MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

vaccination

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The Amercian Medical Association (AMA) recently published a lengthy article on naturopathy in the US. Here are some excerpts:

There are three types of health professionals who offer naturopathic treatment:

  • Naturopathic doctors. These nonphysicians graduate from a four-year, professional-level program at an accredited naturopathic medical school, earning either the doctor of naturopathy (ND) degree or the doctor of naturopathic medicine (NMD) degree.
  • Traditional naturopaths, who have obtained education through some combination of a mentorship program with another professional or at an alternative clinic, distance-learning program or classroom schooling on natural health, or other holistic studies.
  • Other health professionals such as chiropractors, massage therapists, dentists, nurses, nutritionists, or physicians who practice under a professional license but include some naturopathic methods in their practice and who may have studied on their own or taken courses on naturopathic methods.

At least 24 states and the District of Columbia regulate the practice of naturopathy. In order to be licensed, naturopaths in these states must earn an ND or NMD from an accredited naturopathic program and pass the Naturopathic Physicians Licensing Exam. Three states—Florida, South Carolina and Tennessee—prohibit the practice of naturopathy. In states that neither license nor prohibit the practice of naturopathy, traditional naturopaths and NDs alike may practice without being subject to state regulation.

Postgraduate training is neither common nor required of graduates of naturopathic schools, except in Utah … less than 10% of naturopaths participate in an approved residency, and such residencies last only a year and lack a high degree of standardization.

… naturopaths are required to get at least 1,200 hours of direct patient contact, physicians get 12,000–16,000 hours of clinical training…

ND programs emphasize naturopathic principes—for example, the healing power of nature—and naturopathic therapeutics such as botanical medicine, homeopoathy and hydrotherapy. Coursework in naturopathic therapeutics is combined with, and taught alongside, coursework in sciences. But there are no specifications around the number of hours required in each area … naturopathic students may lack exposure to key clinical scenarios in the course of their training … naturopathic students’ clinical experience is typically gained through outpatient health care clinics, as naturopathic medical schools typically do not have significant hospital affiliation. This means there is no guarantee that a naturopathic student completing a clinical rotation will see patients who are actually sick or hospitalized, and they may not be exposed to infants, children, adolescents or the elderly. It has been said that naturopaths tend to treat the “worried well.”

… Naturopaths claim they are trained as primary care providers and, as such, are educated and trained to diagnose, manage and treat many conditions, including bloodstream infections, heart disease and autoimmune disorders. Yet their education and training falls several years and thousands of hours short of what physicians get.

…The AMA believes it is the responsibility of policymakers to ensure that naturopaths’ claims that they can treat a broad range of conditions are backed by facts—facts that include the specific education and training necessary to ensure patient safety.

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The AMA is clearly cautious here. A less polite statement might simply stress that naturopaths are taught a lot of nonsense which they later tend to administer to their unsuspecting patients. On this blog, we have repeatedly discussed the danger naturopaths present to public health in the US and elsewhere, e.g.:

Claims that naturopaths are a viable alternative to evidence-based medicine are wrong, irresponsible and dangerous. Regulators must be reminded that they have the duty to protect the public from charlatans and should therefore ensure that no false therapeutic or diagnostic claims can be made by naturopaths.

The so-called ‘Miracle Mineral Solution’ (MMS) – bleach for you and me – is a SCAM that keeps on giving. On this blog, we have featured MMS several times before, e.g.:

Now,it has been reported that a New Zealand anti-vaxxer has been jailed for selling more than $100,000 worth of an industrial bleach as a “miracle” cure for Covid-19. Roger Blake, who describes himself as a “human man”, was sentenced to just over 10 months’ imprisonment after being found guilty at trial of 29 charges in the Hamilton District Court.

Blake advertised and sold MMS products, claiming it could treat, prevent and cure coronavirus. However, New Zealand’s Ministry of Health had not approved the product, and detailed that when ingested became chlorine dioxide – a bleach commonly used for water treatment, bleaching textiles and paper.

The court heard Blake had marketed the product as a cure in New Zealand from the start of the pandemic between December 2019 and December 2020. Medsafe, the health ministry’s safety authority, said Blake’s company had sales of NZ$160,000 in that period – with sales spiking in March when the country was placed in lockdown.

