Vaccines: Does Europe Do Them Better?

Hi, this is Meryl Horan in For Wendy Zuckerman, and you're listening to Science Versus. This is the show that pits facts against filling up babies with shots. Today on the show, vaccines. In the US, there's been a ton of turmoil around vaccines. The Department of Health and Human Services is being led by a long-time vaccine skeptic, Robert of Candidate, Jr. He's been accused of firing the head of the CDC for not rubber stamping his vaccine policy. He's also added a ton of vaccine skeptics to this big vaccine advisory committee, and President Trump has chimed in here, saying that we've been giving kids way too many shots. They pump so much stuff into those beautiful little babies, it's a disgrace. And last week, the CDC announced a big change, saying they've got new vaccine recommendations for kids. New guidance from the CDC, reducing the number of vaccines recommended for children. They have scaled back the number of vaccines, now only recommending 11 vaccines. The CDC is now saying that some shots that were given to kids routinely instead should be given on a case-by-case basis, like to quote high-risk groups. And to back up these new recommendations, the government has pointed to what some other countries are doing. They say that when you look at the U.S. versus similar countries, some of them don't give kids nearly as many shots. And there's one country in particular that's gotten pointed to a ton. Denmark, Denmark. I hear Denmark a lot. They're a pretty healthy country. Why shouldn't we copy Denmark? Yeah, the CDC seems to be modeling its new recommendations on Denmark. So, is this a fairytale come true for the U.S.? Or is it more like a nightmare? Today, we're going to find out why do some other countries recommend fewer vaccines than the U.S.? Does it make sense to follow their lead? And we'll look at what the fallout could be. Because when it comes to vaccines, there's a lot of beautiful little babies. And then their science. Science versus is coming up after the break. Welcome back. This is Merrill Horn. I'm here with my fellow senior producer, Rose Rimmler. Hey, Rose. Hi, Merrill. So, we're talking about this vaccine news today. What have you been seeing about this? I haven't been following it super closely. I have been following it a little bit. And one thing I saw on social media, that was going around, was this infographic, where there were like two cartoon babies. One cartoon baby is surrounded by syringes. You know, a handful of syringes, but the other cartoon baby is completely encircled with syringes, I guess, full of vaccines. And I think it was from Trump. And it says, like in the text, it says, in the U.S., babies get 72 shots. And I was like, is that true? That does seem like kind of a lot. But the graphic was just so ridiculous, too. So, yeah, I've been following it. I don't know. I don't really know what's true. It's not true. We looked into that one. So, yeah, I mean, it is true that babies get more shots today. Then in the past. Then in the past, yeah. But they're not getting like 72 shots. So, the number, we added them up. And it seems like if you add up all the individual shots that someone gets by the time they're 18 years old, including getting a flu shot and COVID shot every year, then you get 72. That's where they got that from. Yeah. So, it's sort of true, but it's not that babies are getting 72 shots. And then if you just look at the number of diseases that kids are getting vaccinated against, of course, that number is much lower, right? Because it doesn't include all the booster shots. So, how many diseases is it? So, before this change, the CDC was recommending that every kid get vaccinated against 17 diseases. Now, it's just 11. So, they took away six vaccines that they recommend for everybody. Yeah. Which ones? Okay. So, the recommendations changed for hepatitis A and B, meningitis, RSV, rotavirus, and flu. Okay. And they had actually already stopped recommending the COVID shot last year for every kid. So, now, those ones are only recommended to either high-risk groups or, quote, based on shared clinical decision-making, unquote, the, you know, which is basically the idea that you have a conversation with your doctor and decide together instead of being routine. Do more work to get the shot. Yeah. It's not as automatic. And they do say that insurance will still cover these vaccines if people want them. But, you know, on the whole, yeah, it makes it more messy. Okay, Maryl. So, in addition to the babies encircled with syringes, and it's apparently focus. Another thing I saw, I was reading a little bit about these changes that came down. And in the article, it said, "This will bring us in line with Denmark's policy." And I was like, "Denmark." Like, I mean, that's interesting because I think a lot of people in the U.S. like idolize Scandinavia. And like, everything they do is better thought out and smarter and better for children than whatever we're doing in the U.S. Especially when it comes to healthcare. We're often like, "Oh, look at these Scandinavian countries. We should definitely be doing that." Yeah. It's like this utopia of everybody on their wooden bicycles or whatever. Yeah. So, yeah, I mean, that made me sort of stop and think like what's, like, why Denmark basically? Yeah, exactly. Let's start there. Like, a big reason the U.S. government says that it's making this change. It's not because there's a bunch of new vaccine science saying that vaccines aren't safe anymore. It is because we're trying to match up with what other countries are doing, like Denmark. So, to find out how Denmark thinks about all of this, we went directly to the source. The Danish I had for breakfast. Wow. Merrill, go