Guards march within the courtyard of Fredensborg Palace in Denmark. The northern European nation of round 6 million folks has been advised as a mannequin for U.S. childhood vaccination coverage.

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Scott Barbour/Getty Photos Europe/Getty Photos

Well being Secretary Robert F. Kennedy Jr., a long-time vaccine critic, has made it clear he thinks American kids get too many vaccines.

Earlier this month, President Trump issued a memorandum directing Kennedy and the performing director of the CDC to align the U.S. with finest practices on childhood vaccine suggestions from peer nations, and it particularly talked about Denmark. That would imply fewer photographs towards fewer illnesses.

However critics say you may’t merely undertake one other nation’s vaccine schedule within the U.S., which has a really totally different inhabitants and totally different well being dangers.

“It is like becoming a sq. peg in a spherical gap when our purpose is to stop illness,” says Josh Michaud, affiliate director for international and public well being coverage at KFF.

Denmark recommends routinely vaccinating all kids towards simply 10 illnesses. Within the U.S., the immunization schedule requires routine common vaccination towards 16 illnesses. It was 17 illnesses till final week, when the Facilities for Illness Management and Prevention formally dropped the advice to vaccinate all newborns towards hepatitis B.

However Denmark has created its immunization schedule in a really totally different context than that of the U.S., notes Dr. Sean O’Leary, chair of the Committee on Infectious Ailments for the American Academy of Pediatrics.

“It is like evaluating a cruise ship to a kayak,” says O’Leary, a professor of pediatrics and infectious illnesses on the College of Colorado College of Drugs.

Completely different populations, totally different well being programs

For starters, Denmark’s inhabitants is about 6 million folks – roughly that of Wisconsin – in comparison with greater than 343 million folks within the U.S. Denmark additionally lacks the racial and ethnic range and large revenue disparities which might be prevalent within the U.S. Denmark additionally has a extremely unified well being system, with a nationwide well being registry that principally tracks everybody from start to demise, Michaud says.

“And so if there are outbreaks or if there are circumstances of those illnesses, they will simply establish them,” Michaud says. “They’ll deal with them, get them into care, and in addition observe down contacts, if that is wanted for the actual illness we’re speaking about.”

What’s extra, Danish households get a few 12 months of paid parental go away — between the 2 dad and mom — to allow them to keep dwelling with their infants, who doubtlessly aren’t uncovered to as many illnesses. Plus, Denmark has free, common well being care. So for instance, if an toddler is hospitalized with RSV – a illness which Denmark doesn’t routinely vaccinate towards however the U.S. does – then the system will take in the associated fee, so it isn’t a barrier to getting care.

That is very totally different from the U.S., the place many individuals wrestle to entry well being care, says Dr. Jake Scott, an infectious illness specialist at Stanford College College of Drugs.

“Now we have fragmented insurance coverage, we have got hundreds of thousands uninsured, we do not have a nationwide well being registry and we have got huge gaps within the continuity of care,” Scott says. “And we use broader vaccine suggestions as a result of our system cannot reliably establish and observe up with each individual in danger.”

The U.S. additionally has larger charges of childhood weight problems and bronchial asthma than Denmark, Scott notes, which places these youngsters at larger threat of some illnesses.

“What illnesses do they need to convey again?”

All of those advanced variations have led the U.S. to create a distinct immunization schedule than Denmark’s – one which places a better emphasis on illness prevention fairly than administration, says Dr. William Moss, an epidemiology professor on the Johns Hopkins Bloomberg College of Public Well being and director of the varsity’s Worldwide Vaccine Entry Heart.

“The rationale why international locations, notably in Europe, have totally different vaccination schedules just isn’t as a result of they take into account the vaccines to not be secure or that the vaccines do not work,” Moss says. And I believe it is crucial that folks perceive that.”

Scaling again America’s vaccine schedule to mannequin Denmark’s on this very totally different context places America’s kids at actual threat, O’Leary says. “It is like, what illnesses do they need to convey again to the U.S.? Which illnesses do they need youngsters to be hospitalized for that they don’t seem to be shielded from? I merely do not get it.”

Which nation is the outlier?

In his presidential memo, Trump referred to as the U.S. “a excessive outlier within the variety of vaccinations beneficial for all kids” in comparison with peer international locations.

However whenever you take a look at the 30 international locations which might be a part of the European Heart for Illness Prevention and Management, the U.S. may be very a lot according to them, says Michaud of KFF.

“The truth is, it’s Denmark that appears to be the outlier right here when it comes to recommending only a few vaccines,” he says. “Within the case of Germany, France and Italy, we may be speaking about 15 or extra vaccines.”

Even in comparison with different Nordic international locations with related well being programs, Denmark is “unusually minimalist,” says Scott of Stanford. “Sweden, Norway, Finland – all of them cowl extra illnesses.”

It is unclear what Kennedy would possibly do subsequent. The Well being and Human Companies Division notified the press final Thursday that it was going to make “an announcement concerning kids’s well being” with the CDC the following day. However HHS canceled the press convention hours later. Media reviews recommend the administration had deliberate to announce an overhaul of the childhood vaccination schedule. HHS spokesperson Andrew Nixon declined to debate the matter.

In an e mail to media, the HHS stated the announcement had been postponed till after the primary of the brand new 12 months.

Specialists say it is legally murky whether or not the well being secretary might overhaul vaccine coverage by merely asserting it in a press convention, with out going by means of the standard course of for deliberating such adjustments.

Kennedy technically has broad authority in setting vaccine coverage, says Dorit Reiss, a regulation professor on the College of California, San Francisco whose analysis focuses on authorized and coverage points associated to vaccines. However merely asserting such a serious change by way of press convention — fairly than going by means of the CDC’s Advisory Committee on Immunization Practices — might open up the Trump administration to authorized challenges, she says.

“The method makes them very weak to authorized challenges,” Reiss says.