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.
Amen to that.
As with so many of the polarised debates that rage across our society it seems to me that those at the ‘opposite’ extremes do more to support than negate each other. Taoists would be unsurprised.
While it goes without saying that the more idiotic and easily refutable claims of the anti-vaxxers provide ammunition to the pro-vaxxers the contrary is also the case and likely contributes to the confusion of concerned parents who are struggling to assess the risk/benefit of vaccinating their kids. If both sides are deploying misleading hyperbole you might as well go with the ones with the nicest haircuts.
Also of concern is the way the debate is poisoning public discussion of the pros and cons of specific vaccination measures. When I raised concerns about the hasty Australian summertime rollout of the 2009 swine flu vaccine (by health officials who seem to have learned nothing from the 1976 debacle) in the midst of a media generated panic over a new strain of H1N1 I was dismissed by some as an anti-vaxxer prepared to endanger the health of thousands to promote my irrational ideology.
Affirm that. However I’d say that medicine has extended the olive branch (for extraction of its goodness), and practitioners in my acquaintance have accredited in CAM so as to better meet the needs of their patients. ACNEM provides structured, holistic programs, but in my, unregulated world I don’t often see similar concessions in return. Distrust of EBM is preached by vehement conspiracy theorists, and the gang doesn’t tolerate dissent. The Gap is a gulf.