Judge Brett Crowley said Blake’s behaviour had been “utterly disgraceful”. He added that Blake had “seized upon the tragedy” of the pandemic for financial gain. Before selling MMS as a “cure” for the coronavirus, Blake had marketed the product as a preventive of other diseases and illnesses such as cancer, Alzheimer’s, diabetes and HIV.

Medsafe prosecuted him under the Medicines Act, with compliance manager Derek Fitzgerald saying the “fake cure” Blake spruiked presented a “significant public health risk”. “He targeted the vulnerable, preyed on public fears and exposed people to harm”, he said. “This decision sends a strong message that people who engage in selling so called ‘miracle cures’ will be held to account and face fines or imprisonment.”

The website which sold MMS in New Zealand was registered to US-based Mark Grenon, who set up the “Genesis II Church of Health and Healing”. As reported previously, Grenon and his three sons were jailed in October for several years in the US for selling more than US$1m of the product. Michael Homer, an assistant US lawyer who prosecuted the case, said at the time the family targeted people suffering from life-threatening illnesses. The Grenons poisoned thousands of people with their bogus miracle cure, which was nothing more than industrial bleach,” he said.

Medsafe warns: “Drinking MMS is the same as drinking bleach and can cause dangerous side effects, including severe vomiting, diarrhoea, and life-threatening low blood pressure. We strongly encourage people to only go to trusted sources, such as your doctor, to get reliable information”.

Medsafe received three reports of people requiring hospitalizations after drinking MMS. “His conduct presented a significant risk to public health, and that is why Medsafe acted. His actions were in stark contrast to the requirements of the Medicines Act 1981, which is public welfare legislation designed to protect the public” said Mr Fitzgerald.

It has been reported that the New York State Department of Health has issued a $300,000 penalty as part of a Stipulation and Order signed by a Nassau County midwife who created false immunization records. Roughly 1,500 school-aged children from throughout the State are affected by the vaccine scheme, which has resulted in their immunization records being voided. All affected children must be fully up to date with all age-appropriate immunizations, or be in the process of receiving their missing vaccinations, before they can return to school.

“Misrepresenting or falsifying vaccine records puts lives in jeopardy and undermines the system that exists to protect public health,” State Health Commissioner Dr. James McDonald said. “Let it be clear, the New York State Department of Health takes this issue seriously and will investigate and use all enforcement tools at its disposal against those who have been found to have committed such violations.” State Education Commissioner Betty A. Rosa said: “By intentionally falsifying immunization records for students, this licensed health care professional not only endangered the health and safety of our school communities but also undermined public trust. We are pleased to have worked with our partners in government to bring this wrongdoer to justice. We remain committed to upholding the highest standards of health and well-being within our educational institutions.”

The vaccination scheme began at the start of the 2019-2020 school year, just three months after the June 2019 elimination of non-medical exemptions for required school immunizations. Breen supplied patients with the “Real Immunity Homeoprophylaxis Program,” a series of oral pellets marketed by an out-of-state homeopath as an alternative to vaccination. The homeopathic pellets are not authorized by the U.S. Food and Drug Administration (FDA) nor approved by the Centers for Disease Control and Prevention (CDC) or the Department as an immunizing agent against any disease.

Breen was found to have administered 12,449 fake ‘homeopathic’ immunizations to roughly 1,500 school-aged patients as pretext for submitting false information to the New York State Immunization Information System (NYSIIS). The agreed-upon settlement reached between the Department and Breen is the first of its kind addressing a scheme to create false immunization records. It includes a $300,000 monetary penalty and requires that Breen never again administer a vaccination that must be reported to NYSIIS. In addition, Breen is permanently excluded from accessing NYSIIS under any circumstances.

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We have discussed the absurd and dangerous idea of homeoparophylaxis several times before, e.g.:

Suffice to stress just this:

Homeoprophylaxis is a criminally stupid way to endanger lives!

Only a few years ago, measles – a potentially lethal disease – were deemed to be almost eradicated. Now we hear that, in the UK and the US, cases of measles have been rising again. The latest UK outbreaks are centered in the West Midlands and London. The UK Health Security Agency has thus declared a national incident after the outbreaks in the UK West Midlands. Health officials are encouraging people to have the measles, mumps and rubella (MMR) jab, after figures showed uptake at the lowest level for more than a decade.

