(Reuters Health) - Children that visit alternative medical practitioners like acupuncturists and chiropractors may be less likely to receive flu shots than their peers, a U.S. study suggests.

Roughly 33 percent of kids who saw providers of so-called non-Western medicine for services like acupuncture or homeopathic care got vaccinations for influenza, the analysis of national survey data on about 9,000 kids found. About 35 percent of kids who went to practitioners of what’s known as manipulative and body-based therapies such as chiropractic care or massage got flu vaccinations.

In comparison, 43 percent of children who didn’t see these types of alternative medicine providers got vaccinated, researchers report in the journal Pediatrics.

“Some complementary and alternative medicine practitioners have anti-vaccine or vaccine-hesitant viewpoints,” said lead study author William Bleser of Pennsylvania State University in State College.

While the findings don’t prove alternative medicine providers discourage vaccination, these results suggest that it makes sense for pediatricians to ask parents whether their kids use these services to help shape discussions about vaccinations, Bleser added by email.

“More and more patients are using complementary and alternative medicine and may be expecting their health professionals to guide them in making decisions about whether complementary and/or conventional approaches work better for disease treatment or prevention,” Bleser said, “yet most complementary and alternative medicine users do not disclose to their physicians that they use (these services).”

To assess how use of different types of complementary and alternative medicine may influence the odds of vaccination, Bleser and colleagues examined data from the 2012 National Health Interview Survey.

Overall, about two-thirds of children in the study used at least one form of complementary or alternative medicine, including everything from yoga practice to taking daily multivitamins or following various popular diets, the study found.

Excluding multivitamins or mineral supplements, however, only 17 percent of kids used complementary medicine.

When kids did take multivitamins, they were more likely to get the flu vaccine than their peers that didn’t, the study found. About 45 percent of children using multivitamins got vaccinated, compared with 39 percent of other kids.

One limitation of the study is that researchers lacked data on how recently or how often children visited alternative medicine providers, the authors note. They also lacked data on kids under age 4, a group that is at high risk for complications from influenza.

Still, the results highlight the need for pediatricians to understand how parents view alternative medicine, said Linda Greene, a researcher at the University of Rochester Highland Hospital in New York and president-elect of the Association for Professionals in Infection Control and Epidemiology.

“Most likely parents may have been influenced by the beliefs often consistent with alternate medicine,” Greene, who wasn’t involved with the study, said by email. “These beliefs may center on personal control of one’s health through healthy lifestyles rather than traditional medicine.”

It’s also possible that parents who are more worried about the risks of vaccination may be more likely to seek out alternative medicine providers for their kids, noted Dr. Matthew Davis, a pediatrics researcher at Ann and Robert H. Lurie Children’s Hospital of Chicago.

“Respectful discussions with parents can sometimes lead to a change in their decision-making about vaccinations,” Davis, who wasn’t involved in the study, said by email.

SOURCE: bit.ly/2cO1Iip Pediatrics, online October 3, 2016.