USA Increasingly Deviates from Rest of World on COVID-19 Vaccination Policy, Especially with Young Children

The United States COVID-19 vaccination policy continues to deviate from the rest of the developed Western world when it comes to COVID-19 vaccination policy. TrialSite surveyed a handful of western European nations, Australia and Japan for a sense of what COVID-19 vaccination policy is today. While no media covers this striking reality, the USA is the only country in the developed world that TrialSite is aware still promoting vaccination of for healthy children aged 6 months and up. In fact, in most nations now children are not recommended for COVID-19 vaccination anymore.

In the survey below, TrialSite includes the United States, the United Kingdom, Australia, Denmark, Germany, the Netherlands, Italy and Japan for a broad representation. Of course, there are many other countries but the nations selected here represent some of the biggest, most advanced health systems in the world.

The United States (USA)

The USA stands alone in its COVID-19 vaccination policy for broad coverage at this point, despite a far milder variant in Omicron, a broadly exposed and vaccinated population, rare severe symptoms with children at this point, and a growing concern about some side effects such as myocarditis and anaphylaxis. The AstraZeneca vaccine recently withdrew from the market due to mounting litigation and safety reports although that is not the acknowledged official reason.

According to the Centers for Disease Control and Prevention (CDC), for the 2023-2024 COVID-19 vaccine seasons involving either Pfizer-BioNTech, Moderna or Novavax to prevent against series illness from COVID-19 the U.S. government agency recommends “everyone aged 5 years and older should get 1 dose of an updated COVID-19 vaccine to protect against serious illness from COVID-19.” What about children aged 6 months to 4 years of age? This vulnerable cohort, already mostly exposed with some form of immunity and rare morbidity and even rare mortality still is recommended to get “multiple doses of COVID-19 vaccines to be update to date, including at least 1 dose of updated COVID-19 vaccine.”

Not surprisingly, also in the U.S., as in many other nations, people who are moderately to severely immunocompromised or have other comorbidities are recommended to get the latest COVID-19 booster. Additionally, people aged 65 and older who received one dose of any 2023-2024 COVID-19 vaccine (Pfizer-BioNTech, Moderna or Novavax) should receive 1 additional dose of an updated COVID-19 vaccine at least 4 months after the previous updated dose. Meaning the USA government is recommending two doses under six months.

The rationale of the USA government? Those who are up to date face a lower risk of severe illness, hospitalization or death.

But is this policy in alignment with other major western nations?

TrialSite reviewed a select number of major nations and their COVID-19 vaccine policies to determine, finding a wide divergence between the United States and the rest of the world.

The United Kingdom

Run by the National Health Service an individual or child may be offered a COVID-19 vaccine if the following conditions are met:

• Person is 75 years of age or over
• Persons is 6 months to 74 and have a weakened immune system
• Person resides in a long-term care facility for the elderly

Does this mean that healthy persons aged 74 and under are not recommended a COVID-19 vaccine in the United Kingdom? Yes. This is a radical difference from the USA and member of the Anglosphere.

See the UK link.

Australia

Run by the Australian Government Department of Health and Aged Care,  the recommendations are included in the table below:

So, what’s clear for primary course for healthy persons under 18 no recommended vaccination anymore.

For boosters, the Australian government policy is even more different than the USA:

With the case of boosters, even immunocompromised children are not recommended for COVID-19 vaccination. This in a nation that perhaps, more than any other during the pandemic embraced the most extreme measures comparable to the Chinese zero-tolerance COVID policy.

See the link.

Denmark

Denmark via the Danish Health Authority has become even more skeptical of the COVID-19 vaccines. 

In this affluent Nordic nation when referring to who can be vaccinated for COVID-19 the authorities there first identify “everyone aged 65 years or older is offered vaccination against both COVID-19 and influenza. Again, like the other nations, it’s not forced.

According to the Danish Health Authority in a telling statement, “The vast majority of people under 65 years of age are not at risk of becoming severely ill.”

The agency points out, however, for individuals with comorbidity that raise the risk of morbidity and/or mortality the Danish authority recommends vaccination, but not for healthy individuals under aged 65 or up. The authority outlines the conditions they consider for those more at risk, from chronic lung disease to diabetes and many other conditions, such as obesity and pregnant women in second or third trimester.