I have long warned that the rise in measle cases is due to proponents of so-called alternative medicine (SCAM). Particularly implicated are:

  • doctors of anthroposophical medicine,
  • chiroparactors,
  • homeopaths,
  • naturopath,
  • other healthcare professionals who employ these methods.

A recent case seems to suggest that this is as true today as it was years ago.

A midwife in New York administered nearly 12,500 bogus homeopathic pellets to roughly 1,500 children in lieu of providing standard, life-saving vaccines, the New York State Department of Health reported yesterday. Jeanette Breen, a licensed midwife who operated Baldwin Midwifery in Nassau County, began providing the oral pellets to children around the start of the 2019–2020 school year, just three months after the state eliminated non-medical exemptions for standard school immunizations. She obtained the pellets from a homeopath outside New York and sold them as a series called the “Real Immunity Homeoprophylaxis Program.” The program falsely claimed to protect children against deadly infectious diseases covered by standard vaccination schedules, including diphtheria, tetanus, and pertussis (covered by the DTaP or Tdap vaccine); hepatitis B; measles, mumps and rubella (MMR vaccine); polio; chickenpox; meningococcal disease; Haemophilus influenzae disease (HiB); and pneumococcal diseases (PCV).

You might say that this is just one silly midwife, but I’m afraid you would be mistaken. Here is the very first websites that appeared today on my search for measles/alternative medicine:

Few studies have examined the effectiveness of specific homeopathic remedies. A professional homeopath, however, may recommend one or more of the following treatments for measles based on his or her knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person’s constitutional type, includes your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

    • Aconitum , for symptoms that come on suddenly including fever, conjunctivitis, dry cough, and restlessness. It is best used very early in the course of the disease.
    • Apis mellifica , for individuals with swollen lips and eyes and a rash that is not fully developed. Warmth increases itchiness as well as swelling.
    • Belladonna , can be used either during early stages of measles or after the rash has erupted. It is useful for those who have difficulty sleeping and symptoms that include fever, headache, and drowsiness.
    • Bryonia , for individuals with a delayed rash who have a dry, painful cough, headaches, and muscle pain that worsens with movement and warmth. This remedy is most appropriate for people with a rash primarily on the chest, a dry mouth, and a desire for cold drinks.
    • Euphrasia , for nasal discharge, red eyes, and tears associated with measles. This remedy is most appropriate for people who have a strong sensitivity to light.
    • Gelsemium , for the early stages of measles when there is a slow onset of fever and chilliness, cough, headache, weakness, and a watery nasal discharge that burns the upper lip. This remedy is most appropriate for people who are apathetic and have little or no thirst.
    • Pulsatilla , can be used at any stage of the measles but often used after fever has resolved. This remedy is most appropriate for people who may have thick, yellow nasal discharge, a dry cough at night, a productive cough in the daytime, and mild ear pain. Symptoms are frequently mild.
    • Sulphur , for measles in which the skin has a purplish appearance. The individual for whom this remedy is appropriate may have red mucus membranes with a cough and diarrhea that is worse in the mornings.

Similar nonsense can easily be found on ‘X’; here are but a few examples of the dangerous BS that fans of SCAM posted recently:

  • Measles are extremely mild, alternative medicine is better than petroleum-based drugs that don’t even promise to cure anything, and JK Rowling is a Christian.
  • 1. Can we now talk about the fact that MMR does not produce life long immunity? 2. Can we talk about the Hep A, tuberculosis and measles that are now community spread due to not vetting the health of illegals? 3. Can we finally discuss actual homeopathy remedies that work?
  • I so regret obeying our local school district and having my kids vaccinated. Homeopathy has SAFE medicines to prevent childhood illnesses such as chicken pox, measles, polio, small pox, etc, and more SAFE medicines to cure these illnesses. 
  • My kids had chicken pox and pertussis & covid. Cured all 3 with homeopathy. Never had measles.
  • How to Treatment of Measles with Dr.Reckweg R.No.62 Homeopathy Medicine

I think it is high time that:

  1. we realize that SCAM providers can be dangerous through the irresponsible advice they tend to give,
  2. we change their attitude through educating them adequately and, failing this, penalize them for endangering our health.

