Compared to never users, influenza vaccine uptake amongst children who are ever users of alternative medical systems (e.g. acupuncture) and manipulative body-based therapies is lower.
Evidence Rating Level: 2 (Good)
Study Rundown: Complementary and alternative approaches to health (CAM) have seen an increase in popularity as a substitute or accompaniment to conventional medicine. As much as one third of Americans engage in some sort of CAM. Additionally, CAM has been implicated in anti-vaccine and vaccine-hesitant viewpoints amongst practitioners and patients. In the context of increased vaccine hesitancy in the US, this study was the first to explore the effect of CAM use on influenza vaccine uptake among children. CAM was divided into multiple categories, including alternative medical systems (AMS; e.g. acupuncture), manipulative body-based therapies (MBBT; e.g. chiropractic therapy), mind-body therapy (MBT), and biologically based therapies (BBT; e.g. supplements). Multivariate analysis revealed that children ever using AMS or MBBT had significantly lower odds of influenza vaccination in the past 12 months compared to never users of AMS/MBBT. There was no significant association between BBT/MBT and influenza vaccine uptake. This data should encourage makers of public policy and clinicians to engage the CAM community, practitioners and patients alike, in educational efforts to increase vaccine uptake. While this study provides valuable insight, it is limited by the inclusion of “ever” users rather than “often” users to increase statistical power.
Study Author, Dr. William K. Bleser, PhD, MSPH, talks to 2 Minute Medicine: Pennsylvania State University, Department of Health Policy and Administration, University Park, Pennsylvania.
“Complementary and Alternative Medicine (CAM) are approaches to health that are not considered part of but used in conjunction with conventional medicine to treat illness beyond the physical and biomedical contexts. CAM use is increasingly popular in the United States yet most CAM users do not disclose to their physicians that they use CAM and some CAM use is implicated in supporting anti-vaccine viewpoints. This study explores the nationally-representative association of CAM use and influenza vaccine uptake in US children and emphasizes that medical practitioners need to better engage parents of children using particular domains of CAM, and the CAM practitioners advising them.”
In-Depth [cross-sectional study]: This study included a nationally representative cohort of approximately 9000 children from the Child Complementary and Alternative Medicine File of the 2012 National Health Interview Survey. Households answered multiple questions about their use of CAM, whether they had ever used, used in the past 12 months, and what kinds of therapies were utilized. Prevalence of ever use was used in the statistical analysis due to higher statistical power compared to use in the past 12 months. Prevalence ranged from 3.8% to 7.6%, while prevalence of multivitamin use was significantly higher and therefore considered a separate category (62.3%). Forty-three percent of children in the sample receive the flu vaccine in the past 12 months. In unadjusted analysis, uptake of flu vaccine was lower in kids of families using AMS and MBBT and higher amongst those using multivitamins. The relationship between AMS, MBBT utilization, and vaccine uptake remained statistically significant in multivariate analysis (OR 0.61, 95% CI 0.44-0.85 and OR 0.74 95% CI 0.58-0.94, respectively) while use of multivitamins and vaccine uptake was not statistically significant.
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