Understanding and explaining the link between Anthroposophy and vaccine hesitancy: A systematic review

Abstract

Abstract Background: Anthroposophic communities have gained the attention of public health authorities due to low vaccination uptake. This systematic review aimed to summarize the evidence available on the relationship between anthroposophy and vaccine beliefs. The systematic review addressed aimed to collate evidence documenting outbreaks linked to anthroposophic communities, literature on vaccination coverage in anthroposophic communities and lastly describe literature that summarizes theories and factors influencing vaccine decision making in anthroposophic communities. Methods: This is a systematic review using following databases: Medline, Web of Science, Psycinfo and CINAHL. Article screening was conducted by two researchers. Data was summarized to address the research questions. For the third research question the qualitative data was analyzed using thematic analysis with the assistance of Nvivo12.0. Results: There were 12 articles documenting 18 measles outbreaks linked to anthroposophic communities between the years 2000 and 2012. Seven articles describe lower vaccination uptake in anthroposophic communities than in other communities, although one article describes that vaccination uptake in low-income communities with a migrant background have lower coverage than the anthroposophic community they studied. We found eight articles examining factors and theories influencing vaccine decision making in anthroposophic communities. The qualitative analysis revealed four common themes. Firstly, there was a very broad spectrum of vaccine beliefs among the anthroposophic communities. Secondly, there was a consistent narrative about problems or concerns with vaccines, including toxicity, lack of trust in the system. Thirdly, there was a strong notion of the importance of making individual and well-informed choice as opposed to simply following the masses. Lastly, making vaccine choices was highly stigmatized by those outside of the anthroposophic community but also those within the community. Conclusion: Continued research and monitoring of vaccine beliefs in the anthroposophic community is important particularly in view of current COVID-19 vaccine decision debates. The importance of the Waldorf school and community context in influencing vaccine decision making warrants further investigation.