Swiss Tropical and Public Health Institute (Swiss TPH), Socinstrasse 57, 4051, Basel, Switzerland; University of Basel, Petersplatz 1, 4001, Basel, Switzerland.
University of Basel, Petersplatz 1, 4001, Basel, Switzerland; University Department of Medicine, Kantonsspital Baselland, University of Basel, Kantonsspital Baselland, University of Basel, CH-4101, Bruderholz, Switzerland.
Soc Sci Med. 2019 Nov;240:112556. doi: 10.1016/j.socscimed.2019.112556. Epub 2019 Sep 16.
Complementary and alternative medicine (CAM) providers' roles in parents' decision-making about vaccinations for their children have only recently begun receiving research attention, despite studies showing CAM to be used by 25-50% of the population in Western countries. This article examines how CAM practitioners discuss vaccinations with parents in Switzerland, with a focus on childhood vaccinations and human papillomavirus (HPV) vaccinations. We describe how the CAM providers we interviewed (N = 17) and observed during vaccination consultations (N = 18 observations with 5 providers) employed individualized approaches to vaccination. Triangulation of qualitative evidence from interviews and observations allowed us to analyze their discourses and descriptions of experiences (i.e. what they said) and their practices in situ (i.e. what they did). Evidence gathered shows that practitioners framed vaccination decisions as choices at individual and family levels rather than focusing on public health benefits and consequences. They articulated their perspectives in terms of personal clinical experiences and parents' wishes, concerns, and contexts. Such findings challenge recurring narratives depicting CAM providers as categorically anti-vaccination and suggest that approaches to address vaccine hesitancy in clinical practice could benefit from communication and relational approaches similar to those demonstrated by participants in this study. Such approaches include taking time to understand parents' wishes, involving them in vaccination decisions, and taking their concerns seriously.
补充和替代医学（CAM）提供者在父母为孩子接种疫苗的决策中的角色，尽管研究表明，在西方国家，25-50%的人口会使用 CAM，但直到最近才开始受到研究关注。本文探讨了瑞士的 CAM 从业者如何与父母讨论疫苗接种问题，重点关注儿童疫苗接种和人乳头瘤病毒（HPV）疫苗接种。我们描述了我们采访的 CAM 提供者（N=17）以及在疫苗接种咨询中观察到的（N=18 次观察，5 名提供者）如何采用个性化方法进行疫苗接种。访谈和观察的定性证据的三角剖分使我们能够分析他们关于经验的论述和描述（即他们所说的）以及他们在现场的实践（即他们所做的）。收集的证据表明，从业者将疫苗接种决策框架设定为个人和家庭层面的选择，而不是关注公共卫生效益和后果。他们根据个人临床经验和父母的愿望、担忧和背景来表达自己的观点。这些发现挑战了反复出现的叙述，即 CAM 提供者一概而论地反对疫苗接种，并表明在临床实践中解决疫苗犹豫的方法可以从类似于本研究参与者所展示的沟通和关系方法中受益。这些方法包括花时间了解父母的愿望，让他们参与疫苗接种决策，并认真对待他们的担忧。
