Parents who are big fans of complementary and alternative medicine (CAM) may be less willing to get their kids vaccinated for the flu, suggests new research published Monday in the journal Pediatrics.

Researchers examined data taken from the 2012 National Health Interview Survey, specifically looking at around 9,000 families who answered questions about their use of alternative medicine. They found that children whose parents reported using certain CAM practices on them — acupuncture, homeopathy, chiropractic — were less likely to get a flu shot. Overall, one-third of families who turned to these modalities reported vaccinating their children compared to 43 percent of families who didn’t.

“Children who have ever used certain CAM domains that may require contact with vaccine-hesitant CAM practitioners are vulnerable to lower annual uptake of influenza vaccination,” concluded the authors.

Because the study is only observational in nature, it’s impossible to say for sure whether the use of CAM influenced families’ hesitance toward vaccination. And since the flu shot is voluntary and not foolproof, it’s also difficult to tell whether this reluctance applies to vaccination in general. For instance, while the flu vaccine has been recommended for nearly everyone by health agencies like the Centers for Disease Control and Prevention, it’s only 50 to 60 percent effective at preventing infection depending on the season.

That aside, many CAM practitioners often espouse long-debunked beliefs about vaccination, and there’s no shortage of websites that both cater to CAM users while spreading conspiracy theories about the pharmaceutical industry or ideas on how to treat disease that some health professionals would consider dangerous. For example, a blog post on in 2014 advised people that homeopathy could cure Ebola, the often fatal viral disease with no effective treatment as of yet. during the height of an outbreak that spanned West Africa and even reached the U.S. momentarily.

Far from dismissing CAM entirely, the researchers hope that their findings can highlight the importance of building a bridge between mainstream medical providers and guarded parents.

"There is nothing inherently wrong with using CAM," study author Dr. William Bleser, a research assistant at Pennsylvania State University told HealthDay, further noting that most people do regularly use CAM alongside conventional medicine rather than as a complete replacement.

And not all forms of CAM predicted less vaccine use. Families that regularly used multivitamin and multimineral supplements were slightly more likely to get vaccinated, though the difference went away after accounting for other factors.

“Opportunity exists for US public health, policy, and medical professionals to improve child health by better engaging parents of children using particular domains of CAM and CAM practitioners advising them,” the authors wrote.

Of the sample size studied, 4 to 8 percent of children had used some form of CAM besides multivitamins and multiminerals.

Source: Bleser W, Elewonibi B, Miranda P, et al. Complementary and Alternative Medicine and Influenza Vaccine Uptake in US Children. Pediatrics. 2016.