An outbreak of measles in Ontario prompted the provincial and federal health ministers last week to call parents of unvaccinated children irresponsible. But some public health experts are questioning why governments and regulatory bodies are standing back as some licensed health professionals sell ineffective homeopathic "vaccines" and promote anti-vaccine views to patients.
The federal government has approved for sale dozens of nosodes – products homeopaths and naturopaths often call "homeopathic vaccines." Nosodes must carry a disclaimer stating they are not vaccines, but some natural health practitioners market them as safe, effective alternatives.
Some licensed naturopaths and chiropractors in Canada also promote unscientific views about the dangers of traditional vaccines and incorrectly link them to autism, allergies and other health problems.
For instance, the Naturopathic and Medispa Clinic in Markham, Ont., says on its website that the "measles-mumps-rubella or MMR vaccine has been strongly linked to the onset of Autism," and that "Current vaccination schedules overload young, fragile immune systems found in children with a huge number of viruses."
Little Mountain Homeopathy in Vancouver says on its website that homeopathic nosodes "are just as effective or even more effective than regular vaccines."
Toronto's Kew Beach Naturopathic Clinic published an online newsletter last year linking childhood vaccination to toxicity. In a 2012 newsletter, Helena Ovens, a naturopath at the clinic, writes that "relatively benign viral diseases such as Measles … give the body's immune system the ability to create antibodies" and that "unvaccinated children naturally build more antibodies against viruses than vaccinated children."
Last fall, Absolute Chiropractic in Hamilton wrote in an online newsletter that two new studies had confirmed a link between the MMR vaccine and autism.
None of the clinics agreed to answer questions about their claims related to vaccination.
The president of the Canadian Paediatric Society called the lack of action from governments and regulatory bodies on this issue a flagrant double standard.
"The government holds doctors and the pharmaceutical professions to a much higher standard than [chiropractors and naturopaths]," Robert Moriarty said.
In an e-mailed statement, a spokesman for Health Minister Rona Ambrose said the decision to approve nosodes, or homeopathic vaccines, rests with Health Canada scientists.
Jamie Williams, executive director of Bad Science Watch, called that response a "cop-out" and questioned why the government has not pulled nosodes from the market, given they are promoted as alternative vaccines and for no other purpose.
Health professionals in Canada, including doctors, are investigated only as a result of complaints. But patients are unlikely to complain about anti-vaccine messages if they believe them. It is clear that more has to be done to stop the spread of false information, Dr. Moriarty said."I think we have to put pressure on their licensing bodies," he said.
It is impossible to gauge how many naturopaths and chiropractors sell nosodes or promote incorrect information about vaccines. Homeopaths, who are unregulated, also sell those products.
A Canadian study published in the journal PLOS One in 2011 reported that only 50 per cent of children who had visited a naturopath were up to date with their vaccinations. A 2004 study in the journal Vaccine found that only 13 per cent of students at the Canadian College of Naturopathic Medicine would recommend full vaccination.
The professional associations for chiropractors and naturopaths support vaccinations and say their members should refer patients to a medical doctor if they have questions about them. On the ground, however, the story can be different. This poses a major challenge to licensing bodies and the government, says Timothy Caulfield, Canada Research Chair in health law and policy at the University of Alberta's School of Public Health.
"When these professions are regulated by the government, it creates a veneer of legitimacy," Dr. Caulfield said.
Eric Hoskins, Health Minister in Ontario, where 16 cases of measles were recently diagnosed, said in an e-mail that the province "expects that health-care professionals act within their respective scopes and standards of practice," and that concerned patients should contact the regulatory colleges.
In many provinces, naturopaths are regulated, and prevented by legislation from promoting false or misleading information. In Ontario, naturopaths are regulated by the Board of Directors of Drugless Therapy – Naturopathy, and, under provincial rules, are guilty of professional misconduct if they advertise false or misleading statements about treatments. Naturopaths will soon be overseen by the new College of Naturopaths of Ontario, which will also investigate professional misconduct. The board and the council setting up the college declined interview requests.
The Ontario Association of Naturopathic Doctors said naturopaths who sell homoepathic "vaccines" or promote false views could be investigated by the licensing body.
"That definitely is something that's going to be addressed. Like any profession, there are going to be some outliers that need to be talked to," said association chair Alfred Hauk. "I'm not sure what the individual naturopathic doctors are doing. Maybe trying to promote something that they think is beneficial."
It is unclear if any naturopaths have been investigated or disciplined for professional misconduct related to promotion of false information about vaccines.
The Canadian Chiropractic Association says discussions of vaccines are "outside the scope" of practice for chiropractors .
Jo-Ann Wilson, registrar and general counsel of the College of Chiropractors of Ontario, said the college can investigate chiropractors for professional misconduct if it receives a complaint, but that none has come in recently. She acknowledged that the college could crack down on anti-vaccine messaging.
"That is always a possibility," she said.
Kumanan Wilson, senior scientist at the Ottawa Hospital Research Institute, warned against marginalizing the natural health community because some members hold anti-vaccination views. He notes "a lot of good" has come from alternative medicines and that, if anything, the public health and natural health communities should work more closely.
"It's better to engage than not engage," he said.