The controversial topic of chiropractic attitudes toward immunization was addressed at the 120th annual meeting of the American Public Health Association (APHA) held in Washington, D.C., November 8-12, 1992.
The session opened with a paper by Craig Nelson, D.C., associate professor at Northwestern Chiropractic College, "Chiropractic Perspectives on Immunization: A Misguided Crusade." Dr. Nelson reviewed the historic attitudes of the chiropractic profession toward immunization and concluded that current positions taken by organizations within the profession range from outright opposition to silence.
Current opposition centers on two issues: (1) the political question of whether any medical procedure (immunizations) should be mandated; and (2) the scientific question of whether immunizations are safe and effective. Opposition is also predicated on what is considered by some within the profession to be the highest standard: chiropractic philosophy.
Dr. Nelson contends that opposition to immunization has existed since the 19th century in the face of overwhelming evidence as to the benefits of immunization. Dr. Nelson believes this opposition is counterproductive. He states that while the chiropractic profession wishes to be taken seriously in the field of preventive health care, its position on immunization makes that virtually impossible. The principles and mechanisms of immunization do not refute chiropractic principles. Indeed, they are in harmony with those principles. Dr. Nelson concluded that the chiropractic profession should enthusiastically endorse the APHA policies on immunization.
A different viewpoint was presented in a paper by Candace Croft-Greenwell, D.C., which surveyed attitudes toward immunization of Logan Chiropractic College students. Although Dr. Croft-Greenwell was not present, an abstract of her paper was read. Her conclusion is that Logan College stresses the allopathic viewpoint and her recommendation is that the curriculum should be revised to include emphasis on the traditional chiropractic attitude toward immunization wherever discussions of childhood immunizations are presented.
What is the attitude of chiropractors toward immunization? I presented the results of a nationwide survey of chiropractic physicians. This survey sampled one percent of licensed DCs in the U.S. The questionnaire asked for date of graduation, college, ACA or ICA membership, and whether the respondent's own family was immunized (see Table 1, Study Population).
Study Population | |
Random Sample of 1% of American Chiropractors | |
| n=178 | Response Rate ------------------ 37% |
| n=116 | ACA Member --------------------- 62% |
| ICA Member --------------------- 15% | |
| Both/Other --------------------- 24% | |
| n=161 | Instruction in Immunology ------ 96% |
| n=162 | Family Immunization ------------ 73% |
| n=163 | Avg. Graduation Year (1946-92)-- 1982 |
A series of questions about attitudes toward immunization followed. For example, the respondents were asked to indicate agreement or disagreement with the statement "There is no scientific proof that immunization prevents infectious disease." Thirty-seven percent of the respondents agreed with this statement, 39 percent disagreed, and 23 percent were ambivalent. When broken down according to national association affiliation, 24 percent of those who agreed were ACA members and 65 percent were ICA members (See Question 1, Scientific Proof).
In general, ICA members' attitudes toward immunizations were more conservative than ACA members. As would be expected, those respondents felt that proof of immunization should not be required for school entry and 47 percent felt that the chiropractic profession should have an official policy against the APHA immunization resolutions.
In summary, this survey indicated that a significant number of American DCs hold what could be called traditional conservative chiropractic attitudes toward immunization as public health policy. Almost 500 questionnaires were mailed and there was a 37 percent response. It may be that the survey selected for most zealous proponents of a conservative anti-immunization perspective. The survey also suggests that a united immunization policy for the American chiropractic profession may be difficult to obtain because of various political differences.
Drs. Nelson and myself are currently preparing the full texts of our papers for publication in the near future.
Following the papers there was a general discussion of chiropractic attitudes toward immunization by members of the audience. Concern was expressed that chiropractors are widely perceived as being unscientific and backward by opposing a method of preventative public health which has been used effectively for over 100 years, and which has resulted in successes such as the striking decline in polio worldwide and the absolute eradication of smallpox.
Herbert Vear, D.C., president emeritus of Western States Chiropractic College and professor emeritus Canadian Memorial Chiropractic College has recently written a pro-immunization policy which has been accepted by the Canadian Chiropractic Association. He concluded that the widely held anti-immunization attitudes of American chiropractors represents a failure of the educational responsibilities of the colleges.
There was general agreement that this issue is far from settled and that there should be another session on immunization at the 1993 APHA meeting in San Francisco. All chiropractors are encouraged to support preventative health care by joining the American Public Health Association as members of the Radiological Health Section or the Chiropractic Forum.