title: Complementary medicine and childhood immunisation: A critical review.
abstract: Vaccination is one of the most significant and successful public health measures of recent times. Whilst the use of complementary medicine (CM) continues to grow, it has been suggested that CM practitioners hold anti-vaccination views. The objective of this critical review is to examine the evidence base in relation to CM practitioner attitudes to childhood vaccination alongside attitudes to vaccination among parents who visit CM practitioners and/or use CM products.
  
  
  
  A database search was conducted in MEDLINE, PubMed, CINAHL, EMBASE and AMED for research articles published between January 2000 and September 2015 that evaluated either CM practitioner or CM user attitudes and intention towards childhood vaccination.
  
  
  
  A total of 23 articles were found that detailed the attitudes of CM practitioners to vaccination. A further 16 papers examined the association between the use of CM products and visits to CM practitioners, and immunisation. The interface between CM and vaccination is complex, multi-factorial and often highly individualised. The articles suggest that there is no default position on immunisation by CM practitioners or parents who use CM themselves, or for their children. Although CM use does seem positively associated with lower vaccination uptake, this may be confounded by other factors associated with CM use (such as higher income, higher education or distrust of the medical system), and may not necessarily indicate independent or predictive relationships.
  
  
  
  Although anti-vaccination sentiment is significant amongst some CM practitioners, this review uncovers a more nuanced picture, and one that may be more agreeable to public health values than formerly assumed.
authors.affiliation: Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, NSW 2006, Australia. Electronic address: jon.wardle@uts.edu.au.
authors.forename: Jon
authors.initials: J
authors.lastname: Wardle
authors.affiliation: Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, NSW 2006, Australia. Electronic address: jane.frawley@uts.edu.au.
authors.forename: Jane
authors.initials: J
authors.lastname: Frawley
authors.affiliation: Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, NSW 2006, Australia; Endeavour College of Natural Health, Level 2, 269 Wickham St, Fortitude Valley, Brisbane, QLD 4006, Australia. Electronic address: amie.steel@uts.edu.au.
authors.forename: Amie
authors.initials: A
authors.lastname: Steel
authors.affiliation: Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, NSW 2006, Australia. Electronic address: elizabeth.sullivan@uts.edu.au.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sullivan
mesh_terms: D000529:Complementary Therapies; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D010290:Parents; D014611:Vaccination / Q000523:psychology*; D000072758:Vaccination Refusal
keywords: Attitudes; Complementary medicine; Immunisation; Vaccination