Here's some information about some of the diseases you have mentioned and their associated vaccines.
Hep A is not routinely offered in the UK because it's considered very low risk there. Even in the US, hep A is usually only something that gets introduced after someone visits a high incidence country. Likely, hep A's risk in the US is partly because we share a border with a high incidence country. Hep A is spread through contaminated food and water, and it takes an incredibly low amount of virus to cause disease in a person. When you get it as an adult, it can lead to some really serious liver complications, and many cases end up hospitalized. Likely, hep A in the UK is because they don't expect to get an influx of people coming in who are infected with hep A. By the way, currently, we are experiencing a hepatitis A outbreak of unprecendented scale and duration in San Diego, CA, and Michigan.
The point of the chickenpox vaccine is only partly to protect the kids. The vaccine will also mean that kids who are vaccinated against chickenpox won't get shingles. Also, when you get it as an adult, it is Bad Times.
Meningococcus vaccine isn't recommended until you're 12 years old. The CBA on it has been a bit back and forth, but this one is likely due to cultural things - meningococcus meningitis outbreaks are common when kids from all sorts of different places end up in one place (aka, college, frats (especially!!), team sports, spending a lot of time in close contact with others). Because the course of the disease is real quick (healthy to dead in less than 24 hours) and morbidity is so bad, it's pretty much recommended due to an abundance of caution. Two years ago, Santa Clara University had a case, and the state responded by mass vaccinating everyone on campus - something like 5,000 people in two days. Such an effort was hideously expensive, but still worth it to the state in terms of morbidity avoided.
Hep B is recommended because 1) there's no cure for it, and 2) having HBV increases your risk of liver cancer by an insane degree. Infection as a kid usually leads to lifetime infection in a carrier state (or to disease progression), whereas infection as an adult is less likely to lead to chronic illness. It's really common in East Asians and Africans, and HBV is also considered endemic in Latin American countries. Of your listed countries, the USA is also the most ethnically diverse. Basically, you're risking putting your kid at risk for liver cancer down the line. Also, HBV costs Medicare a shit ton of money every year in liver transplant/ liver cancer treatment costs.
As a reader of this site, I feel like you should understand that humans are very bad at evaluating small percentages. Under this lens, look at the risk of harm that the vaccination poses to your child, then look at the risk of harm that getting the disease may pose to your child.
The cost benefit analysis you should be doing is how much it will cost you to do this today versus how much pain it's going to cause your kid in the future.
I appreciate your reply.
The government also makes cars have seatbelts and airbags; is this because seatbelt and airbag manufacturers lobbied the government? How dare they make you pay for features you don't want! If you think you're never going to need that airbag, why should you pay for it?
I was going to knee-jerk reply to this and say I'll gladly pay for that because all advanced nations agree that seatbelts and airbags should be standard, but I thought I'd look it up first. Apparently air bags aren't required by the European Commission!
https://ec.e...
I'm about to have a baby. Any minute now. Well, my partner is. I'm just sitting here not growing a baby wondering what to do with myself.
Maybe I can get a jump on our approach to medical care for the new kiddo.
One thing that sticks out at me is that children in the US get a lot of vaccinations. At my quick count it's something like 37 shots by the time they're 5.
I grew up in the US in the 80s and I don't remember getting nearly this many. Is my memory faulty? I'm pretty sure it was more like 12 back in those days. Is this all really necessary? Nobody likes getting shots, especially not children. What changed, anyway?
Now, I'm not an expert on immunology or epidemiology so I expect diving into the literature isn't going to be fruitful; I won't be able to ante up decades of education and experience fast enough. Presumably this is what we pay people at the US CDC and Department of Health for.
But can you *really* trust them? Aren't all of these vaccinations really convenient for the pharmaceutical industry? Aren't there seemingly constant allegations/lawsuits about the over-prescription of drug interventions in the US?
The health care systems in major world countries have access to all of the same literature, and they're presumably staffed by educated, expert people too so they should all come to the same conclusions as the US system right? Not so!
Here's how many shots each nation's health care system recommends by the time children turn 5.
37 US
25 UK
25 Germany
16 Sweden
16 Denmark
The intersection of vaccines being recommended are TDAP, MMR, Polio, HIB and PCB.
In the US we also recommend: Hep A, Hep B, Rotavirus, Meningococcus, Varicella, and yearly flu shots (for babies and children).
Can we explain the variance? I can think of a few reasons they would vary.
1. Cultural bias. This can be big. A psychiatrist in the UK told me that they're not as pharma heavy as, say, psychiatrists in Germany because of a WW2 era bias: lots of the big pharma companies are German.
2. Cultural and environmental differences. Some diseases are a bigger deal in some countries than others. Japan (not included above) recommends immunization against diseases (TB, Japanese encephalitis) that none of the systems above are too concerned with.
3. Undue industry influence. Run-of-the-mill corruption.
4. Quality of health care systems and social safety nets vary.
When it comes to cultural and environment differences I have a hard time imagining that the orthodoxy varies because Hep A is a much bigger deal in the US. I presume the calculus changes based on your geographic neighbors, but is it a meaningful difference? Or is it a counterproductive cultural bias? For example, in the US we may spend more time thinking about diseases people in central America suffer from than the people in Denmark might, but do the neighbors in this case meaningfully translate to a higher disease risk? Or are we vaccinating against unfounded fears?
Do the other nations vaccinate less than the US because their health care systems are worse? Annoyingly (if you're an American) all of their health care outcomes rank better.
Is the US health care system more corruptible by industry influence?
Is the story a lot simpler and less sinister? That the US vaccinates more than the rest of these countries because the balance of the US's health care system (access to treatment, quality of treatment) is worse? Or is it because having to stay home with a kid that's sick with chicken pox (varicella) is not so big a deal in, say, Denmark, because the social contract is more forgiving of parents who miss work?
Does the poorer quality of health care in the US (going by international rankings) and the lower tolerance for parents missing work combine poorly with the undue influence of industry and therefore lead to more vaccinations?
On the flip side of this argument: so what if we vaccinate kids against more diseases than other countries? Well, they're not free. They cost money to administer, and cost tears because kids hate getting shots. The health risks from vaccines aren't zero, either. Vaccines have side-effects, and sometimes they're serious. Those other nations (presumably) ran cost-benefit analyses too and came to different conclusions. It would be nice if each country showed their work.
When it comes to needles to stick my new kiddo with, I'm not really being persuaded to do more than the intersection of vaccinations between similar nations. The fear that a doctor is about to stick my kid with a needle because there was a meeting in a shady room between a pharma rep and a CDC official is pretty powerful. It doesn't seem like a strictly irrational concern either