December 14, 2025
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Trump Officers Preserve Evaluating the U.S.’s Vaccine Schedule to Denmark’s. They’re Lacking the Level
The U.S.’s and Denmark’s well being programs are starkly totally different, so it is sensible that their vaccination schedules would differ, too
Dado Daniela by way of Getty Pictures
At a controversial assembly of the U.S. Facilities for Illness Management and Prevention’s vaccine advisory panel not too long ago, members voted to take away a long-standing suggestion that every one infants get a primary dose of the hepatitis B vaccine at beginning. Public well being specialists derided the transfer, which matches in opposition to proof that the shot is secure and efficient. Members of the CDC’s Advisory Committee on Immunization Practices (ACIP) and company officers cited a curious rationale for the change: a must align the U.S.’s vaccine schedule with Denmark’s.
Shortly after the assembly, President Donald Trump ordered the CDC to fast-track a overview of the U.S. vaccination schedule to align with that of different “peer, developed nations,” together with Denmark. However there’s one thing rotten on this comparability.
The U.S. and Denmark have starkly totally different populations, illness charges and well being care programs. It is sensible that they’ve totally different vaccination insurance policies.
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“The USA is just not Denmark,” says Katelyn Jetelina, an epidemiologist who writes a preferred well being publication and who beforehand suggested the CDC on its COVID coverage. “The well being care and security internet system of the USA is drastically totally different than different high-income nations world wide. We should always anticipate country-level coverage selections to range.”
The U.S. has greater than 340 million folks; Denmark’s inhabitants is a bit more than six million. Denmark can also be far more demographically and economically homogenous than the U.S. And the nations have totally different burdens of illness.
Take hepatitis B—there have been 99 new circumstances of power hepatitis B in Denmark in 2023, in contrast with greater than 17,000 new circumstances within the U.S. Denmark additionally screens virtually each single pregnant individual for the illness, and most of those that check constructive obtain remedy. Within the U.S., about 85 p.c of pregnant individuals are screened, and plenty of by no means get remedy. Hepatitis B is a liver an infection, and whether it is left untreated and turns into power, it may result in cirrhosis, liver most cancers and loss of life.
The U.S. and Danish well being care programs are incomparable. Apart from Medicare and Medicaid, the U.S. system operates largely on privately funded insurance coverage. Denmark has a common well being system that’s paid for by the federal government, and all residents have entry to free care. The CDC’s advisory panel made no point out of this distinction throughout its latest assembly, and the Trump administration has no urge for food for a common well being care system within the U.S.
“Managing and following a small inhabitants with common well being care is far totally different than an unlimited inhabitants with a number of supply programs and a number of payers,” says Kathryn Edwards, a professor of pediatrics at Vanderbilt College Medical Middle. It’s “like evaluating apples and oranges.”
Jetelina concurs. In Denmark, individuals are much less prone to fall by means of the cracks of their well being system, she says, whereas the U.S. has a “very totally different well being care capability, and we do not have a security internet.”
A consequence of common well being care programs is that nations like Denmark are additionally extra probably than the U.S. to take cost-effectiveness into consideration when deciding which vaccines to advocate and to whom. Though offering vaccines is usually far cheaper than treating a illness, it nonetheless prices cash. For instance, within the U.Ok., which additionally has state-funded common well being care, flu vaccines aren’t routinely really helpful for youngsters as a result of the photographs are less expensive in older adults. Comparable logic might clarify why the hepatitis B vaccine isn’t universally given at beginning in Denmark.
Numerous the dialogue on the December 5 ACIP assembly centered on hypothetical dangers from the hepatitis B vaccine in infants born to individuals who check adverse for the illness; there was little or no emphasis on the societal advantages of widespread vaccination.
In the case of concentrating on vaccination solely to people born to folks who’re recognized to have hepatitis B, Jetelina says, “we’ve examined this earlier than.” Previous to 1991, the U.S. tried to vaccinate solely folks at excessive threat for hepatitis B. “Even when moms screened adverse for hep B and the beginning dose was withheld, hundreds of kids did find yourself contaminated by way of one other member of the family,” she says. In distinction, after ACIP really helpful a common beginning dose in 1991, circumstances declined dramatically: in youngsters, teenagers and younger adults as much as age 19, circumstances of acute hepatitis dropped by 99 p.c from 1990 to 2019.
The push to change the U.S. hepatitis B vaccine suggestion suits right into a broader effort by the Trump administration and plenty of Republican lawmakers to prioritize particular person freedoms over collective motion. But sturdy public well being programs—and vaccination particularly—depend on collective motion to guard those that can’t defend themselves, reminiscent of immune-suppressed folks, older adults and younger infants.
“I’m involved about that,” Jetelina says. “If we land an excessive amount of on individualism, ailments are going to return again.”
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