Proponents of so-called alternative medicine (SCAM) are often – as we had many opportunities to observe here on this blog – not impressed with the safety and efficacy of COVID vaccinations. This is despite the fact that several studies have demonstrated the huge number of lives saved by them, both at national and multi-country level in the earlier stages of the pandemic. I wonder whether the doubters will be convinced by new evidence.

This analysis estimates how many lives were directly saved by vaccinating adults against COVID in the Region, from December 2020 through March 2023.

The researchers estimated the number of lives directly saved by age-group, vaccine dose and circulating Variant of Concern (VOC) period, both regionally and nationally, using weekly data on COVID-19 mortality and COVID-19 vaccine uptake reported by 34 European areas and territories (CAT), and vaccine effectiveness (VE) data from the literature. They calculated the percentage reduction in the number of expected and reported deaths.

The authors found that vaccines reduced deaths by 57% overall (CAT range: 15% to 75%), representing ∼1.4 million lives saved in those aged ≥25 years (range: 0.7 million to 2.6 million): 96% of lives saved were aged ≥60 years and 52% were aged ≥80 years; first boosters saved 51%, and 67% were saved during the Omicron period.

The authors concluded that over nearly 2.5 years, most lives saved by COVID-19 vaccination were in older adults by first booster dose and during the Omicron period, reinforcing the importance of up-to-date vaccination among these most at-risk individuals. Further modelling work should evaluate indirect effects of vaccination and public health and social measures.

The authors feel that their results reinforce the importance of up-to-date COVID-19 vaccination, particularly among older age-groups. Communication campaigns supporting COVID-19 vaccination should stress the value of COVID-19 vaccination in saving lives to ensure vulnerable groups are up-to-date with vaccination ahead of periods of potential increased transmission.

Those SCAM proponents who are not convinced of the merits of COVID and other vaccinations will undoubtedly claim that this new analysis was biased and thus unreliable. Therefore, it seems worth stating that this work was supported by a US Centers for Disease Control cooperative agreement, who had no role in data analysis or interpretation. The authors affiliated with the World Health Organization (WHO) are alone responsible for the views expressed in this publication and they do not necessarily represent the decisions or policies of the WHO.

Patients are increasingly using and requesting so-called alternative medicine Medicine (SCAM), especially during the COVID-19 pandemic. However, it remains unclear whether they use SCAMs in conjunction with conventional medicine or to replace vaccination or other approaches and whether they discuss them with their physicians as part of shared decision-making. This study aimed to evaluate the use and initiation of SCAM during the COVID-19 pandemic, focusing on the association between SCAM-use and COVID-19 vaccination status.

It was a part of the longitudinal cohort of the CoviCare program, which follows all outpatients tested for COVID-19 at the Geneva University Hospitals. Outpatients tested for COVID-19 were contacted 12 months after their positive or negative test between April and December 2021. Participants were asked about their vaccination status and if they had used SCAM in the past 12 months. SCAM-use was defined based on a list of specific therapies from which participants could choose the options they had used. Logistic regression models adjusting for age, sex, education, profession, severe acute respiratory system coronavirus 2 (SARS-CoV-2) infection, and pre-existing conditions were used to evaluate the association between being unvaccinated and complementary medicine use. SARS-CoV-2 infection status was evaluated for effect modification in the association between being unvaccinated and complementary medicine use.

This study enrolled 12,246 individuals (participation proportion = 17.7%). Their mean age was 42.8 years, 59.4% were women, and 63.7% used SCAM. SCAM-use was higher in women, the middle-aged, and those with a higher education level, a SARS-CoV-2 infection, or pre-existing co-morbidities. A third of cases initiated SCAM as prevention against COVID-19. Being unvaccinated was associated with higher levels of SCAM-use (adjusted odds ratio [aOR] 1.22 [1.09–1.37]). SCAMs were frequently used for COVID-19 prevention (aOR 1.61 [1.22–2.12]). Being unvaccinated was associated with the use of several specific SCAMs:

  • zinc (OR 2.25 [1.98–2.55]),
  • vitamin D (OR 1.45 [1.30–1.62]),
  • vitamin C (OR 1.59 [1.42–1.78]).