to your room. Unexceptible planning. We actually talked to Jens Lundgren. He's a professor of-- He's a Danish. Yes, he's a professor of infectious diseases at the University of Copenhagen. And Jens actually advises the Danish health authority on which vaccines to recommend to the Danes. Do you remember the first time you heard that the U.S. was kind of using Denmark as a model and what you thought when you heard that? No, I felt that was very surprising to make that analogy. And then just on critically adopted. So, that was surprising to me, I have to say. Yeah, do you know why we use Denmark in particular? That's probably more for you to answer than me. Right. So, yeah, I went back and did my homework. And so, there was this memo from the White House in December where President Trump's praised Denmark, along with a few other high-income countries. Basically, for just doing fewer childhood vaccines. And then Trump called for a review on the U.S. schedule to see if it should make any changes. And of course, they did. So, I want to understand why does Denmark recommend vaccinated against fewer diseases? Yeah, I have that question. And Jens said that a bunch of things factor into this decision for them of whether or not to recommend a vaccine. So, how effective the vaccine is, the cost. And then there's how common the disease is. So, basically, you have to do a math problem to consider. You know, if you're trying to decide if everyone needs a certain vaccine, you need to think about how many cases of a disease you're going to prevent by vaccinating everyone in the population. We would argue that if the numbers that we need to vaccinate is extraordinary large. In order to reduce the risk for one person for contracting a disease. Then that's a legitimate discussion to have about whether it's worthwhile to reduce the vaccine, although it is effective. Yeah. And so, this is one reason why Denmark might not want to vaccinate every kid. Some diseases are pretty rare. So, an example here that I think is helpful is meningococcal disease, which can cause meningitis. And this is one of the vaccines that the CDC just changed the recommendations around. So, if you look at the number of people who get meningitis every year, it is less than one case in every 100,000 people, both in the US and in Denmark. So, what do you know about meningitis, by the way, Rose? That's the one that college students get when they live in the dorms, right? And it makes your brain swell and it's actually very, very dangerous. Is that right? Yeah, exactly. It's really terrible. It's often caused by a bacteria and it can affect tissues around your brain, which can lead to this huge immune reaction, where it can basically make your brain puff up so much that you die. So, when people get it in the US, maybe 10 to 15 percent of them will die. Sometimes, it happens really quickly, like within 24 hours. But, you know, that hasn't been enough for Denmark to recommend the vaccine for every kid. Here's Yens. It is scary, yes, and it's a serious condition, but it's also rare. And therefore, I mean, the question will become, do you vaccinate blanket minds? So, everybody, are you focusing your vaccination efforts if there's an outbreak? And we have chosen the latter. So, basically, they'll go and vaccinate people. surrounding the person that gets it? - Yeah, that's the idea. Kind of a more target approach there. I talked about this with another researcher though, David Higgins, he's a pediatrician and researcher in Colorado, and he said that if you wanna give the vaccines, like only when you've got an outbreak, then like in order for this to work, you really have to have your little like healthcare docs all in a row. - You have to catch these diseases really fast. You have to quickly be able to find all of their contacts and that ring around the cases to vaccinate them and get vaccines to them. That requires a health system and a public health system that is really well-resourced that doesn't have a lot of gaps and cracks in it where things can fall through. That requires really good access to healthcare. We don't have those things in the US. - Yeah, I could see how that would be harder to do here. - There's a lot more cracks, yeah, it's more fragmented, right? We don't have a national healthcare system like they do. And just a side note, the system doesn't work perfectly in Denmark either. So in 2024, Denmark had 26 known cases of meningococcal disease. And they did this contact tracing and found more than 100 people who were close contacts of people who got it and told them to get vaccinated. But they were only able to confirm that half of those people actually got the vaccine. And the fact that the US has been vaccinating kids for meningitis routinely, it saves lives. So one modeling paper estimated that the vaccine prevented about 500 meningitis cases and 54 deaths in young people. So that was an over a period of about 15 years. - Another thought I have, Meryl is if we're talking about how rare diseases, sometimes diseases are rare because everybody in many people are vaccinated. - Yeah. - Yeah, no, that's another good point, right? We're kind of ignoring that fact. - Right, let me just look at how rare it is today. - Well, could you argue that Denmark is benefiting from the US vaccinating more people in our population? So it's just suppressing meningitis around the world generally? - Well, actually a lot of other European countries do vaccinate for meningitis. And in some cases, they do it even earlier than the US does. - So Denmark is a freeloader off everyone else's vaccination status. - Basically, so yeah, that's kind of one factor that Denmark is looking at, though, how common a disease is. Another reason