Table 3 Summary of seven articles describing vaccination coverage and uptake in anthroposophic communities

Pfaff, G., Leher, A., Fechler, A. and Ouédraogo, N., 2017. Immunization coverage among children in Waldorf kindergartens, South West Germany 2015-2016Gunter Pfaff. European Journal of Public Health, 27(suppl_3)

Germany

2017

We analyzed school entry health examination records of 91.653 children seen in 2014/2015 by either PHS staff (PHS, n = 90 653) or by physicians of Waldorf kindergartens (Waldorf, n = 1 247)

Absence of immunization coverage varied for poliomyelitis (PHS 2,5%/Waldorf 20,2%), diphtheria (1,8%/12,5%), tetanus (1,0%/4,6%), pertussis (2,6%/23,9%), haemophilus influenzae b (3,7%/29,4%), varicella (16,4%/60,1%), hepatitis B (9,8%/48,6%), pneumococcal vaccine (13,1%/51,6%), meningococcus C (13,6%/56,4%) and tick borne encephalitis (65,2%/87,0%). Coverage with measles containing vaccine (MCV) varied for no dose (4,9%/34,0%), first dose (95,1%/66,0%) and two doses MCV (89,2%/55,1%)

MCV coverage among Waldorf children had a calculable impact on state wide MCV coverage (94,7%)

Estimating the immunization coverage among children aged four to five years for Waldorf kindergartens

Low immunization coverage among children in Waldorf kindergartens continues to be a risk indicator for outbreaks of vaccine preventable diseases

Brennan, J.M., Bednarczyk, R.A., Richards, J.L., Allen, K.E., Warraich, G.J. and Omer, S.B., 2017. Trends in personal belief exemption rates among alternative private schools: Waldorf, Montessori, and holistic kindergartens in California, 2000–2014. American journal of public health, 107(1), pp.108–112

USA

2017

Alternative schools had an average Personal Belief Exception (PBE) rate of 8.7%, compared with 2.1% among public schools. Waldorf schools had the highest average PBE rate of 45.1%, which was 19 times higher than in public schools (incidence rate ratio = 19.1; 95% confidence interval = 16.4, 22.2)

Montessori and holistic schools had the highest average annual increases in PBE rates, slightly higher than Waldorf schools (Montessori: 8.8%; holistic: 7.1%; Waldorf: 3.6%)

To evaluate trends in rates of personal belief exemptions (PBEs) to immunization requirements at private kindergartens in California that practice alternative educational methods

Waldorf schools had exceptionally high average PBE rates

Klomp, J.H., van Lier, A. and Ruijs, W.L., 2015. Vaccination coverage for measles, mumps and rubella in anthroposophical schools in Gelderland, The Netherlands. The European Journal of Public Health, 25(3), pp.501–505

The Netherlands

2015

The mean self-reported MMR vaccination coverage in 2012: 83% (95% CI: 79–86%), individual schools (range 45–100%)

in anthroposophical schools in 2014 was 78% (95%CI: 77–80%) and varied less (range 59–88%)

Assess the MMR vaccination coverage in 11 anthroposophical schools in Gelderland, The Netherlands

Social clustering of unvaccinated children in anthroposophical schools remains a public health challenge

Van der Wal, M.F., Diepenmaat, A.C.M., Pel, J.M. and Hirasing, R.A., 2005. Vaccination rates in a multicultural population. Archives of disease in childhood, 90(1), pp.36–40

The Netherlands

2005

The vaccination rates for children between age 5–12 living in Amsterdam in 2003 in the various districts ranged between 79.0% and 99.4% for DPTP and 81.9% and 98.4% for MMR

High proportion (28%) of children attending anthroposophic schools who are not MMR vaccinated

To establish whether there are social or cultural groups of children in Amsterdam with relatively low vaccination coverage for (DPTP), (MMR)

Children who attended anthroposophical schools were found to be considerably less frequently fully immunised than those at other types of schools

Van der Wal, M.F., Diepenmaat, A.C., Pauw-Plomp, H. and van Weert-Waltman, M.L., 2001. High vaccination rates among children of Amsterdam. Nederlands Tijdschrift Voor Geneeskunde, 145(3), pp.131–135

The Netherlands

2001

Children who visited anthroposophical schools were considerably less immunized compared with children visiting other schools: for DPTP and MMR 81.0 and 59.9% respectively versus 94.4, 95.3% for children attending general municipal schools

To examine if in Amsterdam there are social or cultural groups of children with a relatively low vaccination coverage for diphtheria, pertussis, tetanus and poliomyelitis (DPTP) and mumps, measles and rubella (MMR)

Children who visited anthroposophical schools were considerably less immunized compared with children visiting other schools

Mollema L, Wijers N, Hahné SJ, van der Klis FR, Boshuizen HC, de Melker HE. Participation in and attitude towards the national immunization program in the Netherlands: data from population-based questionnaires. BMC public health. 2012 Dec;12(1):1–3

The Netherlands

2013

Ethnicity, religion, income, educational level and anthroposophic beliefs were important determinants of nonparticipation in the NIP

The aim of this study was to determine which factors were associated with nonparticipation in the NIP and which ones were associated with parents' intention to accept remaining vaccinations

Quantitative (n = 458)

Groups with a lower income or educational level or of non-Western descent participated less in the NIP than those with a high income or educational level or indigenous Dutch and have been less well identified previously. Particular attention ought to be given to these groups as they contribute in large measure to the rate of nonparticipation in the NIP, i.e., to a greater extent than well-known vaccine refusers such as specific religious groups and anthroposophics

Zuzak TJ, Zuzak-Siegrist I, Rist L, Staubli G, Simões-Wüst AP. Attitudes towards vaccination: users of complementary and alternative medicine versus non-users. Swiss medical weekly. 2008;138(47–48):713–8

Switzerland

2008

Refusal of basic vaccination was significantly more frequent among CAM (Complementary and Alternative Medicine)-users than among non-users (18.2% versus 3.5%, p (18.2% versus 3.5%, p < 0.001). The highest frequencies of refusal were reported by patients who consulted physicians practicing herbal medicine, anthroposophical medicine or homeopathy. Users and non-users of CAM however, showed comparable rates of immunisation in the case of the vaccinations against invasive meningococcal, pneumococcal disease and flu. Surprisingly, the rate for vaccination against tick-borne encephalitis was higher in the CAM-users group than among the non-users (21.2% versus 15.4%, p

To understand parental decisions behind basic vaccination refusal

(n = 1158)

Refusal of basic vaccination was significantly more frequent among CAM (Complementary and Alternative Medicine)-users than among non-users. CAM users reported high tick-borne encephalitis vaccine choices