“We treat humans, not herds!”: A qualitative study of complementary and alternative medicine (CAM) providers’ individualized approaches to vaccination in Switzerland

Deml, Michael J.; Notter, Julia; Kliem, Paulina; Buhl, Andrea; Huber, Benedikt M.; Pfeiffer, Constanze; Burton-Jeangros, Claudine; Tarr, Philip E.

doi:10.1016/j.socscimed.2019.112556

Cited by 41 publications

(63 citation statements)

References 66 publications

(71 reference statements)

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“…Using nuanced communication suggested to us by four CAM doctors, we were able to develop an intervention approach with the explicit goal of addressing VH among physicians and patients by improving the factual and communicative quality of HPV vaccine information. By inviting CAM doctors as co-authors, we sent a symbolically strong message to practitioners of CAM in Switzerland, indicating that we recognize their important clinical and public health role in providing vaccine counseling, particularly to VH individuals [15,42], and that biomedicine can incorporate CAM vaccination perspectives into materials destined for all HCPs. Through such collaboration, we have shown how it is possible to work with individuals that popular narratives would have us believe to be 'the opponent' when it comes to VH [37].…”

Section: Discussionmentioning

confidence: 99%

“…They encouraged us to instead focus on HPV-vaccine specific safety issues, such as case reports of rare but serious illnesses following vaccination, without inciting fear. While commending our emphasis on large-scale epidemiological evidence, acknowledging such case reports, they argued, would appeal to the tendency of CAM providers to incorporate "experiential" knowledge and anecdotal evidence into their medical practices [15,36]. Finally, CAM co-authors agreed that we point to the collective benefit of the HPV vaccine outweighing the minimal potential risks (Table 3).…”

Section: Vaccine Safetymentioning

confidence: 99%

“…However, research conducted in the setting of our national research program on VH [13,14] has suggested that providers of CAM in Switzerland are not categorically anti-vaccine. They prefer providing individualized vaccination counseling, which includes taking time to understand parent vaccine wishes, involving parents in vaccine decisions, and taking their vaccine concerns seriously [15].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Collaborating with Complementary and Alternative Medicine (CAM) Providers When Writing HPV Vaccine Review Articles

Deml

Dietrich

Wingeier³

et al. 2020

JCM

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Novel strategies are needed to address vaccine hesitancy (VH), which correlates with complementary and alternative medicine (CAM). In Switzerland, CAM providers play important roles in vaccine counseling of vaccine hesitant (VH) parents, and traditional vaccination messaging tends to overlook CAM provider perspectives. In the setting of a Swiss national research program on VH, our key strategy has been to work together closely with CAM providers. To assess the feasibility of generating educational human papillomavirus (HPV) vaccine materials that would interest VH healthcare providers (HCPs), we invited four CAM providers to co-author two HPV vaccine review articles for general practitioners. We conducted thematic analysis of CAM provider comments to identify patterns that could complement and improve vaccination messaging from CAM perspectives. We identified several themes and generated an inventory of CAM provider messaging recommendations related to language use, presentation of background information, nuanced statements regarding HPV vaccine efficacy and safety, and communication tools that would be important to VH HCPs. Contrary to our initial expectations, and in an inclusive, respectful atmosphere of open dialogue, we were able to productively finalize our manuscripts. In the opinion of the CAM co-authors, the manuscripts effectively considered the communication needs and perspectives of VH HCPs. Engaging with CAM providers appears to be a feasible and innovative avenue for providing vaccine information and designing communication tools aimed at VH healthcare providers.

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Section: Discussionmentioning

confidence: 99%

Section: Vaccine Safetymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Collaborating with Complementary and Alternative Medicine (CAM) Providers When Writing HPV Vaccine Review Articles

Deml

Dietrich

Wingeier³

et al. 2020

JCM

Self Cite

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“…This concurs with recent research from Switzerland that found some medical practitioners, who were also trained in CM, described particular concerns about immunization such as the induction of autoimmune disease. 22 Given our findings suggest that some CM practitioners may be vaccine hesitant themselves, future immunization decision aids could be more widely tested in CM clinical settings to examine whether they need to be amended to specifically address common but unfounded concerns for more vaccine-hesitant parents and some CM practitioners. If warranted, the addition of this material may help to address the risk of parents looking elsewhere for this information and being influenced by unreliable sources.…”

