The private schools stress nature, creative expression and hands-on learning but the 27 in the state have very low vaccination rates

On a rainy Saturday in May, small children in tall boots, wool caps and rain gear watched marionettes perform a fairytale in San Francisco’s Golden Gate park. The crowd had gathered to celebrate the 100th anniversary of Waldorf schools, the private schools that emphasize nature, creative expression and hands-on learning over tests and technology.

It was an enchanting scene with piglet puppets, waving stars and tinkling chimes. It may also have been the largest under-vaccinated group of children in the region.

As measles cases soar in the United States and doctors warn of under-vaccinated communities, attention has turned to low vaccination rates in California’s 27 Waldorf schools.

In California, which has more Waldorf schools than any other state, several of the schools had among the lowest vaccination rates last year. At the Sierra Waldorf school in California’s Gold Country, just 7% of kindergartners were fully vaccinated in the 2017-2018 school year, the lowest percentage of vaccinated kindergartners in the state, according to the state’s kindergarten immunization assessment. At the Berkeley Rose Waldorf school and the Marin Waldorf school, full vaccination rates were 29% and 22% respectively. Other California schools with low vaccination rates include Christian charter schools and charter schools for homeschoolers. The state’s average last year was 95%.

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California has some of the country’s strictest vaccination laws. Kindergartners are required to be vaccinated for polio; diphtheria, tetanus and pertussis; measles, mumps and rubella; hepatitis B and chickenpox. Kids are only allowed to enter school or daycare unvaccinated if they are medically exempt. And lawmakers in the state are seeking to tighten regulations around medical exemptions.

Only 4,000 medical exemptions were granted in California last year. Waldorf schools have some of the highest rates of medical exemptions in the state, including 37% of kindergarteners at the Waldorf school of Mendocino and 26% at Santa Cruz Waldorf school, statistics which do not include temporary medical exemptions.

“If [exemptions] were equally distributed, that wouldn’t be a problem,” said Dr. Paul Offit, professor of Vaccinology at the Perelman School of Medicine at the University of Pennsylvania, and author of Deadly Choices: “How the Anti-Vaccine Movement Threatens Us All.” Problems arise, he said, when there are pockets of un-immunized people. “It serves as fertile ground for a virus like measles to spread”, he said. He likened Waldorf schools to New York’s Ultra Orthodox Jewish community and the Somali communities in Minnesota, both of which had large unvaccinated populations and outbreaks of measles.

Waldorf schools, which are based on the philosophy of Austrian thinker Rudolf Steiner, teach cooperation over competition and a holistic approach to learning. Steiner, who died in 1925, was critical – though not invariably – of vaccinations specifically and medicine in general, arguing that they ignored the importance of human spirituality. In a 2019 statement, the International Center for Anthroposophic Medicine and the International Federation of Anthroposophic Medical Associations stressed that anthroposophic medicine, the form of medicine Steiner founded, “fully appreciates the contributions of vaccines to global health and firmly supports vaccinations as an important measure to prevent life threatening diseases.”

“They’re wonderful, cheerful, happy, play-based places to send a child to learn and grow and be fostered and loved, but they’re actually a place where your child will be at risk,” Leah Russin, director of Vaccinate California, a not-for-profit advocacy group, told the Guardian. “There are other schools with low vaccination rates,” she said, but Waldorf schools “share a common philosophy that does not support vaccinations”.

Waldorf officials say Steiner’s medical theories are not taught at their schools, and that the schools abide by the law. “There is no controversy. We follow the law. We’re in compliance,” said Megan Neale, the director of Marin Waldorf school in northern California.

“Schools do not get involved in or influence medical decisions of parents,” said Beverly Amico, executive director for advancement of the Association of Waldorf Schools of North America.

Amico said skepticism towards vaccines was not specific to a Waldorf education, but to some of the families the schools attract. “My assumption, having been in the community a long time, is that our parents tend to really educate themselves and seek healthcare alternatives,” she said.

In a dozen interviews with parents from six California Waldorf schools, only one parent in passing expressed concern that vaccines could trigger autism – a debunked, yet popular argument among anti-vaxx groups. But several linked vaccinations to autoimmune diseases, allergies and asthma. And all parents who opposed mandatory vaccinations said they distrusted big medicine, science and the government.

Waldorf families often “choose natural remedies, eat wholesome, organic food and prioritize good health in the natural world”, said Ashley Schaeffer Yildiz, a parent at Berkeley Rose Waldorf school. “Vaccines are quintessentially the antithesis to all that,” she argued.

“I have a very intense history of autoimmune diseases in my family,” she said. “I easily got medical exemptions for my kids.” She added: “For me, it’s really about the pharmaceutical companies profiting. They don’t have the best interests of our children’s wellbeing.”

“I don’t fear measles, I fear vaccines,” said one Sierra Waldorf mother, who was uncomfortable discussing her vaccination choices in public and asked to remain anonymous. Several months after she vaccinated her daughter, the child developed asthma and severe eczema. The child’s father has asthma, but the mother said she was convinced that “elevated toxins from the vaccine” suppressed her daughter’s immune system, causing her illness.