I talked about with Yens for why they might not recommend a vaccine for every kid is about how deadly the disease is. So an example of this would be road of virus? - Yeah, what is that, by the way? Like, I've only heard it in this context. I have never heard of that disease. - I had no idea either before this episode. But yeah, it's, well, first of all, it is really, really common. So in the US, before the vaccine, basically every kid was getting voted road of virus by the time there were five years old. And this one, it infects your GI tract and can cause really bad diarrhea. And it can get so bad that it will land kids in the hospital. And so yeah, I ask Yens about why they don't recommend vaccinating against this. And he said a lot of factors go into it, but one thing is that it is treatable. - It's not something, at least in all context, that we see as a terribly serious disease. - Again, they confident that a kid who has a bad case of road of virus can't get to a hospital and be treated. Yeah, the healthcare system really matters for that too, right? And then, you know, if you look at the numbers in the US, vaccinating has kept a bunch of kids out of the hospital. So the CDC has calculated that the vaccine prevents 62,000 emergency department visits and 45,000 hospitalizations every year from road of virus, which to me does make me glad that my kids are vaccinated against it, even if it's not going to kill them. I don't want them to go to the ER. - Well, yeah, I mean, that's the thing with kids and getting sick, kids get sick a lot. And you just hope that your kid is going to have an OK case and get over it and this is part of life, but you don't know if your kid's going to be the one that gets really, really sick from something. And if someone in the family has to go to the hospital, that's really disruptive and scary for the kid. Like, I'm thinking about vaccines for childhood diseases that are typically fairly not life-threatening, but very unpleasant. - Yeah. - So one that comes to mind for me is the chickenpox vaccine, which did not exist when I was little. - Me neither, yeah. - One of my earliest memories is like being in the bathtub and some kind of weird solution they give for being covered in sores, you know, clocks. And being in the bathtub, my mom next to me and me just crying 'cause I was so miserable in the awful and I got it. Both my brothers got it and the whole family was just like, so we were all fine and we got through it. But it's like, it'd be nice to not have that happen. Like, I mean, that's good that you don't have to be sick and covered in pot, scar you too. So like, where now it's just this vaccine, which, by the way, is still recommended for everyone. Yeah, Jen, I'm jealous. I'm like, you kids today, you don't even know. We have to go through. If what it makes me think of is just how many sicknesses my young kids are already getting every single winter, it's so brutal, it's just like one after another, after another, after another. Yeah, everyone on the team who has little kids is constantly like, someone's kid is always sick at science versus. And I'm just sort of imagining a parallel universe where a road of virus was also this one that like all the moms would like complain about on the group chat, like, oh my kid. I was like, diarrhea for like a week and like, that sounds like a bad alternate universe. Like I'm going to be open this one where they got some stuff like, it's like oral vaccines. So my kids got something squirted into their mouths. I kind of barely even remember this happening. But yeah, now it does sort of feel like we're going backward with this road of virus vaccine to this time where some kids might now be missing out on it. But yeah, just to go back to the idea that, you know, we want to just be like emulating another country's vaccine schedule. A lot of the people we talk to said that it just doesn't make sense to do this. Like plop one country's vaccine schedule into another's. Here's David. You can't copy and paste the vaccine schedule from another country and expect it to work in the same way that it does in a different context like the US. - Why, Merrill? Because diseases are diseases. It's just biology. - Borders are made up. - So, it convinced me. - Well, like for one, which country do you pick then, right? Because this idea that we need to align with other countries that do fewer vaccines has been around for a while. - One of the things that's brought up is like, okay, the US is an outlier, right? We have vaccines for 18 diseases. Denmark has vaccines for only 10 and Japan 14 and Germany only 15. So we are an outlier and we need to align with peers. Not only are those countries cherry pets, because I can count other countries that have very similar schedule to ours, like Canada, Australia, New Zealand. But also, the fact that we have coverage for more diseases is not evidence of a problem. - That's backward. It's not a competition to see how few diseases we can prevent. - I don't know, some people seem to think that. But no, I mean, another way to, I'm thinking back to that, babies surrounded by the needles, infographic. We talked about in the beginning like, the baby on the left with fewer syringes around it, had a lot of like gaps in its shield and the baby on the right was like fully shielded. So you could completely switch how you look at that. - Yeah. - Yeah. We used to make our own infographic. And so, and then to pick Denmark and then ignore Canada and Australia, New Zealand is a little random other peer countries. - Yeah. And then of course, there are countries that are adding vaccines to their schedule, including Denmark. So yeah, they just added RSV during pregnancy. This awful respiratory virus. The