title: Pediatric vaccination and vaccine-preventable disease acquisition: associations with care by complementary and alternative medicine providers.
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.
authors.affiliation: 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
authors.forename: Lois
authors.initials: L
authors.lastname: Downey
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Tyree
authors.forename: Colleen E
authors.initials: CE
authors.lastname: Huebner
authors.forename: William E
authors.initials: WE
authors.lastname: Lafferty
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000529:Complementary Therapies / Q000523:psychology / Q000706:statistics & numerical data*; D003695:Delivery of Health Care / Q000379:methods*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data*; D019458:Insurance Coverage; D016015:Logistic Models; D008297:Male; D014611:Vaccination / Q000706:statistics & numerical data*; D014612:Vaccines / Q000008:administration & dosage*; D014861:Washington
chemical_list: D014612:Vaccines