Prevalence of anti-vaccination sentiment

"Many parents who normally prefer natural immunity for their children with a healthy diet and constitutional treatment, have become disconcerted by the recent media hyped health scare. The issue of vaccinations is difficult for natural health practitioners to talk about as it has become a religious taboo – i.e. you are plainly irresponsible if you don’t do what the ‘officially sanctioned’ scientists tell you. My response is that everyone must make an INFORMED decision based on FACTS AND NOT FEAR and that is what I support for my clients."   

Meike Lawrence RSHom.

A previous post talked about Society of Homeopaths (SoH) members who had been identified as being anti-vaccination. However, identification was based on obvious membership of certain groups. Confirmation was based on very obvious public anti-vaccination statements.

The overall prevalence of anti-vaccination sentiment among SoH members is to a degree unknowable. If a member is silent on the issue, who knows what their position is? But a sampling exercise has been conducted to evaluate how common openly expressed anti-vaccination sentiment is on SoH member websites (or easily found from there). The reasons are explained here.

Context
Without waiting to labour the point, it is very clear that medically unqualified lay homeopaths have no authority whatsoever to talk about vaccination in a healthcare setting. Legally, they are medically unqualified lay persons with no special knowledge. Whilst everyone is entitled to a personal opinion, in many situations it would be highly unprofessional to express them, let alone act on them. Whilst some lay homeopaths may beg to differ, without doubt, it is beyond their competence to discuss vaccinations in any way with (potential) clients. This includes what is said in marketing.

It is suspected that some SoH board members are ideologically opposed to dealing with vaccination issues in any meaningful way.

Important clarification
Anticipating what some homeopaths and their supporters might say, none of the below is in violation of the General Data Protection Regulation (GDPR). The data used is in the public domain. I am not a business entity. Scientific and statistical analysis is excluded from the GDPR. 

Criteria for Inclusion
The SoH has very slightly over 1000 members. The vast majority are based in the UK. Those who are not tend to be UK ex-pats (which can be tricky). There are a very small number who are also regulated medical professionals.

A list of SoH members was obtained using a combination of web scraping tools. The list was loaded into Microsoft Excel. Minimal cleansing of data was performed. Around 52% of members have one or more websites listed. A sample of 200 SoH members and their websites were selected at random.

Those websites that no longer work, are "under construction", have no content or otherwise non-functional are excluded. No attempt was made to determine if members had another functioning website.

Also excluded are those websites that belong to a clinic with multiple practitioners. The reasoning is that the SoH member may not have control of precisely what goes into their advertising. Sites that are run by two (in one case three) homeopaths are included.

One website was excluded on the basis of being in Japanese with no English content.

This left 147 members and their websites.

Website content
The contents of the members' website were evaluated for vaccine related content. None of the websites reviewed had anything positive to say about vaccination.

One of the problems with evaluating whether the statements of a homeopath are anti-vaccination or not is that they often use unclear language. Some words appear to have different meanings in the world of homeopathy. The determination of whether content is clearly anti-vaccination or not is trickier than it may seem.

Some of those in the sample are known to (have) practice(d) CEASE therapy. They are per force anti-vaccination. However, in terms of the claims made, "vaccines cause autism" is treated as anti-vaccination but lesser claims not involving vaccination are not.

Naive comments likening the mechanism of action of homeopathy to that of immunisation were not regarded as evidence of anti-vaccination sentiment in themselves. If would be odd to make such a statement and then say vaccines are bad.

Something that did crop up on a couple of websites' Frequently Asked Questions was "are homeopaths anti-vaccination?" A straight answer would be - yes, some definitely are - but a straight answer was not given. This was treated as anti-vaccination.

It was also noted that some homeopaths had attended talks/training by known anti-vaccinationists. However, it is extremely unlikely that consumers would recognise this. Nor is mere attendance an outright signifier of anti-vaccination sentiment.

17 websites contained anti-vaccination statements.

"Useful" links
Some member websites have dedicated pages of "useful" links but this also includes links to external websites in any context where it is clear that the intention is that consumers can follow them to obtain further information.

The most commonly linked to sites were Arnica, Informed Parent and the CEASE therapy website. In a few cases more aggressively anti-vaccination websites were linked.

No links were made to NHS information on vaccination.

17 websites had these links.


Social Media
Where a website linked directly to a member's Facebook or Twitter account, those were examined. No attempt was made to find social media accounts not linked to. Whilst a few homeopaths did link to other social media such as Instagram, Pinterest and LinkedIn these were ignored. There was a distinct preference for posting on Facebook as opposed to Twitter. 

Some social media posts were obviously anti-vaccination. Sharing of anti-vaccination stories often involved anti-vaccination comments made by the member but when comments were not made, it was still treated as anti-vaccination. Being familiar with Twitter, yes, sometimes uses are ironic in their retweeting but this is not what is going on here.

No pro-vaccination posts were made. Nor were there any critical comments when sharing anti-vaccination content. 

19 websites linked to social media with anti-vaccination content.

Overall
When any indicator of anti-vaccination sentiment is considered, 41 websites were anti-vaccination. That's around 27%.

Because some of those in the sample who don't meet the criteria for being anti-vaccination are known through other sources to be anti-vaccination and in some cases extremely so, the actual prevalence of anti-vaccination sentiment among homeopaths with an online presence is going to be higher than 27%. How high? Impossible to estimate based on current information.

Ouch
To quote again from a blogpost from the (now former) CEO of the SoH Mark Taylor -

The current threat from the Good Thinking Society (Chair, Simon Singh) to pursue a judicial review against the Professional Standards Authority (PSA) is a case in point. Their accompanying statement is a quite deliberate one-eyed commentary, ignoring the evidence and containing statements that are simply false. 

One example: ‘A patient could, via the PSA’s list of accredited practitioners, find themselves consulting with a homeopath who discourages vaccination and believes they can cure children of autism.’ That is simply not true.

How consumers find homeopaths is a bit of a mystery but if they were selecting them at random from the SoH's website they would have >27% chance of ending up with one who is anti-vaccination.

Whilst some might find this amuses, it does present the SoH with a very difficult problem. To quote from their position statement - 

The Society supports informed decision making in regard to vaccination. We recommend that patients seek advice from their GP, as well as organisations that specialise in providing information about this complex issue, so they can make an informed choice for themselves and their children.

This is meaningless. In the section on homeoprophylaxis they also say -

Currently there is no homeopathic alternative to vaccination or anti-malarial drugs which has been proven beyond doubt to be clinically effective. It is therefore unethical for a homeopath to advise a patient against the use of conventional vaccines or anti-malarial drugs.

So, potentially >27% of their members are potentially acting unethically?

The Society expects its members to comply with its Code of Ethics and the above position statements at all times, and any breaches may be treated as disciplinary matters. In order to ensure patient safety and in line with our guidelines, we will check the websites and marketing of all our members on a regular basis to ensure they are adhering to this statement.

This is difficult to believe. 

Further research
It would be possible to increase the sample size by looking at all SoH member sites. This might include determining whether members with non-functioning websites had other functioning websites.

It might also be possible to look at social media that isn't directly linked to by a member's website. It might also be possible to look at claims that they might have made on clinic websites and also third party directories.

Various automated techniques could be applied to the analysis of website content etc. Whilst this would not remove all need for inspection by a human being, it could, for example rule out websites that that have no vaccine related content.

It would be possible to expand the research to members of other homeopathy associations such as the Alliance of Registered Homeopaths, the Homeopathic Medical Association and the Faculty of Homeopathy. There are other associations that register homeopaths too. The constraining factor here is the difficulty of web scraping. Different websites can require different technical approaches.