補充與替代醫療使用者之新冠疫苗猶豫

背景：新冠疫苗自問世以來，被許多人視為對抗疫情、回歸正常生活的唯一方法。然而疫苗本身安全性使民眾對新冠疫苗有著很多疑慮，並且出現疫苗猶豫的情況，根據過去研究發現CAM使用者有較高的疫苗猶豫現象。然而使用CAM不見得拒打疫苗，其背後有著複雜、特殊的決策情境。雖然使用CAM在臺灣普遍存在，但民眾使用程度、方式不一。本研究欲呈現對CAM有強烈信仰、對西醫有所排斥的這群CAM使用者在面對新冠疫苗時的經驗。目的：本研究欲瞭解CAM使用者在面對新冠疫苗接種決策時，影響其決策的因素及資訊來源。本研究也將比較過去新冠疫苗猶豫之研究與本研究中CAM族群的新冠疫苗猶豫存在何種相同與相異之處。方法：本研究採用質性研究方式，以半結構式訪談作為主要研究方法，並輔以線上社團的參與式觀察。在半結構式訪談部分，透過訪談的方式理解CAM使用者的健康觀點以及其疫苗訊息來源，並瞭解其做出決策的過程。而在線上社團的參與式觀察部分則以瞭解社團參與者的健康觀點以及他們如何看待新冠肺炎與疫苗作為主軸。結果：研究發現CAM使用者基於其自身的健康觀點，認為自身免疫力才是面對疫情最可靠的方式，但同時對於疫情間接種疫苗採取開放、具彈性的決策模式。這群CAM使用者的資訊來源十分多元，包括線上社群、國內外新聞、學術論文，且不論在日常生活提升免疫力上與疫苗決策上這群CAM使用者都十分具有彈性，願意做出不同於過往健康觀點的決定。他們可能基於疫情考量而使用平時不願使用的保健食品；亦可能考量公共利益而願意接種疫苗。本研究也發現這群非西醫療法使用者對於當前體制相對不信任，且此社群的不信任有其特殊脈絡，此種不信任早在疫情之前即存在，並繼而影響他們對於新冠疫苗的態度。結論：CAM使用者雖具特殊健康觀點，但若衛生當局能理解該社群之健康觀點、屏除成見並提供完整資訊、充足之風險溝通，建立該社群對體制之信任，便能協助該族群做出適切決策。

關鍵字

新冠疫苗接種；疫苗猶豫；補充與替代醫療；健康觀點；信任

並列摘要

Background: COVID-19 vaccines were viewed as a way back to normal life since its launch. Despite this, concerns regarding the safety of the vaccines have resulted in vaccine hesitancy among the general population. Previous research has shown that users of complementary and alternative medicine (CAM) have a higher prevalence of vaccine hesitancy. Nevertheless, the use of CAM does not necessarily imply refusal to receive vaccines, as there may be complex and unique decision-making contexts involved. Although the use of CAM is widely prevalent in Taiwan, how people use CAM is varied. This study aims to present the experiences of this group of CAM users who have strong belief in CAM and reject Western medicine when facing the COVID-19 vaccine. Aims: The objective of this study is to investigate the factors and information sources that impact the decision-making process of CAM users when considering COVID-19 vaccination. This study also compares the vaccine hesitancy among the CAM users in this study with past studies of COVID-19 vaccine hesitancy. Methods: This study adopted a qualitative research approach, using semi-structured interviews as the main research method and supplemented by participatory observation in online communities. The semi-structured interviews were used to understand CAM users’ view of health, their information sources and their decision-making process. The online community participation observation was used to understand participants’ view of health and how they see COVID-19 vaccines. Results: The study finds that CAM users have different view of health than conventional medicine. They emphasized that the only way to protect oneself is to strengthen one’s immune system, but they also adopted a flexible and open decision-making model for vaccination during the pandemic. These CAM users receive their information from a variety of sources, including online community, news, and research papers. These CAM users are flexible with their ways to cope with COVID-19 and are willing to compromise. They may take dietary supplements which they never used considering the ongoing pandemic. They may also take the vaccines for public interest. The study also finds that these CAM users relatively distrust institutions when comparing with the public. Their institutional distrust, which developed prior to the pandemic, also impact their attitudes toward COVID-19 vaccines. Conclusion: While CAM users may have unique health perspectives, health authorities can still help CAM users to make their own decisions. Health authorities can establish CAM communities’ trust by understanding their health perspectives, overcoming stereotypes, providing complete and accurate information, and engaging in risk communication. With the trust in the system, they can make appropriate decisions.