Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.
Department of Global Health and Development, London School of Hygiene and Tropical, London, UK.
BMC Public Health. 2023 Nov 13;23(1):2238. doi: 10.1186/s12889-023-17081-w.
Due to low vaccination uptake and measles outbreaks across Europe, public health authorities have paid increasing attention to anthroposophic communities. Public media outlets have further described these communities as vaccine refusers or "anti-vaxxers". The aim of this review was to understand the scope of the problem and explore assumptions about vaccination beliefs in anthroposophic communities. For the purpose of this review, we define anthroposophic communities as people following some/certain views more or less loosely connected to the philosophies of anthroposophy. The systematic review addresses three research questions and (1) collates evidence documenting outbreaks linked to anthroposophic communities, (2) literature on vaccination coverage in anthroposophic communities, and (3) lastly describes literature that summarizes theories and factors influencing vaccine decision-making in anthroposophic communities.
This is a systematic review using the following databases: Medline, Web of Science, Psycinfo, and CINAHL. Double-blinded article screening was conducted by two researchers. Data was summarized to address the research questions. For the qualitative research question the data was analysed using thematic analysis with the assistance of Nvivo12.0.
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 coverage in low-income communities with a migrant background was lower than in 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 and lack of trust in the system. Thirdly, there was a strong notion of the importance of making individual and well-informed choices as opposed to simply following the masses. Lastly, making vaccine choices different from public health guidelines was highly stigmatized by those outside of the anthroposophic community but also those within the community.
Continuing to further knowledge of vaccine beliefs in anthroposophic communities is particularly important in view of increasing measles rates and potential sudden reliance on vaccines for emerging diseases. However, popular assumptions about vaccine beliefs in anthroposophic communities are challenged by the data presented in this systematic review.
由于欧洲各地疫苗接种率低和麻疹爆发，公共卫生当局越来越关注人智学社区。大众媒体进一步将这些社区描述为疫苗拒绝者或“反疫苗接种者”。本研究的目的是了解问题的范围，并探讨人智学社区中与疫苗接种相关的假设。出于本研究的目的，我们将人智学社区定义为或多或少遵循与人智学哲学相关的某些/某些观点的人。系统评价解决了三个研究问题，（1）整理记录与人智学社区相关的暴发的证据，（2）关于人智学社区疫苗接种率的文献，以及（3）最后描述总结人智学社区中疫苗决策的理论和因素的文献。
这是一项系统评价，使用以下数据库：Medline、Web of Science、Psycinfo 和 CINAHL。两名研究人员进行了双盲文章筛选。数据汇总以解决研究问题。对于定性研究问题，使用主题分析方法并在 Nvivo12.0 的协助下对数据进行分析。
在 2000 年至 2012 年间，有 12 篇文章记录了 18 起与人智学社区相关的麻疹暴发。有 7 篇文章描述了人智学社区的疫苗接种率低于其他社区，尽管有一篇文章描述了低收入社区和移民背景社区的疫苗接种率低于他们所研究的人智学社区。我们发现了 8 篇文章，这些文章研究了影响人智学社区疫苗决策的因素和理论。定性分析揭示了四个共同的主题。首先，人智学社区中存在着非常广泛的疫苗信念。其次，存在一种关于疫苗问题或担忧的一致说法，包括毒性和对系统的不信任。第三，有一种强烈的观念认为，做出个人和明智的选择比简单地随大流更为重要。最后，与公共卫生指南相比，做出不同的疫苗选择在人智学社区之外的人甚至在社区内部也受到强烈的污名化。
鉴于麻疹发病率不断上升，以及潜在的新兴疾病突然依赖疫苗，继续深入了解人智学社区中的疫苗信念尤其重要。然而，本系统评价中呈现的数据挑战了关于人智学社区中疫苗信念的普遍假设。
