| アブストラクト | Context * The growth of Internet-based information and social networking has increased the accessibility and importance of antivaccine information. That information has led to a questioning of vaccination schedules and policies by many individuals. Although the attitudes of complementary and alternative practitioners, such as homeopaths and chiropractic students, toward vaccination have been assessed, despite the growth of integrative medicine, no assessment of the attitudes and practices regarding vaccination of these physicians has been performed. Objective * The study intended to evaluate the attitudes and practices regarding vaccination of members of the American Board of Integrative and Holistic Medicine (ABIHM). Design * The research team conducted a survey of practitioners. Setting * The administration and evaluation of the survey took place at San Diego State University (San Diego, CA, USA). Participants * Prospective participants were 1419 diplomats of the ABIHM on June 19, 2013. Outcome Measures * The survey assessed members' (1) use of and confidence in the vaccination recommendations of the Centers for Disease Control and Prevention (CDC) and of medical-specialty associations, (2) confidence in the manufacturing safety of vaccines and in manufacturer's surveillance of adverse events, and (3) attitudes toward vaccination mandates. The questionnaire included 33 items, with 5 open-ended questions that provided a space for comments. Results * The survey was completed by 290 of 1419 diplomats (20%). The survey showed a diversity of opinions in many vaccination issues. Integrative medicine physicians were less likely to administer vaccinations than physicians in traditional allopathic medicine. Among the 44% who provide vaccinations, 35% used alternative schedules regularly. Integrative medicine physicians showed a greater support of vaccination choice, were less concerned about maintaining herd immunity, and were less supportive of school, day care, and employment mandates. Toxic chemical and viral contaminants were of greater concern to a higher percentage of integrative medicine physicians. Integrative medicine physicians were also more likely to accept a connection between vaccinations and both autism and other chronic diseases. Overall, there was dissatisfaction with the Vaccine Adverse Event Reporting System as well as the vaccination recommendations of the CDC and their primary specialty. Conclusions * This survey documents significant variations in the vaccination attitudes and practices of integrative medicine physicians. This survey provides benchmark data for future surveys of this growing specialty and other practitioners. It is important for public health leaders and the vaccination industry to be aware that integrative medicine physicians have vaccination attitudes and practices that differ from the guidelines of the CDC and the Advisory Council on Immunization Practices. |
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