Pg 11 0 R /K [18] >> endobj 93 0 obj << /Type /StructElem /S /Figure /P 65 0 R /Pg 11 0 R /A [259 0 R 0] /K [19] >> endobj 94 0 obj << /Type /StructElem /S /Figure /P 65 0 R /Pg 11 0 R /A [260 0 R 0] /K [20] >> endobj 95 0 obj << /Type /StructElem /S /Figure /P 65 0 R /Pg 11 0 R /A [261 0 R 0] /K [21] >> endobj 96 0 obj << /Type /StructElem /S /Figure /P 65 0 R /Pg 11 0 R /A [262 0 R 0] /K [22] >> endobj 97 0 obj << /Type /StructElem /S /Figure /P 65 0 R /Pg 11 0 R /A [263 0 R 0] /K [23] >> endobj 98 0 obj << /Type /StructElem /S /Figure /P 65 0 R /Pg 11 0 R /A [264 0 R 0] /K [24] >> endobj 99 0 obj << /Type /StructElem /S /Figure /P 65 0 R /Pg 11 0 R /A [265 0 R 0] /K [25] >> endobj 100 0 obj << /Type /StructElem /S /H3 /P 66 0 R /T (HPV Up-to-Date Dose by Sex) /E (HPV Up-to-Date Dose by Sex) /Pg 12 0 R /K [0] >> endobj 101 0 obj << /Type /StructElem /S /Figure /P 66 0 R /Pg 12 0 R /A [266 0 R 0] /K [1] >> endobj 102 0 obj << /Type /StructElem /S /Figure /P 66 0 R /Pg 12 0 R /A [267 0 R 0] /K [2] >> endobj 103 0 obj << /Type /StructElem /S /H3 /P 66 0 R /T /E /Pg 12 0 R /K [3] >> endobj 104 0 obj << /Type /StructElem /S /H3 /P 66 0 R /T (Over 90% of HPV-associated cancers are preventable through vaccination.1 The HPV vaccine is recommended for preteens at ages 11 or 12, but can be given as early as age 9. Only two doses are needed if given before age 15; those older than 15 years or with a weakened immune system will require three doses. Catch-up vaccination is recommended through age 26. Vaccination may be administered to persons aged 27 to 45 through shared clinical decision-making \(discussion of the benefits and risks of vaccination with your health care provider\). ) /E (Over 90% of HPV-associated cancers are preventable through vaccination.1 The HPV vaccine is recommended for preteens at ages 11 or 12, but can be given as early as age 9. Only two doses are needed if given before age 15; those older than 15 years or with a weakened immune system will require three doses. Catch-up vaccination is recommended through age 26. Vaccination may be administered to persons aged 27 to 45 through shared clinical decision-making \(discussion of the benefits and risks of vaccination with your health care provider\). ) /Pg 12 0 R /K [4 6 5] >> endobj 105 0 obj << /Type /StructElem /S /H3 /P 66 0 R /T (The graphs below are from the National Immunization Survey \(NIS\) Teen, and show trends in HPV vaccination among adolescents aged 13-17 who received at least one dose and those who are up-to-date \(completed the recommended 2-3 doses\) in New Jersey.) /E (The graphs below are from the National Immunization Survey \(NIS\) Teen, and show trends in HPV vaccination among adolescents aged 13-17 who received at least one dose and those who are up-to-date \(completed the recommended 2-3 doses\) in New Jersey.) /Pg 12 0 R /K [7] >> endobj 106 0 obj << /Type /StructElem /S /H3 /P 268 0 R /T (HPV vaccination coverage \(at least one dose and up-to-date\) has steadily increased in the United States, while New Jersey rates have fluctuated over time. However, neither has reached the Healthy People 2030 target of 80% coverage among adolescents