Kids Who Get Some Forms of CAM Less Likely to Get Flu Shot

Marcia Frellick

October 04, 2016

There may be a connection between children receiving some types of complementary or alternative medicine (CAM) and their not getting influenza shots, according to the results of a nationally representative study.

The study, by William K. Bleser, PhD, MSPH, from the Department of Health Policy and Administration at Pennsylvania State University in University Park, and colleagues, found that children in the United States who have used certain forms of CAM that may put them in contact with providers documented as being vaccine-hesitant are less likely to receive influenza vaccinations.

The authors note that vaccine hesitancy is increasing, as is use of CAM, with a previous analysis showing that one third of all people in the United States had used at least one form of CAM in the last year.

In the current study, published online October 3 in Pediatrics, Dr Bleser and colleagues looked at data from 9000 children between ages 4 and 17 years included in the Child Complementary and Alternative Medicine File of the 2012 National Health Interview Survey.

Researchers examined odds of getting an influenza vaccination by those who had ever used five major CAM domains. Overall, children who have ever used any type of alternative medical systems care (eg, acupuncture) or manipulative and body-based therapies (eg, chiropractic manipulation) had lower odds of receiving an influenza vaccination, whereas those who used multivitamins were more likely to be vaccinated.

Table. CAM Domains and Odds of Getting an Influenza Shot

CAM Domain Percentage Who Used Domain in the Last Year Percentage Vaccinated Odds of Vaccination, Multivariate Model (95% Confidence Interval)
CAM never users 34.1% 43% Reference
Alternative medical systems 3.8% 33% 0.61 (0.44 - 0.85)
Biologically based therapies, excluding multivitamins/multiminerals; Example: herbal supplements 7.6% 39% 0.83 (0.68 - 1.02)
Multivitamins/multiminerals 62.3% 45% 1.12 (0.98 - 1.28)
Manipulative and body-based therapies 7.3% 35% 0.74 (0.58 - 0.94)
Mind–body therapies; Example: yoga 5.3% 43% 1.01 (0.78 - 1.32)

Among those who had received any type of alternative medical systems care, homeopathy was the most prevalent (3.2%), followed by naturopathy (0.70%). Chiropractic or osteopathic manipulation was the most common type of manipulative and body-based therapy used, with a prevalence of 5.49%.

With respect to naturopathy and chiropractic manipulation, Dr. Bleser and colleagues write, "These specific types of CAM may require contact with CAM practitioners shown to have vaccine-critical viewpoints, advise against vaccination, or advise vaccine schedules different from those recommended by the federal government."

Therefore, people who have had this contact may be disinclined to get the influenza shot. Understanding that influence may provide an opportunity for health professionals and educators to better engage CAM and conventional medicine practitioners in training, parents of children using particular forms of CAM, and the CAM practitioners advising them.

"The prevalence of CAM is highest among middle-aged, non-Hispanic white women of high socioeconomic status, as well as those with multiple health conditions and who frequently visit medical facilities," the authors write.

The study was supported by the Department of Health Policy and Administration at Pennsylvania State University. The authors acknowledge assistance provided by the Population Research Institute at Pennsylvania State University, which is supported by the National Institutes of Health. Dr Bleser is providing consultation on mumps vaccine litigation unrelated to this study. The other authors have disclosed no relevant financial relationships.

Pediatrics. Published online October 3, 2016. Abstract

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