Only 4% of participants discussed using SCAM with their primary care physicians.

The authors concluded that, while SCAM is increasingly used, it is rarely discussed with primary care physicians. SCAM-use, especially for COVID-19 prevention, is associated with COVID-19 vaccination status. Communication between physicians, patients, and SCAM therapists is encouraged to facilitate a truly holistic approach to making a shared decision based on the best available information.

This survey confirmed the findings of several previous investigations. It also shows that the terminologies often employed are inadequate:

  • alternative medicine: as it does not work, it cannot be an alternative;
  • complementary medicine: many patients do not use it to complement real medicine.

As I have explained many times, I thus find SCAM a much more appropriate term.

The last sentence of the authors conclusion is puzzeling. What can SCAM pratitioners contribute to a ‘truly holistic approach’ to decisions about vaccinations? I feel this sentence should be changed into something like the following:

Communication between physicians and patients should be encouraged.  To facilitate an effective approach to making shared decisions on vaccinations, SCAM practitioners should be excluded until they are able to convincingly demonstrate that their advice is based on sound evidence.

Carola Javid-Kistel is a German medical homeopath who states on her website that “homeopathy is a very powerful yet gentle medicine with no side effects, which accompanies me as a doctor for the rest of my life. Thanks to homeopathy, I was completely cured of my ailments…” (my translation).

She is famous in Germany – not so much for her devotion to homeopathy but for repeatedly breaking the law and evading justice.

Now, finally, the doctor from Duderstadt has been arrested. The Göttingen public prosecutor’s office confirmed that she was handed over to the German authorities by the Swiss judiciary in Constance. She has been charged with issuing false medical certificates for exemption from the obligation to wear a mask.

Carola Javid-Kistel has since been released from custody. As a condition, she had to pay 30,000 Euros bail and surrender her passport and identity card. She also had to report regularly to the Duderstadt police station.

According to the Göttingen public prosecutor’s office, the 57-year-old physician was arrested on arrival at Zurich airport. Javid-Kistel had fled to Mexico last year to avoid a criminal trial that had already been scheduled at the Duderstadt district court. She was due to stand trial there for issuing false certificates, among other things.

Further charges from the Göttingen public prosecutor’s office could include:

  • Incitement to hatred, defamation and insult.
  • At a rally in Herzberg, Javid-Kistel had claimed that the coronavirus measures were “worse than the Holocaust”.
  • She also accused a fellow doctor in a video of “vaccinating patients sick and to death”.
  • Furthermore, she is alleged to have said to police officers and officials during a search of her practice: “This is fascism, you’re all crazy.”

The date for her new trial has not yet been announced.

Sources:

Dr. med. Carola Javid-Kistel (naturheilpraxis-duderstadt.de)

Ärztin aus Duderstadt in der Schweiz festgenommen (aerzteblatt.de)

Flüchtige Corona-Leugnerin Carola Javid-Kistel gefasst | NDR.de – Nachrichten – Niedersachsen – Studio Braunschweig

On this blog, we had more than our fair share of comments from the anti-vax clan. This article asked a question that I have often been pondering:

How to convince the unvaccinated proportion of the population of the benefits of a vaccination?

Designing more successful communication strategies, both in retrospect and looking ahead, requires a differentiated understanding of the concerns of those that remain unvaccinated. Guided by the elaboration likelihood model, this paper has two objectives: First, it explores by means of a latent class analysis how unvaccinated individuals might be characterized by their attitudes towards COVID-19 vaccination. Second, the researchers investigate to what extent (i) varying types of evidence (none/anecdotal/statistical) can be employed by (ii) different types of communicators (scientists/politicians) to improve vaccination intentions across these subgroups. To address these questions, the authors conducted an original online survey experiment among 2145 unvaccinated respondents from Germany where a substantial population share remains unvaccinated.

The results suggest three different subgroups, which differ regarding their openness towards a COVID-19 vaccination:

  • vaccination opponents (N = 1184),
  • sceptics (N = 572)
  • those in principle receptive (N = 389) to be vaccinated.

