While Denmark only has 5.8 million people, this Nordic nation has an impressive economy, sophisticated culture, and highly educated population. What goes on in Denmark should matter to the rest of the world. Yet medical and research news is often contained or cordoned off by country. The Danish Health Authority has announced it would temporarily stop all COVID-19 vaccination efforts by mid-May. The Nordic nation has ceased administration of a fourth dose showing far more restraint than in America.
The Scandinavian country became the first country to cease all pandemic restrictions by February 1st, as it notified its population that COVID-19 was no longer a critical threat. After all, with a highly vaccinated population, recognition of robust natural immunity for those already infected, waning infections, and stabilized rate of hospitalizations the Danish Health Authority made the move to essentially transition their nation to the endemic stage of COVID-19 as the virus was essentially in control.
Now, reports are that the Danish government has decided to cease its COVID-19 vaccination program starting May 15, 2022. However, public health officials stand ready to reactivate the vaccine program after the summer, as Scandinavia enters its chilly fall and dreary and cold winter.
But what about Booster doses?
According to the Danish Health Authority website,
“Due to the high level of immunity in the population, the current 3rd wave of covid-19 is flattening. The high vaccine coverage in Denmark means that we can handle the high incidence of infection without severe illness; this is especially due to many given booster doses. Therefore, the Danish Health Authority has assessed that a 3rd dose to people under the age of 18 and a 4th dose for further groups will not be offered for the time being. The Danish Health Authority is also considering phasing out the covid-19 vaccination program later in the spring.”
The Danish health authorities appear to want to avoid administering a fourth COVID-19 vaccine dose if at all possible.
This is similar to Dr. Anthony Fauci’s recently shared opinion that the pandemic has transitioned to endemic. Even with still uncomfortably high infection rates, the combination of vaccinated persons and those with natural immunity represents the vast majority of persons in many countries.
Thus, the Danish Health Authority reassessed all further vaccination efforts. This included a fourth dose for high-risk cohorts such as nursing homes.
What’s the Danish Health Authority's stance on boosters?
The public health agency uses interesting language for the fourth dose, declaring the “4th dose is currently not needed for many groups.” They declared, “Previous assessments by the Danish Health Authority showed that elders living in nursing homes and people over the age of 85 are well protected after a 3rd dose of vaccination.”
The agency continued, “Following a further review of the evidence, the Danish Health Authority has assessed that a 4th dose is currently not necessary for the oldest citizens.”
Bolette Søborg, the nation’s chief physician and Director of the Department of Preparedness and Infectious Diseases, Danish Health Authority went on the record:
“The high level of societal contagion has caused more infection at nursing homes and in the oldest age groups. Fortunately, at the same time, we have seen that only a few in these groups have experienced severe illness, which means there is continued strong protection from the 3rd dose. At the same time, we are also seeing a decline in the epidemic, and with spring soon arriving, we do not see the need for people living in nursing homes and people over 85 being offered a 4th dose this season.”
Dr. Søborg furthermore stated that “The Danish Health Authority will, of course, follow the epidemic closely, and we are ready to change our decision, if, against expectation, a fourth wave or a worrisome variant is detected during spring.”
What about a third dose?
The Danish Health Authority has determined at this time that based on the confluence of factors and forces mentioned above there is no “substantive basis for offering a 3rd dose to people under the age of 18.” The Danish agency notes that the European Medicines Agency (EMA) has not approved a 3rd dose for this cohort either.
What about young children aged 5 to 11?
The Danish Health Authority did advocate vaccination of children aged 5 to 11 not primarily as a means of protection for the children but to stop community transmission. Interestingly, this was during the Delta variant when durability challenges were first identified (e.g., breakthrough infections were already occurring with the vaccines and thus community transmission was a reality even after one became fully vaccinated). However, the effect of this strategy has been less than they expected, especially with the Omicron variant.
The chief physician went on the record:
“We extended the vaccination program to also include 5–11-year-olds in November, and I am satisfied with a coverage of about half the population. The effect of it is less than we had anticipated because we faced a different variant underway, but our new assessment shows that despite everything, by including the 5–11-year-olds in the vaccination program we have increased the immunity in the population against omicron by approx. 2 % at an important time of the epidemic. Even though children typically are not faced with severe illness due to covid-19 and that the protection of the children was not the primary reason for extending the vaccination program to this age group, we are happy to see very few vaccinated children getting the severe covid-19 syndrome MIS-C.”
This agency understands that children rarely get seriously ill from COVID-19 but from time-to-time MIS-C is a risk. Thus, the agency will continue recommending COVID-19 vaccination for children during the winter months as a means to protect against MIS-C. Unfortunately, the Danish Health Authority doesn’t share their underlying risk-benefit calculus used to make that determination.