Filice Eric, Dubé Eve, Graham Janice E, MacDonald Noni E, Bettinger Julie A, Greyson Devon, MacDonald Shannon, Driedger S Michelle, Kawchuk Greg, Meyer Samantha B
School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
Département Anthropologie, Université Laval, Québec City, Québec, Canada.
PLoS One. 2020 Aug 12;15(8):e0236691. doi: 10.1371/journal.pone.0236691. eCollection 2020.
Vaccine hesitancy-the reluctance to receive recommended vaccination because of concerns and doubts about vaccines-is recognized as a significant threat to the success of vaccination programs and has been associated with recent major outbreaks of vaccine-preventable diseases. Moreover, the association between complementary and alternative medicine (CAM) use and vaccine hesitancy and/or refusal has been frequently reported in the literature. To date, significant gaps persist in our understanding of contemporary Canadian CAM providers' beliefs regarding vaccination and how socio-professional influences may shape their vaccine-related attitudes and behaviours. To address the latter gap, the current study aims to explore the content of professional guidelines, recommendations and other discourses among CAM providers as they concern vaccination by analyzing both academic, peer-reviewed literature and Canadian organizational webpages prepared by and/or for practicing chiropractors, naturopaths and homeopaths. In the academic literature, we identified a number of complex and diverging views on vaccination that spanned topics of effectiveness; safety; theoretical, empirical, and ethical soundness; political justifiability; and compatibility with CAM philosophy and professional boundaries. However, in its current state the CAM literature cannot be described in broad strokes as being either pro- or anti-vaccination without considering finer areas of disagreement. Compared to the academic literature, which focuses more on the conceptual and evidentiary basis of vaccination, a greater proportion of vaccine-related content on Canadian CAM organizations' webpages seems to be dedicated to offering specific directives and prescriptions to providers. Guidelines and standards of practice address a number of issues, including vaccine administration, counsel, education and marketing. As CAM organizations further evolve in Canada and elsewhere as part of a broader "professionalization" initiative, greater attention will need to be directed at their role in shaping providers' beliefs and practices that both support and undermine vaccine promotion efforts.
疫苗犹豫——即由于对疫苗的担忧和疑虑而不愿接受推荐的疫苗接种——被认为是疫苗接种计划成功实施的重大威胁，并与近期可通过疫苗预防的疾病的主要暴发有关。此外，文献中经常报道使用补充和替代医学（CAM）与疫苗犹豫和/或拒绝之间的关联。迄今为止，我们对当代加拿大补充和替代医学从业者关于疫苗接种的信念以及社会专业影响如何塑造他们与疫苗相关的态度和行为的理解仍存在重大差距。为了填补后者的差距，本研究旨在通过分析学术性、同行评审文献以及由执业整脊师、自然疗法医生和顺势疗法医生编写和/或为他们准备的加拿大组织网页，探讨补充和替代医学从业者中与疫苗接种相关的专业指南、建议和其他论述的内容。在学术文献中，我们发现了关于疫苗接种的一些复杂且不同的观点，这些观点涵盖了有效性、安全性、理论、实证和伦理合理性、政治正当性以及与补充和替代医学理念及专业界限的兼容性等主题。然而，就目前的情况而言，如果不考虑更细微的分歧领域，补充和替代医学文献不能一概而论地被描述为支持或反对疫苗接种。与更多关注疫苗接种的概念和证据基础的学术文献相比，加拿大补充和替代医学组织网页上与疫苗相关的内容中，更大比例似乎致力于为从业者提供具体的指导和处方。实践指南和标准涉及多个问题，包括疫苗接种管理、咨询、教育和营销。随着加拿大和其他地方的补充和替代医学组织作为更广泛的“专业化”倡议的一部分进一步发展，需要更多关注它们在塑造从业者信念和实践方面的作用，这些信念和实践既支持也破坏疫苗推广工作。