On average, neither the provision of statistical nor anecdotal evidence increased the persuasiveness of information regarding the efficacy of a COVID-19 vaccine. However, scientists were, on average, more persuasive than politicians (relatively increase vaccination intentions by 0.184 standard deviations). With respect to heterogeneous treatment effects among the three subgroups, vaccination opponents seem largely unreachable, while sceptics value information by scientists, particularly if supported by anecdotal evidence (relatively increases intentions by 0.45 standard deviations). Receptives seem much more responsive to statistical evidence from politicians (relatively increases intentions by 0.38 standard deviations).

According to the authors, these insights suggest that, in the short term, receptives and sceptics are the most promising target groups for vaccination campaigns. Yet, in the medium term, opponents need not be forgotten. While mandatory vaccinations may appear as the only strategy to target strict vaccination opponents, politicians and researchers are advised to focus on ways how to rebuild trust and address beliefs in misinformation within this population group. The inconsistency in vaccine related communication has led to a loss of trust in political and scientific decision-makers. It is therefore important to rebuild this trust through evidence-based communication. The way we understand and perceive the credibility of a source significantly impacts our processing of messages and can also significantly affect related behaviours. Using evidence to validate relevant and reliable information can therefore also be vital to build trust and credibility in the vaccines themselves and their safety.

The authors concluded that our study employed sociopsychological theory to challenge the view of the existence of a single homogeneous group of unvaccinated citizens. By drawing on a large sample of unvaccinated citizens and combining latent class analysis with experimental methods, we encourage decision-makers to carefully consider heterogeneities in the effectiveness of their communication strategies, especially regarding their communicator and employed evidence type.

In many parts of the world, vaccination rates have been declining in recent years.

Why?

This study aimed to determine the rates and reasons for parental hesitancy or refusal of vaccination for their children in Türkiye. A total of 1100 participants selected from 26 regions of Türkiye were involved in this cross-sectional study conducted between July 2020 and April 2021. Using a questionnaire, the researchers collected data on:

  • the sociodemographic characteristics of parents,
  • the status of vaccine hesitancy or refusal for their children,
  • the reasons for the hesitancy or refusal.

Using Excel and SPSS version 22.0, they analysed the data with chi-square test, Fisher’s exact test and binomial logistic regression.

Only 9.4% of the participants were male and 29.5% were aged 33-37 years. Just over 11% said they were worried about childhood vaccination, mainly because of the chemicals used in manufacturing the vaccines. The level of concern was greater among those who:

  • got information about vaccines from the internet, family members, friends, TV, radio, and newspapers,
  • used so-called alternative medicine (SCAM).

The authors concluded that parents in Türkiye have several reasons for hesitating or refusing to vaccinate their children, key among which are concerns about the chemical composition of the vaccines and their ability to trigger negative health conditions such as autism. This study used a large sample size across Türkiye, although there were differences by region, the findings would be useful in designing interventions to counter vaccine hesitancy or refusal in the country.

The fact that SCAM users are more likely to be against vaccinations has been reported often and on this blog we have discussed such findings regularly, e.g.:

The questinon I ask myself is, what is the cause and what the effect? Does vaccination hesitancy cause people to use SCAM, or does SCAM use cause vaccination hesitancy? I think that most likely both is true. In addition the two are linked via a common trait, namely that of falling for conspiracy theories. We know that someone believeing in one such theory is likely to believe in other such notions as well. In my view, both vaccination heaitancy and SCAM can qualify to be called a conspiracy theory.

That proponents of anthroposophic medicine have strange attitudes towards established and effective immunizations is hardly a secret. The authors of this review defined anthroposophic communities as people following some/certain views more or less loosely connected to the philosophies of anthroposophy. Their systematic review firstly collated evidence documenting outbreaks linked to anthroposophic communities.

A total of 18 measles outbreaks occurred between 1997 and 2011 in European countries. Eight out of 18 measles outbreaks started at Waldorf schools throughout Germany, Switzerland, Austria, Netherlands, and the UK. Although data from community reporting was limited, the measles cases at Waldorf schools were predominantly higher than in mainstream private or state schools across the five countries. Offering measles vaccination catch-ups by public health authorities (which is an effective way to manage a measles outbreak) was described in several articles but was largely refused by both parents and Waldorf schools. The most effective outbreak control strategy was the immediate closure of the Waldorf school and strict rules regarding entry to the school upon reopening.