Germany

Europe’s biggest economy, vaccine policy is set by the Federal Ministry of Health. First and foremost, the Ministry acknowledges that with the Omicron variant of SARS-CoV-2 and a relatively high vaccinated population and mass exposure via previous infection (hybrid immunity), COVID-19 poses far less of a risk than it did even a year ago.

Germany’s Standing Committee on Vaccination (STIKO) sets actual recommendations and currently recommends all persons aged 18 and up get a COVID-19 booster. So, Germany is more in line with the USA but not when it comes to the vaccination of healthy children.

Who should consider getting a vaccination in Germany?

• All persons aged ≥ 18 years
• Residents of long-term care facilities
• Children and adolescents aged between six months and 17 years with an underlying condition that confers a higher risk of severe illness
• Persons of any age with a higher occupational infection risk on account of their work in health or long-term care that brings them into direct contact with patients or residents
• Family members and close contacts from the age of six months of persons for whom the COVID-19 vaccination is unlikely to produce a protective immune response
• Women of reproductive age and pregnant women

Again, healthy young people under 18 are NOT recommended for COVID-19 vaccination, like all of the other nations except for the United States.

See the link.

Netherlands

The vaccine policy is promulgated in the Netherlands by the
National Institute for Public Health and the Environment Ministry of Health, Welfare and Sport. (RVIM).

Interestingly, the agency (RVIM) still acknowledges we are not sure about vaccine effectiveness. According to the agency:

“RIVM is monitoring COVID-19 trends in the Netherlands. In addition, RIVM is researching vaccine effectiveness, willingness to vaccinate among the general population, and the degree of immunity to COVID-19 after vaccination and/or infection.”

According to the Dutch agency, “COVID-19 vaccination restores a sufficient level of protection against severe illness and hospital admission. COVID-19 vaccination is still available for:

• pregnant people
• adults and children in medical high-risk groups (such as people with severely impaired immunity, also known as immunocompromised patients) as advised by their treating physician
• People who have been referred by a treating physician for other reasons that those listed here

This means that no longer are healthy adults or children receiving COVID-19 vaccination—a substantial departure from US CDC policy.

Italy

As reported by a team of medical researchers affiliated with Department of Public Health and Laboratory Services and Department of Experimental Medicine of the Teaching Hospital of the University of Campania, "Luigi Vanvitelli" as well as Department of Movement Sciences and Wellbeing, University of Naples the Italian Ministry of Health recommended the administration of the bivalent second booster dose of the new available mRNA COVID-19 vaccine for subjects aged 60 y and over, and not for healthy individuals under 60, and for those with comorbidities, immunosuppressed and other frailties aged 12 y and up along with health-care workers.

In Italy by 2021, priority vaccination based on Epicento was for the following:

• category 1: very frail people, i.e. people with severe physical, sensory, intellectual or mental disabilities or extremely vulnerable individuals with conditions that can become life-threatening with COVID-19 (for a detailed list, see Table 1 on page 42 of the document)
• category 2: people aged 70 to 79 years, for whom the COVID-19 case fatality rate is 10%
• category 3: people aged 60 to 69 years, for whom the COVID-19 case fatality rate is 3%
• category 4: people under 60 years of age with comorbidities that are not of the same severity as those affecting people in category 1; most of the conditions are the same, but their level of severity is considered to be lower (for a detailed list, see Table 4 on page 44 of the document)
• category 5: other people under 60 years of age.

Japan

Japan aligns more with the USA but still doesn’t recommend under the age of 5 years of age for any COVID-19 vaccination. And in fact, the nations Ministry of Health, Labor and Welfare only recommends for children five years to 11 years of age if they have underlying medical conditions.

See the link.

Interestingly, several national links have not been updated since 2021 in English, including China and Italy for example. It should be clear form this representative sampling that the USA stands alone in its zeal for ongoing COVID-19 vaccination, a departure from other comparable modern democracies.  

While all of the countries continue to embrace the COVID-19 vaccines, a handful recognize that they are not needed for healthy adults, and all except the USA acknowledged there is no need to vaccinate healthy children against COVID-19.