Section: Bias and Balancementioning

confidence: 92%

Exploring complementary medicine practitioners’ attitudes towards the use of an immunization decision aid, and its potential acceptability for use with clients to reduce vaccine related decisional conflict

Frawley

McKenzie

Forssman³

et al. 2020

Human Vaccines & Immunotherapeutics

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While Australia boasts a high immunization rate, geographical pockets of low uptake still challenge herd immunity on a community level. For some parents, concerns about immunization lead to distrust of conventional sources of vaccine information and complementary medicine (CM) practitioners may be more readily trusted as a source of information about vaccines. Decision aids are common educational resources that are developed to support informed decision making. We interviewed CM practitioners to explore their attitudes to immunization decision aids in general and the acceptability of recommending this resource to parents with concerns or questions about immunization. While some practitioners felt that it might be biased towards immunizations, all said that they would recommend the resource to parents. CM practitioners are a trusted source of information, including immunization advice for some parents. CM practitioners were generally supportive of decision aids as a tool they could use in their practice to help parents with immunization questions, where a premium is often placed on patient choice.

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“…Finally, in order to fully appreciate the complexity of how people interact with health information in order to make vaccination choices, we will conduct both thematic analysis56 and critical discourse analysis57–59 of any sources of information mentioned as being important or determinative during vaccination discussions. A first manuscript containing initial results of the qualitative research phase has been published 68…”

Section: Methods and Designmentioning

confidence: 99%

Determinants of vaccine hesitancy in Switzerland: study protocol of a mixed-methods national research programme

et al. 2019

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IntroductionVaccine hesitancy is a complex public health issue referring to concerns about the safety, efficacy or need for vaccination. Relatively little is known about vaccine hesitancy in Switzerland. This ongoing study (2017–2021) focuses on biomedical and complementary and alternative medicine (CAM) providers and their patients since healthcare professionals play important roles in vaccination decision-making. This national research programme seeks to assess the sociocultural determinants of vaccine hesitancy regarding childhood and human papillomavirus vaccines in Switzerland. We aim to provide a detailed characterisation of vaccine hesitancy, including CAM and biomedical perspectives, patient–provider interactions, and sociocultural factors, to establish the mediating effects of vaccine hesitancy on underimmunisation, and to design an intervention to improve vaccination communication and counselling among physicians, parents and adolescents.Methods and analysisOur transdisciplinary team employs a sequential exploratory mixed-methods study design. We have established a network of more than 150 medical providers across Switzerland, including more than 40 CAM practitioners. For the qualitative component, we conduct interviews with parents, youth, and biomedical and CAM providers and observations of vaccination consultations and school vaccination information sessions. For the quantitative component, a sample of 1350 parents of young children and 722 young adults (15–26 years) and their medical providers respond to questionnaires. We measure vaccine hesitancy with the Parent Attitudes about Childhood Vaccines 15-item survey and review vaccination certificates to assess vaccination status. We administer additional questions based on findings from qualitative research, addressing communication with medical providers, vaccine information sources and perceptions of risk control vis-à-vis vaccine-preventable diseases. The questionnaires capture sociodemographics, political views, religion and spirituality, and moral foundations.Ethics and disseminationThe study was approved by the local ethics committee. The results will be published in peer-reviewed journals and disseminated to healthcare professionals, researchers and the public via conferences and public presentations.

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“We treat humans, not herds!”: A qualitative study of complementary and alternative medicine (CAM) providers’ individualized approaches to vaccination in Switzerland

Cited by 41 publications

References 66 publications

Collaborating with Complementary and Alternative Medicine (CAM) Providers When Writing HPV Vaccine Review Articles

Collaborating with Complementary and Alternative Medicine (CAM) Providers When Writing HPV Vaccine Review Articles

Exploring complementary medicine practitioners’ attitudes towards the use of an immunization decision aid, and its potential acceptability for use with clients to reduce vaccine related decisional conflict

Determinants of vaccine hesitancy in Switzerland: study protocol of a mixed-methods national research programme

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