Vaccine hesitancy is strongly associated with distrust of conventional medicine, and only weakly associated with trust in alternative medicine

Rationale and objective: It is well established that people who use complementary and alternative medicines (CAM) are, on the whole, more vaccine hesitant. One possible conclusion that can be drawn from this is that trusting CAM results in people becoming more vaccine hesitant. An alternative possibility is that vaccine hesitancy and use of CAM are both downstream consequences of a third factor: distrust in conventional treatments. We conducted analyses designed to disentangle these two possibilities. Method: We measured vaccine hesitancy and CAM use in a representative sample of Spanish residents (N = 5200). We also measured their trust in three CAM interventions (acupuncture, reiki, homeopathy) and two conventional medical interventions (chemotherapy and antidepressants). Results: Vaccine hesitancy was strongly associated with (dis)trust in conventional medicine, and this relationship was particularly strong among CAM users. In contrast, trust in CAM was a relatively weak predictor of vaccine hesitancy, and the relationship was equally weak regardless of whether or not participants themselves had a history of using CAM. Conclusions: The implication for practitioners and policy makers is that CAM is not necessarily a major obstacle to people's willingness to vaccinate, and that the more proximal obstacle is people's mistrust of conventional treatments.