Letter from our Chair, Doug Robinson, M.D.

Our Broken Healthcare System is the Main Reason We Can't Vaccinate Children Like Denmark Does 

Dear members and friends of Health Care Justice ● NC, 

On December 5, 2025, President Trump directed the HHS Secretary Kennedy and the Acting Director of the CDC to “review best practices from peer, developed countries for core childhood vaccination recommendations.” In his memorandum, he cited Denmark for vaccinating children against just 10 diseases, along with Japan’s 14 and Germany’s 15, compared to 18 diseases in the US childhood immunization schedule. Based on their assessment of immunization practices in 20 high-income nations, HHS recommended updating our childhood immunization schedule to align with Denmark’s, and the CDC accepted the recommendation. 

Needless to say, the decision has been met with an outcry from pediatricians, public health experts, and infectious disease specialists across the country, citing the obvious: we aren’t Denmark, and we don’t live in Denmark. You can say that again! 

There are many reasons the US shouldn’t follow the Danish vaccination schedule, which is among the least extensive of wealthy nations. Obviously, we’re bigger, have a more diverse population, and don’t own Greenland. But the main reason we shouldn’t follow the Danish immunization schedule is the stark disparity between our healthcare systems that necessitates a more robust vaccination schedule in the US. The United States, unlike “peer” high-income nations with universal healthcare, has a fragmented, complex, costly, and inconsistent healthcare system. We treat healthcare like a commodity, with cost and access often controlled by for-profit insurance companies. 

Right now, about 9% of Americans are uninsured, and 23% underinsured with unaffordable out-of-pocket costs. Those numbers will increase dramatically in the coming months and years with the loss of the ACA enhanced premium tax credits and Medicaid cutbacks in the One Big Beautiful Bill. Access to affordable healthcare in America is bad and getting worse. 

Denmark, by comparison, has universal healthcare financed mainly through a progressive income tax. They spend half as much as we do in the US on healthcare, both as a % of GDP and per capita. Danish residents enjoy easy access to quality medical care free at the point of care. Their system emphasizes primary care. They have national registries for diseases and immunizations. The experts say vaccines are just more important in a system like ours, which provides limited access to healthcare. For example, in the US, a parent might hesitate to take their sick child for a costly 

doctor’s visit or to the hospital, while in Denmark, cost and access don’t enter into the decision. 

Not every pregnant woman and baby gets appropriate care regularly in the US, and that makes vaccines more important here as well. In Denmark, no woman falls through the cracks, with nearly all pregnant women tested for hepatitis B compared to only 85% of pregnant women in the US. Their maternal and infant mortality rates are significantly lower. They have universal prenatal care, and a midwife sees every pregnant woman. There is subsidized childcare, paid sick leave, and paid maternity leave, and the child poverty rate is significantly lower in Denmark. 

Dr. Celine Gounder is an infectious disease specialist, epidemiologist, and public health editor-at-large at KFF Health News, and was recently interviewed on NPR’s 1A program. She summed up the issue, saying that a comparison of our vaccine schedule to countries like Denmark is “really an apples-to-oranges argument…those are not the right peer countries…Our peer countries would be countries like Chile, Saudi Arabia, Poland, Turkey, Brazil. Those are countries, by the way, that still have all those vaccines that were taken off the must-have universal list. They still recommend all of those vaccines because, quite frankly, the US is essentially two countries. We are the most high-income developed country in the world, and we're also a developing country at the same time. To try to formulate guidance for our public health system that ignores the vast majority of people who live in low-income settings without access to health care is really leaving most of the population behind.” 

So, no, sadly, we aren’t like Denmark about healthcare. Our broken system makes a comprehensive childhood immunization schedule all the more important. We shouldn’t adopt the limited Danish vaccine schedule, but we should eagerly adopt their universal healthcare approach. The debate over the childhood vaccine schedule brought our healthcare shortcomings compared to “peer wealthy nations” into sharp focus. To truly become a peer of other wealthy nations, we must have universal publicly funded healthcare for everyone in the United States. 

I’ll close on an upbeat note. The tsunami of bad news about the future of American healthcare has activated Americans at home and in Washington in a profound way. We have people’s attention. A recent Data for Progress poll showed that Americans are more ready than ever for transformational healthcare reform. It showed that 65% of likely US voters—including 78% of Democrats, 71% of Independents, and 49% of Republicans—either strongly or somewhat support “creating a national health insurance program, sometimes called Medicare for All that would cover all Americans and replace most private health insurance plans.” Overall support for such a system dropped just two percentage points when survey respondents were informed that Medicare for All would replace insurance premiums with higher taxes, abolish most private insurance, and eliminate copays and deductibles. That’s a big deal and a marked shift from earlier polling that showed a decline in support for M4A. 

There is movement on Capitol Hill as well. The congressional Medicare for All Act, H.R. 3069, now has 111 cosponsors, having added 6 new cosponsors in the last quarter of 2025. The Senate version, S. 1506, has 17 cosponsors, adding 2 new cosponsors in the last quarter. Call your legislators, and if they haven’t co-sponsored the bill, ask them to do so. If they are a co-sponsor, thank them and tell them to convince their colleagues to sign on as well. 

Douglas Robinson, M.D. 

Chair, Health Care Justice ● NC 

Below is a list of your Senators' and Representatives' office phone numbers.

Senator Thom Tillis: (202) 224-6342

Senator Ted Budd: (202) 224-3154

Representatives:

District 1    Don Davis                   (202) 225-3101

District 2    Deborah Ross            (202) 225-3032

District 3    Greg Murphy             (202) 225-3415

District 4    Valerie Foushee        (202) 225-1784

District 5    Virginia Foxx              (202) 225-2071

District 6    Addison McDowell    (202) 225-3065

District 7    David Rouzer             (202) 225-2731

District 8    Mark Harris                (202) 225-1976

District 9    Richard Hudson        (202) 225-3715

District 10  Pat Harrigan              (202) 225-2576

District 11  Chuck Edwards         (202) 225-6401

District 12  Alma Adams              (202) 225-1510

District 13  Brad Knott                 (202) 225-4531

District 14  Tim Moore                 (202) 225-5634

Not sure who your Representative is? You can find out here:

https://www.house.gov/representatives/find-your-representative.