Pediatric vaccination and vaccine-preventable dise... [Matern Child Health J. 2010] - PubMed result

Matern Child Health J. 2010 Nov;14(6):922-30.

Pediatric vaccination and vaccine-preventable disease acquisition: associations with care by complementary and alternative medicine providers.

Downey L, Tyree PT, Huebner CE, Lafferty WE.

Source
Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of Washington, Box 359765, 325 Ninth Avenue, Seattle, WA 98104, USA. ldowney@u.washington.edu

Abstract
This study investigated provider-based complementary/alternative medicine use and its association with receipt of recommended vaccinations by children aged 1-2 years and with acquisition of vaccine-preventable disease by children aged 1-17 years. Results were based on logistic regression analysis of insurance claims for pediatric enrollees covered by two insurance companies in Washington State during 2000-2003. Primary exposures were use of chiropractic, naturopathy, acupuncture, or massage practitioner services by pediatric enrollees or members of their immediate families. Outcomes included receipt by children aged 1-2 years of four vaccine combinations (or their component vaccines) covering seven diseases, and acquisition of vaccine-preventable diseases by enrollees aged 1-17 years. Children were significantly less likely to receive each of the four recommended vaccinations if they saw a naturopathic physician. Children who saw chiropractors were significantly less likely to receive each of three of the recommended vaccinations. Children aged 1-17 years were significantly more likely to be diagnosed with a vaccine-preventable disease if they received naturopathic care. Use of provider-based complementary/alternative medicine by other family members was not independently associated with early childhood vaccination status or disease acquisition. Pediatric use of complementary/alternative medicine in Washington State was significantly associated with reduced adherence to recommended pediatric vaccination schedules and with acquisition of vaccine-preventable disease. Interventions enlisting the participation of complementary/alternative medicine providers in immunization awareness and promotional activities could improve adherence rates and assist in efforts to improve public health.

PMID:19760163[PubMed - indexed for MEDLINE] PMCID: PMC2924961[Available on 2011/11/1]
Pediatric vaccination and vaccine-preventable dise... [Matern Child Health J. 2010] - PubMed result




Study Reveals Association Between Childhood Vaccination and Care by CAM Providers

Children in Washington State who receive care from complementary and alternative medicine (CAM) providers are less likely to receive recommended pediatric immunizations and are more likely to be diagnosed with a vaccine-preventable disease. This is according to a study funded by NCCAM and published in the Maternal and Child Health Journal. Previous research has shown an association between parents who use and support CAM therapies and opposition to childhood vaccinations.

Researchers from the University of Washington and the University of Missouri-Kansas City analyzed insurance claims and enrollment data in Washington State from 2000 to 2003. The researchers analyzed two subsets of the data. In the first, they correlated provider-based CAM use with vaccinations in 11,144 children ages 1 to 2 years. CAM services were provided by chiropractors, naturopaths, acupuncturists, or massage therapists.

A total of 10,719 children received conventional care only, 376 received conventional and CAM care, and 49 received only CAM care. Among all of the children, 75 percent received diphtheria/tetanus or Haemophilus influenza type B vaccinations, 67 percent received measles/mumps/rubella vaccinations, and 51 percent received chickenpox vaccinations. Children who saw conventional and CAM providers had significantly lower vaccination rates for all four vaccines than children who saw only conventional health care providers. Children who saw only CAM providers had even lower vaccination rates. Those who received naturopathic care had consistently reduced rates of all four vaccinations, while those who received chiropractic care had reduced rates of all except diphtheria/tetanus.

The second aspect of the study focused on the relationship between CAM use and the diagnosis of a vaccine-preventable disease. The researchers examined family insurance records of 213,884 children ages 1 to 17 years. More than 7 percent of the children received care from a CAM provider, most commonly a chiropractor, and approximately 30 percent had family members who used CAM providers. Children who saw a CAM provider were more likely to be diagnosed with a vaccine-preventable disease than than those who saw only a conventional provider; the percentage of those diagnosed was low (about 1 percent)—and most diagnoses (85 percent) involved chickenpox. Use of naturopathy was associated with significantly more vaccine-preventable disease diagnoses than were other CAM therapies.

The researchers noted that although the findings suggest that parents who use CAM providers for their children are less likely to meet recommended pediatric vaccination schedules, the data do not clarify whether the reduced vaccination rates among children who see CAM providers reflect an increased likelihood that vaccine-hesitant parents seek out CAM practitioners, or a direct result of influence of CAM providers on parents’ attitudes and choices. However, the researchers suggest that outreach and promotion of immunization awareness and education as well as intervention strategies with parents and CAM providers may be needed to increase their support for and adherence to recommendations regarding childhood immunizations.

Reference
Downey L, Tyree PT, Huebner CE, et al. Pediatric vaccination and vaccine-preventable disease acquisition: associations with care by complementary and alternative medicine providers. Maternal and Child Health Journal. 2010;14(8):922–930. ► Pediatric vaccination and vaccine-preventable dise... [Matern Child Health J. 2010] - PubMed result

Study Reveals Association Between Childhood Vaccination and Care by CAM Providers [NCCAM Research Results]