Bean Sandra J, Catania Joseph A
College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
SAGE Open Med. 2018 Oct 31;6:2050312118807625. doi: 10.1177/2050312118807625. eCollection 2018.
Parental pediatric vaccine decisions are influenced by parents' health provider networks. Complementary and alternative medical providers may be key influences in the networks of those parents who do not vaccinate their children.
From March to July 2013, we conducted semi-structured interviews of Oregon complementary and alternative medical providers ( = 36) in five disciplines likely to treat parents or children, or both, and whose practitioners are known to express opinions about vaccines and vaccination. We interviewed them concerning their immunology beliefs, vaccine positions, and what these providers recommend to their patients concerning vaccines. We conducted face-to-face interviews and analyzed the interview data using thematic analysis methodology.
This article identifies the range and type of immunological beliefs of complementary and alternative medical providers concerning pediatric vaccine recommendations. From repeated readings of the data, we identified three areas of alternative immunological beliefs among complementary and alternative medical providers (i.e. "natural is best," "innate intelligence," and "the fragile immune system"). In addition, complementary and alternative medical providers who embraced mainstream medicine were likely to be vaccine accepters and to mention vaccines as a positive health measure to their patients-these themes were "vaccines prevent illness" and "herd immunity."
Complementary and alternative medical providers influence their patients' vaccination decisions, particularly urging caution or complete vaccine avoidance, and may be a major influence in states like Oregon with high non-medical exemption rates. Complementary and alternative medical providers come to their anti-vaccine positions largely through post-graduation continuing education courses and seminars. In Oregon, such courses are unregulated and not vetted.
父母对儿科疫苗的决策受其医疗服务提供者网络的影响。补充和替代医学提供者可能是那些不给孩子接种疫苗的父母网络中的关键影响因素。
2013年3月至7月，我们对俄勒冈州五个学科的补充和替代医学提供者（n = 36）进行了半结构化访谈，这些学科可能会治疗父母或孩子，或两者皆治，并且已知其从业者会表达有关疫苗和接种的意见。我们就他们的免疫学信念、疫苗立场以及这些提供者向患者推荐的疫苗相关内容进行了访谈。我们进行了面对面访谈，并使用主题分析方法对访谈数据进行了分析。
本文确定了补充和替代医学提供者在儿科疫苗推荐方面的免疫学信念范围和类型。通过对数据的反复研读，我们在补充和替代医学提供者中确定了三个替代免疫学信念领域（即“自然就是最好的”、“先天智慧”和“脆弱的免疫系统”）。此外，接受主流医学的补充和替代医学提供者可能是疫苗接受者，并会向患者提及疫苗是一项积极的健康措施——这些主题是“疫苗预防疾病”和“群体免疫”。
补充和替代医学提供者会影响其患者的疫苗接种决策，特别是敦促谨慎或完全避免接种疫苗，并且在非医学豁免率高的州（如俄勒冈州）可能是一个主要影响因素。补充和替代医学提供者形成其反疫苗立场主要是通过毕业后的继续教育课程和研讨会。在俄勒冈州，此类课程不受监管且未经审核。
