title: Complementary and Alternative Medicine and Influenza Vaccine Uptake in US Children.
abstract: Complementary and alternative medicine (CAM) is increasingly used in the United States. Although CAM is mostly used in conjunction with conventional medicine, some CAM practitioners recommend against vaccination, and children who saw naturopathic physicians or chiropractors were less likely to receive vaccines and more likely to get vaccine-preventable diseases. Nothing is known about how child CAM usage affects influenza vaccination.
  
  
  
  This nationally representative study analyzed ∼9000 children from the Child Complementary and Alternative Medicine File of the 2012 National Health Interview Survey. Adjusting for health services use factors, it examined influenza vaccination odds by ever using major CAM domains: (1) alternative medical systems (AMS; eg, acupuncture); (2) biologically-based therapies, excluding multivitamins/multiminerals (eg, herbal supplements); (3) multivitamins/multiminerals; (4) manipulative and body-based therapies (MBBT; eg, chiropractic manipulation); and (5) mind-body therapies (eg, yoga).
  
  
  
  Influenza vaccination uptake was lower among children ever (versus never) using AMS (33% vs 43%; P = .008) or MBBT (35% vs 43%; P = .002) but higher by using multivitamins/multiminerals (45% vs 39%; P < .001). In multivariate analyses, multivitamin/multimineral use lost significance, but children ever (versus never) using any AMS or MBBT had lower uptake (respective odds ratios: 0.61 [95% confidence interval: 0.44-0.85]; and 0.74 [0.58-0.94]).
  
  
  
  Children who have ever used certain CAM domains that may require contact with vaccine-hesitant CAM practitioners are vulnerable to lower annual uptake of influenza vaccination. Opportunity exists for US public health, policy, and medical professionals to improve child health by better engaging parents of children using particular domains of CAM and CAM practitioners advising them.
authors.affiliation: Department of Health Policy and Administration, Pennsylvania State University, University Park, Pennsylvania.
authors.forename: William K
authors.initials: WK
authors.lastname: Bleser
authors.affiliation: Department of Health Policy and Administration, Pennsylvania State University, University Park, Pennsylvania.
authors.forename: Bilikisu Reni
authors.initials: BR
authors.lastname: Elewonibi
authors.affiliation: Department of Health Policy and Administration, Pennsylvania State University, University Park, Pennsylvania.
authors.forename: Patricia Y
authors.initials: PY
authors.lastname: Miranda
authors.affiliation: Department of Health Policy and Administration, Pennsylvania State University, University Park, Pennsylvania rzb10@psu.edu.
authors.forename: Rhonda
authors.initials: R
authors.lastname: BeLue
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D008297:Male; D015999:Multivariate Analysis; D044469:Racial Groups; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D007252:Influenza Vaccines; D014815:Vitamins