Despite an alarming uptick in measles infections, the U.S. has decided to reduce the number of CDC-recommended childhood vaccinations. HHS Secretary RFK Jr has made it clear that he thinks the US over-vaccinates, and that vaccines are unsafe and provide undeserved profits to the pharmaceutical industry. The childhood vaccination schedule used in Denmark was held up as an exemplar.

Why had the US been requiring 17 vaccinations (plus Covid in 2022) and Denmark only 10?

There are, in fact, data-driven reasons that our CDC has in the past recommended these vaccinations while other developed nations choose to administer fewer.

Public health experts explain that vaccine schedules take into account a number of factors: How prevalent the disease is, but also how seriously the disease affects people within the population. As one Danish-American vaccine expert put it: “Authorities look at how many children get sick, how many are hospitalized, how many die, and then they calculate the cost of vaccination versus the cost of illness.”

In other words, the difference in vaccine schedules comes down to a calculation of cost and benefit. Denmark, for example, which has a population smaller than that of Massachusetts, has a relatively genetically homogeneous population and an expansive health care and social benefits system. That system provides universal coverage of medical needs, extensive health tracking records, and 46 weeks of paid leave for new parents. Dr. Anders Hviid, who leads research on vaccine safety and effectiveness at the Statens Serum Institut, Denmark’s equivalent of the U.S. Centers for Disease, says that some childhood vaccinations are omitted in Denmark because the disease does not pose a sufficient risk within their population to warrant the cost of administering them.

The US health care system does not provide universal medical coverage like Denmark’s. In the US, where 8 percent of the population is uninsured and the cost of health care can keep even insured families from seeking medical care, contracting disease can pose a greater risk. Dr. Lone Graff Stensballe, a professor of pediatric vaccinology at the University of Copenhagen says “The risk of severe consequences of an infection in the United States is much higher than in Denmark. If not everyone has free access to hospitals, vaccines are even more important. It would be such a risk and such a potential waste of life not to be immunized…”

CDC data show how effective childhood vaccinations have been: From 1994 to 2023 childhood vaccines in the US have prevented 6 million hepatitis B cases, 4 million hepatitis A cases, and 30 million rotavirus cases.

Vaccine safety is underpinned by data collected through international collaboration. Decisions about vaccines in other countries rely on these data. But this is no longer true in the US.

The first vaccination our current CDC delisted was for hepatitis B (HBV), which until recently was recommended for all newborns in the US. HBV affects an estimated 0.5% of the US population. It can be contracted from infected individuals, especially from infected mothers to a newborn, and can lead to liver cancer and liver failure. The CDC Advisory Committee on Immunization Practices (ACIP) said they were worried about harm to newborns from the hepatitis B vaccine. A pediatric disease expert who serves on Germany’s vaccine recommendation committee told the NYTimes that he vehemently disagreed with that concern. Billions of doses of the vaccine have been administered worldwide, he said, “and there’s absolutely no evidence that it does cause any harm to the baby.” He noted that universal vaccination at birth in the United States had nearly eliminated the disease in American newborns. “It is very astonishing for us that such a program is scrutinized,” he said.

These decisions by our new public health officials are examples of promoting ideology at the expense of scientific data. The choice of Denmark as the model for our vaccination schedule was apparently made because, of all the developed nations, Denmark recommends the least number of childhood vaccines. There is apparently no other reason or evidence that supports this decision.

Dr. Yvonne Maldonado, a professor of global health and infectious diseases at Stanford University, was quoted as saying about the new schedule: “There are no data, no papers, no discussions at all that are cited in this quote-unquote exhaustive search. So we have no idea who made these decisions and why they were made now,” she said.

Even the recent chair of the ACIP acknowledges that these new decisions are purely political. “I am glad to have this dealt with by executive action,” Dr. Robert Malone, who chaired the committee’s last meeting, said in a message. “Since everything vax-related has been politicized, then let the politicos make the call,” he said. “They have the ultimate authority anyhow.”

Welcome to our world of post-science public health.

About the author

Dr. Anne L. Plant is an American biochemist. She is an Emerita Fellow and former research chemist with the National Institute of Standards and Technology where she was previously chief of the Biosystems and Biomaterials Division. Dr. Plant holds a M.S. in human nutrition from the University of Nebraska-Lincoln and a Ph.D. in biochemistry from Baylor College of Medicine.

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