Doctors said there was no scientific evidence linking childhood vaccines with autoimmune diseases or asthma.

We don't know how to combat this. We used to be able to tell people: 'This is science' Dr Yvonne Maldonado

Jennifer Schmid, a nurse whose three children attended Waldorf school in Silicon Valley, blogs about wellness topics including vaccinations and what she believes are its harmful effects from injecting babies with “bio-hazardous chemicals and diseases”.

She distrusts the science, she said, because “all the studies are industry-funded”.

“We don’t know how to combat this,” said Dr Yvonne Maldonado, chairwoman of the American Academy of Pediatrics committee on infectious diseases and a professor at Stanford School of Medicine. “We used to be able to tell people: ‘This is science.’

“They don’t see the diseases so they don’t think it’s a risk to their child,” she said of parents who doubt the need for vaccines.

Abhijit Ghosh, a computer scientist, loves that his second-grade daughter attends San Francisco’s Golden Bridges Waldorf school and can identify flowers, weeds and trees. But he has seen the effects of measles firsthand and knows the risks. In India, where he was born, “if you don’t vaccinate, your chance of dying or being crippled is high. Vaccination is not an option. It’s a matter of survival.” Ghosh sees the skepticism “as a typical first-world, privileged people’s problem”.

“The modern anti-vaccination movement is largely white, educated and privileged,” said Vaccinate California’s Russin. “And that’s who goes to Waldorf schools.”

“The larger problem is that our model of medicine has changed. It used to be that doctors were godlike,” said Dr Daniel Salmon, director of the Johns Hopkins Institute for Vaccine Safety. Salmon said it was good that parents were now more involved in decision-making but the abundance of misinformation online had made it hard for many to separate fact from fiction. For example, he noted, parents seeking information must distinguish between the American Academy of Pediatrics and the American Academy of Family Physicians, which are mainstream medical organizations, and the American Association of Physicians and Surgeons. The latter, a small, conservative organization that publishes articles claiming federal involvement in medical care is un-American and that HIV does not cause Aids, was “full of misinformation and opposes mandatory vaccinations”, Salmon said.

Many families who do believe in vaccinations send their children to Waldorf schools, balancing their appreciation for the schools’ methods with the medical risks for their families and the community. “It’s a matter of weighing risk and benefit,” said Khori Dastoor, whose child attends the Berkeley Rose Waldorf school. Dastoor values the “loving, nature-based, whole-child approach” her child was receiving, compared with the approach of traditional preschools, which she and her husband find overly academic, too dependent on devices and synthetic materials, and overly stimulating. “For us, the minimal risk was worth the immense benefit of keeping her in the program,” she said.

Before the measles vaccine became available in 1963, there were at least 500,000 reports of measles annually, though many more cases went unreported, according to the CDC. At least 500 of those cases were fatal.

Last year, 82,596 people contracted measles in Europe and 72 children and adults died. It is highly contagious and can be spread by a sneeze, cough or breathing. Someone entering a room two hours after an infected person has left can become infected.

Decisions parents make can have implications far beyond their own family, especially for babies and people with compromised immune systems. To eradicate measles, 95% of the population must be immunized.

“Ten percent of children with measles will get ear infections which can result in permanent hearing loss. One of 20 children with measles will get pneumonia, one in 1,000 children will get encephalitis, and one to two per 1,000 children with measles will die,” Salmon said.

The Los Angeles pediatrician Edmond Sarraf, who is part of Physicians for Informed Consent, a group that energetically opposes mandatory vaccinations, has some Waldorf children in his practice.

Sarraf supports medical exemptions for “medically injured and fragile children” and argues that concerns about low vaccination rates endangering society are overblown.

He claimed there had not been any large outbreaks in less-vaccinated schools and downplayed recent measles cases at ultra-Orthodox Jewish schools in New York. “The morbidity and mortality is very low,” he said about the ultra-Orthodox schools.

He sees no reason to worry about schools with low vaccination rates. “We haven’t had any problems,” he said, “What are we worried about?”

Maldonado, the Stanford professor, argued there was a lot to worry about. “We used to see one death every week from vaccine-preventable diseases. We don’t see that any more,” she said. “Why would you do that to your child?”

Many California lawmakers appear to share her concern. On Wednesday, the state senate passed a bill requiring medical exemptions granted by physicians to be reviewed by a state board.

At a hearing this spring, the state senator Richard Pan, a pediatrician and the author of the bill, said the legislation was designed to weed out fake medical exemptions and protect society. “The ultra-low vaccination rates at schools including Waldorf schools are the tinder for a disease wildfire that is just waiting to be ignited and cause harm to students, teachers, staff and the surrounding communities. California cannot allow a handful of unethical physicians to take advantage of misinformed parents by selling them fake medical exemptions.”

The bill is now headed for a vote in the state assembly.