Université Paris Cité, CNRS, Inserm, Cermes3, F-94800, Villejuif, France.
Observatoire régional de la santé PACA (ORS Paca), Aix-Marseille Université, Marseille, France.
Soc Sci Med. 2023 Jul;328:115952. doi: 10.1016/j.socscimed.2023.115952. Epub 2023 May 3.
How much does endorsement of complementary and alternative medicine (CAM) correlate with negative attitudes towards vaccines? One of the difficulties of analysing the relationship between attitudes to CAM and attitudes towards vaccines rests in the complexity of both. Which form of CAM endorsement is associated with what type of reticence towards vaccines? While the literature on the relationship between CAM and attitudes towards vaccines is growing, this question has not yet been explored. In this study we present the results of a survey conducted in July 2021 among a representative sample of the French mainland adult population (n = 3087). Using cluster analysis, we identified five profiles of CAM attitudes and found that even among the most pro-CAM group, very few respondents disagreed with the idea that CAM should only be used as a complement to conventional medicine. We then compared these CAM attitudes to vaccine attitudes. Attitudes to CAM had a distinct impact as well as a combined effect on attitudes to different vaccines and vaccines in general. However, we also found a) that attitudes to CAM provide a very limited explanation of vaccine hesitancy and b) that, among the hesitant, pro-CAM attitudes are often combined with other traits associated with vaccine hesitancy such as distrust of health agencies, radical political preferences and low income. Indeed, we found that both CAM endorsement and vaccine hesitancy are more prevalent among the socially disadvantaged. Drawing on these results, we argue that, to better understand the relationship between CAM and vaccine hesitancy, it is necessary to look at how both can reflect lack of access and recourse to mainstream medicine and distrust of public institutions.
补充和替代医学（CAM）的认可与对疫苗的负面态度有多大关联？分析 CAM 态度与疫苗态度之间关系的困难之一在于两者的复杂性。CAM 认可的哪种形式与对疫苗的哪种类型的抵触有关？虽然关于 CAM 与对疫苗的态度之间关系的文献不断增加，但这个问题尚未得到探讨。在这项研究中，我们展示了 2021 年 7 月在法国大陆成年人口（n=3087）中进行的一项代表性调查的结果。使用聚类分析，我们确定了 CAM 态度的五个特征，并发现，即使在最支持 CAM 的群体中，也只有极少数人不同意 CAM 应该仅作为常规医学的补充的观点。然后，我们将这些 CAM 态度与疫苗态度进行了比较。CAM 态度对不同疫苗和一般疫苗的态度既有直接影响，也有综合影响。然而，我们也发现 a）CAM 态度对疫苗犹豫的解释非常有限，b）在犹豫的人群中，支持 CAM 的态度通常与其他与疫苗犹豫相关的特征相结合，如对卫生机构的不信任、激进的政治偏好和低收入。事实上，我们发现，CAM 认可和疫苗犹豫都在社会劣势群体中更为普遍。基于这些结果，我们认为，要更好地理解 CAM 与疫苗犹豫之间的关系，有必要研究两者如何反映对主流医学的获取和求助不足以及对公共机构的不信任。
