Ever since Wakefield’s flawed MMR-autism study was published in the Lancet – surely that journal’s biggest regret – attitudes to vaccination seem to have become a litmus test for ‘science’ versus ‘non-science’.
The opposing camps are broadly assumed to lie on either side of a river, with mainstream medicine’s castle on one bank battling alternative health practitioners on the other.
But just how clean is that divide?
A review in the latest Vaccine (by Wardle et al. University of Technology Sydney) looks at all studies that examine vaccination attitudes of complementary medicine practitioners and their clients.
Results from the 39 papers reveal a mixed bag of results that mire the waters; the imaginary river turns out to be more a muddy meeting ground.
The authors point out, “There is no default position on immunisation by complementary medicine practitioners or parents who use complementary medicine themselves, or for their children.”
Attitudes vary depending on different populations, but also on what question is being asked.
A UK survey found that, when asked for email advice, no homeopath and only 5% of chiropractors actively recommended MMR.
In contrast, a Canadian study found that two thirds of all chiropractors in Alberta with children had arranged for their own child to be vaccinated. While this is considerably lower than the national average, clearly not every alternative practitioner is helping fortify the anti-vaxxer camp.
The majority of students start their complementary medical course being pro-vaccine, although a steady stream of students cross the divide each year, with the majority in the ‘no’ camp by graduation. Interestingly, this was true even in courses that don’t teach any anti-vaccine message – students report influence by informal sources and peer opinion.
Although nearly every study found a vocal anti-vax minority, it seems most naturopaths, homeopaths and chiropractors do not actually advise either way. That muddy middle ground is full of bystanders.
When it came to users of complementary medicine – parents or children – there was a consistent association with lower childhood vaccination uptake, as expected. However, it is hard to show causation, because other studies demonstrated that parents who use alternative practitioners already hold differing views on the trustworthiness of mainstream medicine.
So, while it is certainly true that complementary medicine advocates have a tendency to sit on the anti-vax side of the divide, a substantial proportion are milling around in the middle.
While diplomatic negotiation between opposing camps usually ends in tears, perhaps vaccine advocates might gain some traction if they are prepared to step onto the middle ground and muddy their feet.