UK just added varicella chicken pox to their list. So this idea that the US needs to like match up with some other country. It's a moving target anyway. - Some of them are trying to match up with us, at least previous us. - Yeah, actually we heard that too. And yeah, so we actually reached out to experts in other countries to ask them what they thought of these changes in the US. And they all told us that it was surprising. One of them told us, quote, it is like watching a train wreck in slow motion. - Unquote. - Yeah, that's kind of what it feels like. - For sure. - From the inside too. Being in a train wreck in slow motion. Yeah. And, you know, we did reach out to the Health and Human Services Department. They basically defended this decision. They said in a statement that quote, "Evidence from peer develops nations shows high vaccination rates "can be achieved through trust and public health education "and strong doctor-patient relationships," unquote. And they also pointed out the access thing, saying that quote, "insurance will continue to cover more vaccines "for children in the US than in peer nations," unquote. All right, so after the break, what's next? What's gonna happen from here? Yeah, we're all gonna be staggering around with our road of iris. Yeah. coming at our buttholes after the ring. Welcome back. This is Merrill. I'm here with Rose. Hi, Merrill. So we're talking about this big change and vaccine recommendations and we just heard some reasons why experts don't think it makes sense for us to to cosplay as Denmark. They're like black licorice grows. But the other thing we wanted to know is like how much do these changes actually matter? Like how big a deal is this? I talked about this with David Higgins who you heard from before. So on a scale from one to ten, how big of a vaccine emergency is this? Well, I would say that this is an eight and eight and eight or nine. Okay. Now, here's why I think that a ten would be the no access to some life-saving vaccines that parents want to choose for their children or that we want to get as patients. This in some ways does still preserve some choice because parents still can get these if they want them. Is that right? That's right. Except, except it is a big deal and here's why because over time, this is likely to decrease the availability and access for parents who want to vaccinate their children. So yeah, David's worried that even if parents still technically have access to these vaccines, these changes have injected some confusion into the system. Since, you know, it's a lot easier to just say, like, here's your list of shots. Go and get them. That's how people figure out, like, is my kid high-risk or should we do this thing? I need to talk to my doctor. So one example where this does get really confusing is RSV, which is really terrible. Here's David. RSV is just a horrible nasty virus that every pediatrician, every winter, we are just swimming in RSV. Kids get super saudi with it. And like, I admit it, more kids at the hospital put more kids at oxygen. It had more complications than any other disease by far. And these are healthy kids, right? We had a particularly bad RSV season several seasons ago. And I remember walking into the emergency department for a shift several times and walking into, I mean, the waiting room is filled with kids on oxygen that hadn't been seen yet. And so yeah, it's, it's terrible. And one thing that's exciting is that we do have these new ways of protecting babies against it. But it's, so let me tell you about how it works because it is really complicated and it's taken me forever to wrap my head around it. You mean how the vaccine works? Yeah, for starters, the vaccine itself is kind of a weird one. So the vaccine was approved in 2023 for pregnant people. But then at the same time, we got a separate treatment, not a vaccine, but something called monoclonal antibodies that babies can get after they're born. So if the mom didn't get the shot when she was pregnant, then the babies can take the antibodies and these both worked pretty well. Okay. Okay. So in the old recommendations, you had RSV at the top of the list, you know, primo placement saying, babies should get these antibodies right away when they're born, specifically if the mom hadn't been vaccinated or they didn't know her vaccine status. But now when you look at the new recommendations and you look at like where RSV is listed, it's in this whole new category that's further down of kids who are, quote, high risk. And this could mean that the kid has chronic health problems. But it could also mean that your mom didn't get the vaccine, like that makes you high risk too. Okay. And that actually could be a lot of kids because the vaccine is only recommended if you're in a certain stage of pregnancy at a certain time of year. Well, so that's not what you're saying is because the vaccination of people doing pregnancy is not universal by any means, a lot of kids are going to be born without having been vaccinated while in the womb, which makes them a candidate for like a high risk. But yeah, it's not clear maybe that your kid is high risk just because you didn't get the vaccine. You have to kind of, you have to know that. It's tricky. Yeah. And you know, David pointed out that this detail is kind of tucks into a footnote in this new schedule. Parents are going to look at the schedule and say, they're not going to read the footnote. The, how this is described is enough. But they're going to see the schedule, the nice colors and say, oh, my, my child's not high risk. Yeah. And normal pregnancy. I had, you know, we left the hospital after two days and everyone said, your baby's healthy and great, why should they be getting this? So