Wardle Jon, Frawley Jane, Steel Amie, Sullivan Elizabeth
Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, NSW 2006, Australia.
Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, NSW 2006, Australia; Endeavour College of Natural Health, Level 2, 269 Wickham St, Fortitude Valley, Brisbane, QLD 4006, Australia.
Vaccine. 2016 Aug 31;34(38):4484-4500. doi: 10.1016/j.vaccine.2016.07.026. Epub 2016 Jul 27.
Vaccination is one of the most significant and successful public health measures of recent times. Whilst the use of complementary medicine (CM) continues to grow, it has been suggested that CM practitioners hold anti-vaccination views. The objective of this critical review is to examine the evidence base in relation to CM practitioner attitudes to childhood vaccination alongside attitudes to vaccination among parents who visit CM practitioners and/or use CM products.
A database search was conducted in MEDLINE, PubMed, CINAHL, EMBASE and AMED for research articles published between January 2000 and September 2015 that evaluated either CM practitioner or CM user attitudes and intention towards childhood vaccination.
A total of 23 articles were found that detailed the attitudes of CM practitioners to vaccination. A further 16 papers examined the association between the use of CM products and visits to CM practitioners, and immunisation. The interface between CM and vaccination is complex, multi-factorial and often highly individualised. The articles suggest that there is no default position on immunisation by CM practitioners or parents who use CM themselves, or for their children. Although CM use does seem positively associated with lower vaccination uptake, this may be confounded by other factors associated with CM use (such as higher income, higher education or distrust of the medical system), and may not necessarily indicate independent or predictive relationships.
Although anti-vaccination sentiment is significant amongst some CM practitioners, this review uncovers a more nuanced picture, and one that may be more agreeable to public health values than formerly assumed.
疫苗接种是近代最重要且最成功的公共卫生措施之一。虽然补充医学(CM)的使用持续增加,但有人认为补充医学从业者持有反对疫苗接种的观点。本批判性综述的目的是研究与补充医学从业者对儿童疫苗接种的态度相关的证据基础,以及拜访补充医学从业者和/或使用补充医学产品的父母对疫苗接种的态度。
在MEDLINE、PubMed、CINAHL、EMBASE和AMED数据库中进行检索,查找2000年1月至2015年9月期间发表的评估补充医学从业者或补充医学使用者对儿童疫苗接种的态度和意向的研究文章。
共发现23篇文章详细阐述了补充医学从业者对疫苗接种的态度。另有16篇论文研究了补充医学产品的使用、拜访补充医学从业者与免疫接种之间的关联。补充医学与疫苗接种之间的关系复杂、多因素且通常高度个体化。文章表明,补充医学从业者或自行使用补充医学的父母及其子女在免疫接种方面没有默认立场。虽然使用补充医学似乎确实与较低的疫苗接种率呈正相关,但这可能会被与使用补充医学相关的其他因素(如较高收入、较高教育水平或对医疗系统的不信任)所混淆,不一定表明存在独立或预测关系。
虽然在一些补充医学从业者中,反对疫苗接种的情绪较为明显,但本综述揭示了一幅更为细致入微的图景,而且这幅图景可能比以前认为的更符合公共卫生价值观。