Secondly, the review summarized the literature on vaccination coverage in anthroposophic communities. Six articles described vaccine coverage in anthroposophic communities, and one article described the personal belief exception (PBE) rate at Waldorf school in the USA. The papers focussed predominantly on diphtheria, pertussis, tetanus and poliomyelitis (DPTP), and mumps, measles and rubella (MMR) vaccines. Two studies studying the vaccination coverage at Waldorf pre-schools/schools, demonstrated overall low immunization coverage at those schools. One article focusing on PBE rates demonstrated a proportionally high rate at Waldorf schools in California. Three studies from the Netherlands measure vaccination coverage in general and focussed specifically on whether there were special groups that showed specifically low coverage. In these studies, anthroposophic communities were identified as showing low coverage. However, one study suggested that anthroposophic communities are not as significant in terms of low coverage as low-income groups. One paper described rates of vaccination refusal in Switzerland. It showed that complementary alternative medicine users, including people who draw on anthroposophic medicine, are more likely to refuse vaccination. However, the paper also shows that this group was more likely to vaccinate against tick-borne diseases and encephalitis than the general population.

Thirdly, the review discussed the literature that summarized theories and factors influencing vaccine decision-making in anthroposophic communities. Eight articles examining factors and theories influencing vaccine decision-making in anthroposophic communities were included. Five articles focused on parents of children attending Waldorf schools or who considered themselves part of an anthroposophic community. Three articles focused on the perspectives of anthroposophic healthcare providers, although two of those articles mixed and compared views with other alternative/complementary providers or allopathic health providers. Of the eight articles, two were quantitative and did not provide an in-depth discussion. The qualitative findings from six articles were summarized in-depth and revealed four themes.

The authors concluded that this systematic review showed that there have been several measles outbreaks linked to anthroposophic communities in Europe. Although studies on vaccination coverage in anthroposophic communities are limited, it appears that coverage is lower than in the general population. Monitoring outbreak numbers and vaccination coverage could be important. Popular beliefs about the anthroposophic communities’ vaccination beliefs are challenged in this review. As the evidence shows the communities are not categorically against vaccines. Moreover, there are a myriad of factors that influence vaccine decision-making of parents belonging to an anthroposophic community. The importance of experiencing childhood illnesses and concerns over long-term side effects were mentioned. Moreover, parents want to be able to individually select vaccines for their children. They consider themselves actively engaged in vaccine decision-making and well-informed. Stigma regarding vaccine choices was mentioned repeatedly mostly by people outside of the anthroposophic community but also by people within the community. This review calls for a better understanding of vaccine choices and beliefs for vaccines beyond MMR, in particular HPV vaccines. The review also highlights a potentially important research gap, which constitutes understanding not only a belief system but the role that stigma may play in making decisions about vaccines.

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If you ask where this strange anti-vaccination stance of anthroposophic medicine comes from, you don’t need to look far:

“In the future, we will eliminate the soul with medicine.

Under the pretext of a ‘healthy point of view’, there will be a vaccine by which the human body will be treated as soon as possible directly at birth,
(1) so that the human being cannot develop the thought of the existence of soul and Spirit.

To materialistic doctors, will be entrusted with the task of removing the soul of humanity.

As today, people are vaccinated against this disease or disease, so in the future, children will
(2) be vaccinated with a substance that can be produced precisely in such a way that people, thanks to this vaccination, will be immune to being subjected to the “madness” of spiritual life.

He would be extremely smart, but he would not develop a conscience, and that is the
(3) true goal of some materialistic circles.

With such a vaccine, you can easily make the etheric body loose in the physical body.
Once the etheric body is detached, the relationship between the universe and the etheric body would become extremely unstable, and man would become
(4) an automaton, for the physical body of man must be polished on this Earth by spiritual will.

So, the vaccine becomes a kind of arymanique [Ahrimanic] force; man can no longer get rid of a given materialistic feeling.
(5) He becomes materialistic of constitution and can no longer rise to the spiritual “.

Rudolf Steiner 

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