Summary of Vaccines: Does Europe Do Them Better?

Overview of Science Versus — “Vaccines: Does Europe Do Them Better?”

This episode examines recent U.S. federal changes to childhood vaccine recommendations, the argument that the U.S. should “model” Denmark and other European countries, and whether that makes sense given differences in disease burden, health systems, and public-health capacity. Hosts Meryl Horan and Rose Rimler interview Danish advisor Jens Lundgren and U.S. pediatrician David Higgins and unpack what changed, why it changed, and the likely consequences for parents and public health.

Key points / main takeaways

• The CDC’s recent guidance reduced the list of vaccines it recommends routinely for all children from vaccines against 17 diseases to 11 — six vaccines are now recommended only for high‑risk groups or via “shared clinical decision‑making.”
• The six vaccines moved off the universal list are: hepatitis A, hepatitis B, meningococcal (meningitis), RSV (respiratory syncytial virus), rotavirus, and flu. The COVID vaccine had already been removed from the routine childhood list earlier.
• The viral “72 shots” infographic is misleading: 72 is the total number of injections someone could receive from birth through age 18 if you count annual boosters (flu, COVID) and repeat doses — not the number of shots babies routinely get.
• Denmark and some other high‑income countries recommend fewer routine childhood vaccines than the U.S., but that difference reflects country‑specific calculations (disease incidence, severity, cost‑effectiveness) and relies on robust public‑health infrastructure for targeted responses.
• Experts warn that copying another country’s schedule without adjusting for differences in health systems and epidemiology is risky. The U.S. health system is more fragmented, making outbreak‑targeted strategies (ring vaccination, rapid contact tracing) harder to execute.
• Even if insurance continues to cover these vaccines, shifting them to non‑routine status is likely to increase confusion and barriers to uptake, and over time may reduce availability and coverage — increasing risk of disease resurgence.

Why Denmark (and other countries) recommend fewer routine vaccines

• Decision factors: current disease incidence, how severe the disease is, vaccine effectiveness, cost‑effectiveness, and health‑system capacity to detect and respond to cases.
• Example: meningococcal disease is very serious but very rare (<1 case per 100,000). Denmark treats meningococcal vaccination as targeted (ring vaccination) rather than universal; the U.S. historically chose routine vaccination and modeling suggests routine use prevented hundreds of cases and dozens of deaths over 15 years.
• Example: rotavirus is common and can lead to hospitalization, but Denmark considers it generally treatable within their health system and has not made routine vaccination universal. The U.S. data show rotavirus vaccination prevents tens of thousands of ED visits and thousands of hospitalizations annually.
• Important nuance: a disease can appear rare because of prior vaccination programs. Lower observed incidence in a country today may reflect vaccination success, not lack of underlying threat.

Why the U.S. context matters

• Fragmentation: The U.S. lacks a unified national health system and consistent public‑health capacity for rapid contact tracing and ring vaccination, making targeted strategies less reliable.
• Access and equity: Even if a vaccine is technically still available, reclassifying it as “shared decision‑making” or “high‑risk” introduces friction — more steps, more clinician time, more opportunity for missed vaccination — which tends to lower uptake.
• Public perception: Moving vaccines off the routine schedule can signal they are less important and fuel hesitancy. “Vaccines are victims of their own success” — when a disease disappears from everyday experience, people question the need for vaccination.
• Real‑world consequences: Measles resurgence and loss of elimination status in other countries illustrate how coverage declines can lead to outbreaks.

Notable data & examples mentioned

• CDC pre-change: routine protection against 17 diseases. Post-change: routine for 11 diseases.
• The “72 shots” count equals all possible injections through age 18 if you count annual boosters (e.g., flu, COVID), not what infants receive at a single visit.
• Modeling: routine meningococcal vaccination in the U.S. estimated to have prevented ~500 cases and ~54 deaths over ~15 years.
• Rotavirus vaccination in the U.S. prevents an estimated ~62,000 emergency department visits and ~45,000 hospitalizations per year.

Expert perspectives

• Jens Lundgren (University of Copenhagen; adviser to Danish Health Authority): Surprised the U.S. would uncritically adopt Denmark as a model; Denmark’s choices are based on local epidemiology, cost‑effectiveness, severity, and the ability to respond to outbreaks.
• David Higgins (pediatrician/researcher): Rates this policy shift high on the risk scale (8–9/10). He argues that although parents can technically still get the vaccines, practical access and coverage will fall; he recommends clinicians and families continue to follow the American Academy of Pediatrics (AAP) schedule.

Practical implications for parents

• The AAP still recommends the traditional childhood vaccine schedule; many clinicians advise following that rather than the new federal simplification.
• Ask your pediatrician directly about any vaccine shifted to “shared decision‑making” (e.g., hepatitis A/B, RSV, rotavirus, flu, meningococcal) — clarify whether your child falls into a high‑risk group and whether you should get the vaccine now.
• Hepatitis A: still circulating in other regions; consider vaccination especially if travel or other exposure risks exist.
• RSV protection is complex: options include maternal vaccination in pregnancy and monoclonal antibodies for newborns; timing and eligibility matter, and the new schedule’s footnotes may obscure who qualifies.
• If you want a vaccine that is no longer classified as routine, be prepared for extra steps: discussing with the provider, possibly more paperwork, and ensuring access.

Risks & what to watch next

• Potential for lower uptake and more barriers, leading to increased susceptibility to outbreaks (measles, hepatitis A, meningitis, rotavirus complications).
• Policy drift could continue; experts fear more changes that may erode vaccine availability, trust, and coverage.
• International schedules are not static — some countries add vaccines while others do not — so “matching” another country’s list is not a fixed benchmark.

Closing notes / sources

• The episode cites 61 references; the producers direct listeners to the episode transcript and show notes for full citations.
• Science Versus recommends hearing from your pediatrician and consulting the AAP schedule if you want practical guidance today.