that's my concern with that one. Yeah. That is really confusing. Yeah. And, you know, this point about confusion, we're already seeing this play out like for me, Rose, even you? Yeah. I am one of these confused parents, not not because of RSV, but actually a different vaccine. So, okay. So last week, I took my, my son to the pediatrician, he's two. And the doctor was basically like, good news. You don't need any vaccines today. So he would have needed the hepatitis A vaccine, but now that's not on the schedule for everyone. And she told me, you know, that's fine because there's barely any HEPA in the U.S. anyway. Okay. And in the moment, I was relieved because I didn't have to like watch my toddler scream cry. But then I left the appointment, not really sure what's a thing. So I asked David about about HEPA. Hepitis A is a good example where prior to using the vaccine, especially kind of through the 90s, it was spreading through our communities. Now, what the vaccine has done is it stopped that spread. Just as recent as the 90s though, it was, it was out there. That's right. That's right. And so we, uh, now we, because so many people in the community, especially kids are protected with the vaccine, we don't see it spreading routinely through the community. That doesn't mean that it's not out there. It is still out there and can still absolutely come right back. So vaccines are victims of their own success, right? We, we use it. It works. And then people start questioning why it's necessary. Yeah. Because they don't see any more because the vaccine worked. And unfortunately, these diseases will come back when we stop vaccinating. They're, they're being held at bay with vaccines. They're not eradicated. So what does that mean for your two-year-old, Marles? Are you going to go and get them the shot? Yeah, actually. I'm like, okay, I need to put this on my to-do list for the next time we go back, especially because hepatitis A is still really common in other parts of the world. And I don't want to have to worry about him like getting a shot later. If he's traveling, it just makes it more messy. We are very interconnected in the world where one of these diseases is only a plane flight away and can be introduced to a community that has a vaccination rate that's way too low. And what's going to happen? Well, I think of it like a dry forest and sparks being thrown into the dry forest. Eventually, that spark is going to land in the wrong place and it's going to start a wildfire. And, you know, going to a different disease now, we are seeing some of this with resurgence with measles in the U.S. right now, right? Like we've got that spreading, especially in these unvaccinated communities. And it's happening in other countries too, like Canada. They've lost their status as a country that's eliminated measles. And we might too. And that's going on even though the official recommendations still tell you to get your kid vaccinated for it. And so yeah, with these new recommendations, there's this concern that parents won't know what to do. That a lot of the vaccines sort of feel optional. So I asked David, should parents still get all of these vaccines for their kids? I still recommend all of the vaccines that are on the American Academy of Pediatrics vaccine schedule. That is what I'm looking to. That is what I am recommending for my families. That is what I'm telling other clinicians and vaccination providers to look at. And so that hasn't changed. With these new recommendations from the federal government. Yeah. So the AAP still basically abides by the old schedule that the CDC used to have before this recent change. David says that, you know, best case scenario is that people do that. They keep following that old schedule. But that's not necessarily what he thinks is most likely. Oh, I wish I had a crystal ball on a doubt. Right. I am concerned that this is one step among more steps to come that are going to continue to erode trust or availability of vaccines. I don't think we're done here. I think in this next year we're going to see more and more things happen. They're going to make parents question that are going to make parents hesitant not because the science changes. And unfortunately, I think what we're going to see is when parents want to vaccinate, it's become harder and harder. There are going to be more barriers, more things that they have to overcome to get their kids vaccinated when they want to. That's science versus. We have 61 citations in this week's episode. Check out our transcripts if you want to see all of them. You can find the link in our show notes. If you have questions or thoughts about vaccines, we want to hear them. Our email is [email protected] and our Instagram is science_vs. This episode was produced by Blythe Tarell with me, Merrill Horn, with help from Rose Rimler, Michelle Dang, and Aketi Foster Keys. We're edited by Blythe Tarell, additional research help from Erica Ikeko Howard. Our executive producer is Wendy Zergerman, mixed in sound design by Bobby Lorde, music written by Emma Munger, so wily, Peter Leonard, Gumi Hadakka, and Bobby Lorde. Thanks very much to the unbiased science network who connected us with David Higgins. They've been doing some amazing work on trying to explain what's going on with the U.S. and vaccines. Unbiased science check out their podcasts and their socials. Thanks very much to all the scientists we spoke to and emailed with about these changes. And special thanks to Bernadette Shandra and Lawrence Horn. This versus is a Spotify Studios original, listen for free on Spotify or wherever you listen to your podcasts. And if you do listen on Spotify, follow us and tap the bell for episode notifications. Fact you next week!