Why do experts say Denmark is not a model for US vaccine policy?

The Trump administration wants to revise U.S. childhood vaccination recommendations to bring them in line with those of some other allied nations, including a small country in northern Europe.

Should ISA model its vaccine policy after Denmark?Experts say we have nothing in common

Health Secretary Robert F. Kennedy Jr., a long-time opponent of vaccines, has made it clear that he believes American children are getting too many vaccines.

Earlier this month, President Trump issued a memorandum directing Kennedy and the acting director of the CDC to better align the United States with child vaccination recommendations from partner countries, and he specifically mentioned Denmark.This could mean fewer shots and fewer infections.

But critics say you can't follow another country's vaccination schedule in the U.S., which has a different population and different health risks.

"It's like putting a nail in a round hole when our goal is to prevent disease," says Josh Michaud, KFF's deputy director of global and public affairs.

Denma's message will always keep all children 10.Ma U.S

But Denmark created its immunization schedule in a very different context than the United States, says Dr. Sean O'Leary, chairman of the Committee on Infectious Diseases of the American Academy of Pediatrics.

"It's like comparing a cruise ship to a kayak," said O'Leary, a professor of pediatrics and infectious diseases at the University of Colorado School of Medicine.

Different populations, different health systems

For starters, Denmark's population is about 6 million people—roughly the size of Wisconsin—and the more than 343 million people in the U.S. Denmark also lacks the racial and ethnic diversity and wide income disparities that exist in the U.S. Denmark also has a highly integrated health care system, with national health care that covers everyone from birth to a primary health registry.

"And so if there are outbreaks or diseases like that, they can easily identify them," says Michaud."They can treat them, take care of them and trace contacts if that's necessary for the specific disease we're talking about."

In addition, Danish families get a year of parental leave - between both parents - so that they can stay at home with their children, apparently not affected by many illnesses.In addition, Denmark has free public health care.So, for example, if a newborn is hospitalized with RSV - a disease that Denmark does not usually vaccinate but the US does - this system will cover the cost, so it is not a barrier to care.

This is the U.S.In stark contrast, many here struggle to access health care, says Dr. Jack Scott, an infectious disease specialist at Stanford University School of Medicine.

"We have fragmented insurance, we have millions of uninsured, we don't have a national health registry, and we have huge gaps in the continuum of care," says Scott."And we use broader vaccine recommendations because our system cannot reliably identify and track every person at risk."

satisfy me

"What diseases do they want to bring back?"

All of these complex differences have led the United States to develop a different immune system than Denmark, one that emphasizes disease prevention rather than management, said Dr. William Moss, a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health and director of the school's Center for Global Vaccine Access.

"The reason countries, especially Europe, have different vaccination programs is not because they think vaccines are unsafe or because vaccines don't work," Moss said."I think it's really important for people to understand that."

America's retroactive vaccine scandal to the Danish model in this very different context puts America's children at serious risk, says O'Leary.

Which country is better?

In his presidential memorandum, Trump called the United States "beyond the number of vaccines recommended for all children" compared to neighboring countries.

But when you look at the 30 countries that are part of the European Center for Disease Prevention and Control, the American KFF's Michaud says they are very consistent.

"In fact, Denmark seems to stand out here in terms of recommending very few vaccines," he said."In the case of Germany, France and Italy, we are probably talking about 15 or more vaccines."

Even compared to other Nordic countries with similar health systems, Denmark is "simple," Stanford's Scott said.“Sweden, Norway, Finland – they all cover a lot of diseases.”

It's unclear what Kennedy will do next.The Department of Health and Human Services announced last Thursday that it will issue a "Children's Health Notice" with the CDC.But the HHS briefing was canceled an hour later.According to the media, the administration had ordered changes to the children's vaccination program.HHS spokesman Andrew Nixon declined to comment.

In an email to the media, HHS said the announcement has been delayed until the first of the new year.

Experts say it is legally unclear whether the health secretary can revise vaccine policy simply by announcing it at a press conference, without going through the normal process of debating such changes.

Kennedy technically has broad authority to set vaccination policy, said Dorit Reiss, a law professor at the University of California, San Francisco whose research focuses on legal and policy issues related to vaccines.But simply announcing such a major change at a press conference — instead of going to the CDC's Advisory Committee on Immunization Practices — could open the Trump administration to legal challenges, he said.

"This process makes them very vulnerable to legal challenges," says the director.