receiving the recommended doses.) /E (HPV vaccination coverage \(at least one dose and up-to-date\) has steadily increased in the United States, while New Jersey rates have fluctuated over time. However, neither has reached the Healthy People 2030 target of 80% coverage among adolescents receiving the recommended doses.) /Pg 12 0 R /K [8] >> endobj 107 0 obj << /Type /StructElem /S /H3 /P 269 0 R /T (In New Jersey, HPV vaccination coverage for at least one dose has fluctuated over time but has remained around 70%.) /E (In New Jersey, HPV vaccination coverage for at least one dose has fluctuated over time but has remained around 70%.) /Pg 12 0 R /K [9] >> endobj 108 0 obj << /Type /StructElem /S /H3 /P 270 0 R /T (Similarly, the up-to-date dose rate in New Jersey has also fluctuated over time, but has remained around 56%. ) /E (Similarly, the up-to-date dose rate in New Jersey has also fluctuated over time, but has remained around 56%. ) /Pg 12 0 R /K [10] >> endobj 109 0 obj << /Type /StructElem /S /H3 /P 271 0 R /T (Over the years, there has been no consistent difference observed in up-to-date HPV vaccination coverage between females and males in New Jersey.) /E (Over the years, there has been no consistent difference observed in up-to-date HPV vaccination coverage between females and males in New Jersey.) /Pg 12 0 R /K [11] >> endobj 110 0 obj << /Type /StructElem /S /H1 /P 66 0 R /T (HPV IMMUNIZATION COVERAGE) /E (HPV IMMUNIZATION COVERAGE) /Pg 12 0 R /K [12] >> endobj 111 0 obj << /Type /StructElem /S /P /P 66 0 R /E (03) /Pg 12 0 R /K [13] >> endobj 112 0 obj << /Type /StructElem /S /P /P 66 0 R /E (Healthy People 2030) /Pg 12 0 R /K [14] >> endobj 113 0 obj << /Type /StructElem /S /H2 /P 66 0 R /T (Key Findings) /E (Key Findings) /Pg 12 0 R /K [15] >> endobj 114 0 obj << /Type /StructElem /S /Figure /P 66 0 R /Pg 12 0 R /A [272 0 R 0] /K [16] >> endobj 115 0 obj << /Type /StructElem /S /Figure /P 66 0 R /Pg 12 0 R /A [273 0 R 0] /K [17] >> endobj 116 0 obj << /Type /StructElem /S /Figure /P 66 0 R /Pg 12 0 R /A [274 0 R 0] /K [18] >> endobj 117 0 obj << /Type /StructElem /S /Figure /P 66 0 R /Pg 12 0 R /A [275 0 R 0] /K [19] >> endobj 118 0 obj << /Type /StructElem /S /Figure /P 66 0 R /Pg 12 0 R /A [276 0 R 0] /K [20] >> endobj 119 0 obj << /Type /StructElem /S /Figure /P 66 0 R /Pg 12 0 R /A [277 0 R 0] /K [21] >> endobj 120 0 obj << /Type /StructElem /S /H3 /P 278 0 R /T (NJDOH. HPV: nj.gov/health/cd/topics/hpv.shtml) /E (NJDOH. HPV: nj.gov/health/cd/topics/hpv.shtml) /Pg 13 0 R /K [0 154 0 R] >> endobj 121 0 obj << /Type /StructElem /S /Span /K [1] /Pg 13 0 R /P 154 0 R >> endobj 122 0 obj << /Type /StructElem /S /H3 /P 279 0 R /T (Immunize.org: immunize.org/vaccines/a-z/hpv) /E (Immunize.org: immunize.org/vaccines/a-z/hpv) /Pg 13 0 R /K [2 155 0 R] >> endobj 123 0 obj << /Type /StructElem /S /Span /K [3] /Pg 13 0 R /P 155 0 R >> endobj 124 0 obj << /Type /StructElem /S /H3 /P 280 0 R /T (American Cancer Society. HPV Vaccination Resources for Health Professionals: cancer.org/health-care-professionals/hpv-vaccination-information-for-health-professionals/hpv-vaccination-resources-for-health-professionals.html) /E (American Cancer Society. HPV Vaccination Resources for Health Professionals: cancer.org/health-care-professionals/hpv-vaccination-information-for-health-professionals/hpv-vaccination-resources-for-health-professionals.html) /Pg 13 0 R /K [4 156 0 R] >> endobj 125 0 obj << /Type /StructElem /S /Span /K [5] /Pg 13 0 R /P 156 0 R >> endobj 126 0 obj << /Type /StructElem /S /H3 /P 281 0 R /T (Protect Me With 3+: protectmewith3.com) /E (Protect Me With 3+: protectmewith3.com) /Pg 13 0 R /K [6 157 0 R] >> endobj 127 0 obj << /Type /StructElem /S /Span /K [7] /Pg 13 0 R /P 157 0 R >> endobj 128 0 obj << /Type /StructElem /S /H3 /P 282 0 R /T (American Academy of Pediatrics. Human Papillomavirus Vaccines: aap.org/en/patient-care/immunizations/human-papillomavirus-vaccines) /E (American Academy of Pediatrics. Human Papillomavirus Vaccines: aap.org/en/patient-care/immunizations/human-papillomavirus-vaccines) /Pg 13 0 R /K [8 158 0 R] >> endobj 129 0 obj << /Type /StructElem /S /Span /K [9] /Pg 13 0 R /P 158 0 R >> endobj 130 0 obj << /Type /StructElem /S /H3 /P 283 0 R /T (*American Cancer Society. Prevent 6 Cancers with the HPV Vaccine: cancer.org/cancer/risk-prevention/hpv/hpv-vaccine.html) /E (*American Cancer Society. Prevent 6 Cancers with the HPV Vaccine: cancer.org/cancer/risk-prevention/hpv/hpv-vaccine.html) /Pg 13 0 R /K [10 159 0 R] >> endobj 131 0 obj << /Type /StructElem /S /Span /K [11] /Pg 13 0 R /P 159 0 R >> endobj 132 0 obj << /Type /StructElem /S /H3 /P 67 0 R /T (1. American Cancer Society. HPV. Available at: cancer.org/cancer/risk-prevention/hpv.html) /E (1. American Cancer Society. HPV. Available at: cancer.org/cancer/risk-prevention/hpv.html) /Pg 13 0 R /K [12 151 0 R 14 152 0 R] >> endobj 133 0 obj << /Type /StructElem /S /Span /K [13] /Pg 13 0 R /P 151 0 R >> endobj 134 0 obj << /Type /StructElem /S /Span /K [15] /Pg 13 0 R /P 152 0 R >> endobj 135 0 obj << /Type /StructElem /S /H2 /P 67 0 R /T (To view the HPV Data Brief, visit: nj.gov/health/cd/vpdp.shtml) /E (To view the HPV Data Brief, visit: nj.gov/health/cd/vpdp.shtml) /Pg 13 0 R /K [16 160 0 R] >> endobj 136 0 obj << /Type /StructElem /S /Span /K [17] /Pg 13 0 R /P 160 0 R >> endobj 137 0 obj << /Type /StructElem /S /H1 /P 67 0 R /T (DATA SOURCES) /E (DATA SOURCES) /Pg 13 0 R /K [18] >> endobj 138 0 obj << /Type /StructElem /S /H3 /P 284 0 R /T (NJ State Cancer Registry SEER* Stat Database: April 8, 2026, analytic file. Rates are per 100,000 and age-adjusted to the 2000 U.S. Std Population \(age <1 and 90+ - Census P25-1130 standard.) /E (NJ State Cancer Registry SEER* Stat Database: April 8, 2026, analytic file. Rates are per 100,000 and age-adjusted to the 2000 U.S. Std Population \(age <1 and 90+ - Census P25-1130 standard.) /Pg 13 0 R /K [19] >> endobj 139 0 obj << /Type /StructElem /S /H3 /P 285 0 R /T (National Immunization Survey - Teen \(NIS-Teen\). Data accessed on April 08, 2026, via TeenVaxView portal at: cdc.gov/teenvaxview/index.html ) /E (National Immunization Survey - Teen \(NIS-Teen\). Data accessed on April 08, 2026, via TeenVaxView portal at: cdc.gov/teenvaxview/index.html ) /Pg 13 0 R /K [20 153 0 R] >> endobj 140 0 obj << /Type /StructElem /S /Span /K [21] /Pg 13 0 R /P 153 0 R >> endobj 141 0 obj << /Type /StructElem /S /H1 /P 67 0 R /T (RESOURCES) /E (RESOURCES) /Pg 13 0 R /K [22] >> endobj 142 0 obj << /Type /StructElem /S /P /P 67 0 R /E (*The link to this website is intended to provide additional information pertaining to immunizations strictly for informational or educational purposes. The New Jersey Department of Health is not responsible for the content of this website and does not endorse private organizations.) /Pg 13 0 R /K [23] >> endobj 143 0 obj << /Type /StructElem /S /H1 /P 67 0 R /T (REFERENCES) /E (REFERENCES) /Pg 13 0 R /K [24] >> endobj 144 0 obj << /Type /StructElem /S /P /P 67 0 R /E (04) /Pg 13 0 R /K [25] >> endobj 145 0 obj << /Type /StructElem /S /Figure /P 67 0 R /Pg 13 0 R /A [286 0 R 0] /K [26] >> endobj 146 0 obj << /Type /StructElem /S /Figure /P 67 0 R /Pg 13 0 R /A [287 0 R 0] /K [27] >> endobj 147 0 obj << /Type /StructElem /S /Figure /P 67 0 R /Pg 13 0 R /A [288 0 R 0] /K [28] >> endobj 148 0 obj << /Type /StructElem /S /Figure /P 67 0 R /Pg 13 0 R /A [289 0 R 0] /K [29] >> endobj 149 0 obj << /Type /StructElem /S /Figure /P 67 0 R /Pg 13 0 R /A [290 0 R 0] /K [30] >> endobj 150 0 obj << /Type /StructElem /S /Figure /P 67 0 R /Pg 13 0 R /A [291 0 R 0] /K [31] >> endobj 151 0 obj << /Type /StructElem /S /Link /P 132 0 R /Alt (. ) /Pg 13 0 R /K [133 0 R 292 0 R] >> endobj 152 0 obj << /Type /StructElem /S /Link /P 132 0 R /Alt (cancer.org/cancer/risk-prevention/hpv.html) /Pg 13 0 R /K [134 0 R 293 0 R] >> endobj 153 0 obj << /Type /StructElem /S /Link /P 139 0 R /Alt (cdc.gov/teenvaxview/index.html ) /Pg 13 0 R /K [140 0 R 294 0 R 295 0 R] >> endobj 154 0 obj << /Type /StructElem /S /Link /P 120 0 R /Alt (nj.gov/health/cd/topics/hpv.shtml) /Pg 13 0 R /K [121 0 R 296 0 R] >> endobj 155 0 obj << /Type /StructElem /S /Link /P 122 0 R /Alt (immunize.org/vaccines/a-z/hpv) /Pg 13 0 R /K [123 0 R 297 0 R] >> endobj 156 0 obj << /Type /StructElem /S /Link /P 124 0 R /Alt (cancer.org/health-care-professionals/hpv-vaccination-information-for-health-professionals/hpv-vaccination-resources-for-health-professionals.html) /Pg 13 0 R /K [125 0 R 298 0 R 299 0 R] >> endobj 157 0 obj << /Type /StructElem /S /Link /P 126 0 R /Alt (protectmewith3.com) /Pg 13 0 R /K [127 0 R 300 0 R] >> endobj 158 0 obj << /Type /StructElem /S /Link /P 128 0 R /Alt (aap.org/en/patient-care/immunizations/human-papillomavirus-vaccines) /Pg 13 0 R /K [129 0 R 301 0 R 302 0 R] >> endobj 159 0 obj << /Type /StructElem /S /Link /P 130 0 R /Alt (cancer.org/cancer/risk-prevention/hpv/hpv-vaccine.html) /Pg 13 0 R /K [131 0 R 303 0 R 304 0 R] >> endobj 160 0 obj << /Type /StructElem /S /Link /P 135 0 R /Alt (nj.gov/health/cd/vpdp.shtml) /Pg 13 0 R /K [136 0 R 305 0 R] >> endobj 161 0 obj << /Title (HPV ASSOCIATED CANCERS) /Dest [11 0 R /Fit] /Parent 7 0 R /Prev 17 0 R /First 306 0 R /Last 306 0 R /Count -1 /Next 307 0 R >> endobj 162 0 obj << /Title (DATA SOURCES) /Dest [13 0 R /Fit] /Parent 7 0 R /Prev 308 0 R /First 309 0 R /Last 310 0 R /Count -2 /Next 18 0 R >> endobj 163 0 obj << /Title (NJDOH. 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