By Russell R. Barksdale, Jr.
The Centers for Disease Control and Prevention was founded on July 1, 1946, in Atlanta, Georgia, with a narrow mission: stop malaria at home after World War II. In the decades that followed, the CDC has grown into one of the most powerful public-health institutions in the world, charged with protecting more than 330 million Americans from disease, injury, and disability. Its authority rested on a simple idea—that science, data, and domestic epidemiology, not politics or ideology, would guide public-health decisions.
That premise is now under strain.
Few issues reveal this more clearly than the debate over childhood vaccination policy, where U.S. officials are increasingly looking abroad for models—notably to Denmark.
The CDC currently recommends vaccines protecting against roughly 18 infectious diseases across childhood and adolescence. These include diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, chickenpox, hepatitis A and B, pneumococcal disease, Haemophilus influenzae type b (Hib), rotavirus, influenza, meningococcal disease, human papillomavirus (HPV), COVID-19, and more recently RSV protection for infants and pregnant women. Some vaccines are universal; others are recommended based on age, risk, or geography. Together, they reflect an expansive approach aimed at preventing outbreaks before they occur.
Denmark takes a more restrained path.
Denmark’s national childhood vaccination program, administered by the Danish Health Authority, targets about ten diseases. Danish children are routinely vaccinated against diphtheria, tetanus, whooping cough, polio, Hib, pneumococcal disease, measles, mumps, rubella, and HPV. Notably absent from the routine schedule are vaccines for chickenpox, rotavirus, seasonal influenza, hepatitis A, and a universal birth dose for hepatitis B. Other vaccines, including influenza and COVID-19 shots, are offered selectively to older adults or high-risk groups rather than universally to children.
The contrast is not arbitrary.
Denmark is a country of about 5.9 million people with a centralized, tax-funded healthcare system, uniform medical records, and an elevated public trust in government health institutions. Vaccination decisions are made nationally, implemented consistently, and supported by comprehensive disease surveillance. If a disease is rare or poses limited domestic risk, Danish officials can decide that routine vaccination is unnecessary, relying instead on monitoring and targeted responses.
The United States operates in a fundamentally different environment. Its population is more than fifty times larger, far more diverse, and far less centralized. Healthcare delivery is highly fragmented across states, insurers, and providers. International travel is constant, compliance varies widely, and outbreaks are harder to contain. The CDC’s broader vaccination schedule should reflect these realities, emphasizing prevention in a system where rapid, uniform response is often impossible.
Still, the appeal of Denmark’s model is growing. Some policymakers and commentators argue that a leaner vaccination schedule could improve public trust, reduce parental anxiety, and encourage more thoughtful, individualized decision-making. Denmark’s cautious expansion of its vaccine program and strong post-marketing safety surveillance are frequently cited as evidence that “more” is not always better.
Critics push back just as forcefully. They warn that importing another country’s health policy without fully accounting for scale, culture, and infrastructure risks unintended consequences. A narrower schedule in the U.S., they argue, could leave gaps in protection—especially in communities already struggling with low vaccination rates and limited healthcare access. What Denmark can manage through centralized oversight, the U.S. may not.
There is also a deeper concern about governance. Public health policy can be more than purely technical. It can reflect national values about risk, responsibility, and accountability. When American agencies appear to look overseas for validation rather than grounding decisions clearly in U.S. data, it raises an uncomfortable question: who, ultimately, sets health policy for Americans and for our school systems? In a country with such diverse views, does any governmental agency have the level of public trust to build consensus on something as personal as healthcare?
The U.S. should not ignore international experiences. Comparative analysis has long been essential to scientific progress, and Denmark’s emphasis on transparency, restraint, and public communication offers lessons worth studying. Arguably, however, learning from another country is not the same as adopting its policies blindly.
The CDC’s credibility may lie in the balance and its effectiveness solely dependent upon maintaining its core mission without political bias: evidence-based recommendations tailored to American conditions, informed but not dictated by global trends. Denmark may quickly drive America’s vaccination policy. The challenge is ensuring that, in an era of political pressure and public skepticism, the CDC can regain its effectiveness and trust.
Russell R. Barksdale, Jr., PHD, MPA/MHA, FACHE President and CEO Waveny LifeCare Network.
