title: Attitudes towards vaccination: users of complementary and alternative medicine versus non-users.
abstract: BACKGROUND
  Children whose parents use complementary and alternative medicine (CAM) often show a lower rate of vaccination than those of parents favouring conventional medicine. We have investigated whether this applies to the paediatric patients presenting to an emergency department in German-speaking Switzerland, where popularity of CAM is rather high.
  
  
  METHODS
  A cross-sectional survey was performed of paediatric patients presenting to an urban, tertiary paediatric emergency department. 1,007 (63%) of the distributed 1,600 questionnaires were available for analysis.
  
  
  RESULTS
  12.7% of all respondents reported refusing some basic vaccination: 3.9% because of recommendation of the physician, 8.7% despite their physician's recommendation. Socio-demographic characterisation of the group of patients refusing vaccination showed older age of children, higher proportion of girls, more single-mothers families and decreased household income. Refusal of basic vaccination was significantly more frequent among CAM-users than among non-users (18.2% versus 3.5%, p <0.001). The highest frequencies of refusal were reported by patients who consulted physicians practicing herbal medicine, anthroposophical medicine or homeopathy. Users and non-users of CAM however, showed comparable rates of immunisation in the case of the vaccinations against invasive meningococcal, pneumococcal disease and flu. Surprisingly, the rate for vaccination against tick-borne encephalitis was higher in the CAM-users group than among the non-users (21.2% versus 15.4%, p <0.05).
  
  
  CONCLUSIONS
  A considerable proportion of the study population did not fully accept basic vaccinations. Refusal to follow the basic vaccination schemata was more frequent among CAM-users than non-users and reflected in most cases parental wishes rather than physicians' recommendations.
authors.affiliation: University Children's Hospital of Zurich, Zurich, Switzerland. tycho.zuzak@kispi.uzh.ch
authors.forename: Tycho Jan
authors.initials: TJ
authors.lastname: Zuzak
authors.forename: Isabelle
authors.initials: I
authors.lastname: Zuzak-Siegrist
authors.forename: Lukas
authors.initials: L
authors.lastname: Rist
authors.forename: Georg
authors.initials: G
authors.lastname: Staubli
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Simoes-Wüst
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D000529:Complementary Therapies / Q000523:psychology*; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D012737:Sex Factors; D014611:Vaccination / Q000523:psychology*