Attitudes toward vaccination: a survey of Canadian chiropractic students

BackgroundAlthough the Canadian Chiropractic Association and the Canadian Memorial Chiropractic College (CMCC) endorse vaccination, the prevalence of anti-vaccination attitudes among Canadian chiropractors is unknown. This study describes the prevalence of anti-vaccination attitudes among Canadian chiropractic students.MethodsAn 11-item questionnaire about attitudes toward vaccination was distributed to students enrolled at CMCC during the 1999/2000 academic year. The responses for the 11 items were then summed to arrive at a total score ranging from 0 (most negative attitude toward vaccination) to 22 (most positive attitude toward vaccination). Respondents'' perceptions of sources of vaccine information were also investigated.ResultsOver 75% of the students (467 of 621) completed the questionnaire. Most students (53.3%) reported that in general they agreed with vaccination. This was especially true among first-year students (60.7%). However, among fourth year students, only 39.5% agreed with vaccination. The proportion of respondents who stated that they were against vaccination in general was 5 (4.5%) of 112 first-year students, 10 (8.3%) of 121 second-year students, 16 (13.9%) of 115 third-year students and 35 (29.4%) of 119 fourth-year students. The mean scores on the questionnaire were progressively lower with each higher year of study at the College. The mean survey scores for each year of study were first year, 15.9 (95% confidence interval CI] 15.2–16.6); second year, 16.1 (95% CI 15.3–17.0); third year, 14.5 (95% CI 13.5–15.4); and fourth year, 12.8 (95% CI 11.7–13.9). The mean scores varied among year of study and were statistically significant using one-way ANOVA (p < 0.0001). Among students who relied primarily on informal sources of vaccine information, such as the chiropractic literature and informal talks at CMCC, anti-vaccination attitudes were more prevalent in later years. InterpretationMost CMCC students reported pro-vaccination attitudes, but there appeared to be an increase in anti-vaccination attitudes as students progressed through the CMCC program. This pattern was seen almost exclusively among students who relied primarily on informal sources of vaccine information rather than on core CMCC lectures or prior lectures at university. Chiropractic is the third-largest regulated health care profession in North America, after allopathic medicine and dentistry, and it is growing rapidly.^1,2 A 1997 Angus Reid poll revealed that 25% of all Canadians use, or have made use of, chiropractic.³ Additional studies have reported a substantial pediatric sample within this population.^4,5,6 Chiropractors are therefore likely to play an increasingly influential role in the formulation of societal perceptions on public health issues such as vaccination. Vaccination, however, remains a contentious issue for a vocal subpopulation of the Canadian chiropractic profession,^7,8,9 despite the positive official stance of the Canadian Chiropractic Association (CCA).¹⁰Currently there are approximately 5000 practising chiropractors in Canada, of whom 4000 are members of the CCA.¹¹ Furthermore, approximately 80% of Canadian chiropractors are graduates of the Canadian Memorial Chiropractic College (CMCC),⁶ the only English-language chiropractic college in Canada. It is possible that attitudes formed during the 4-year program at CMCC will be indicative of attitudes held by practising chiropractors.¹² This study reports the findings of a survey of students attending CMCC during the 1999/2000 academic year, which was designed to investigate their attitudes toward vaccination.