David Heinemeier Hansson

January 1, 2022

Should you vaccinate your kids?

On the face of it, this seems like a basic medical question. One where reasonable people can weigh the same trade offs, yet arrive at different conclusions. And, as foreign as that might seem to Americans at the moment, that's largely how this question has been tackled in Denmark in the public forum so far.

There are Danish pediatricians arguing that the determining factor should be that kids themselves don't stand to benefit much from the vaccine. That the Danish principle on vaccines has up until this point weighed protecting the vaccinated themselves as the number one goal. And thus Denmark should not recommend the vaccine for kids broadly.

Then there are the health authorities saying that regardless of whether the vaccines are likely to help the individual kid, it's important that they get it to keep society going. Having kids out sick or even just confirmed infected is a major disruption (for their education and for the parents having to quarantine with them). Besides, the vaccines are safe, given the data we have so far.

This debate is had in the public sphere in good faith. Being eager to vaccinate kids is one reasonable stance, being hesitant to vaccinate kids is another reasonable stance. Ultimately, the choice has been left to the parents without coercion.

And this is where it gets interesting. While more than nine out of ten Danish adults are fully vaccinated, only 40% of kids between 5-12 have gotten the first jab, and as of a few days ago, only around 2% had gotten both jabs.

This is a country with a very high level of trust in the health authorities (#1 in Europe, I believe). Very little in form of large-scale demonstrations against the pandemic restrictions. With an open and mostly non-contentious political and social debate. And yet the majority of parents of kids under 12 have still so far decided not to vaccinate their kids.

One perspective on this could be that Danish parents are simply being irrational. That if just the Danish state pushed harder, perhaps by making life more difficult for the unvaccinated kids and their parents, it would get the compliance it sought. This seems like a common sentiment in certain American circles.

But the Danes are explicitly going in the other direction. Even as the health authorities recommend vaccinating kids, they continue to stress that this is an invitation, not a requirement. And the societal debate is full of admonishments to ensure that schools don't end up making unvaccinated kids feel different. That this is a family choice, and everyone needs to respect that.

What a contrast to the American public dialogue! Which seems to have dug into the trenches of vaxx v anti-vaxx. With one side seeing the pressure for kids to be vaccinated as tyrannical governmental overreach and the other the failure to vaccinate as an ignorant, possibly evil, sin.

Meanwhile, it seems like both societies are still grappling with how to integrate the long-run risk for kids contracting the virus and the latest data on the propensity for vaccinated individuals to contribute to the spread.

Here's a chart comparing the proportion of vaccinated v unvaccinated per 100,000 in each group who are currently being infected in Denmark:

who's getting infected in denmark.png

It's basically an even split. So the vaccines don't appear to do much if anything to prevent someone from contracting the virus, and therefore don't do much to contain the overall spread. That seems to be confirmed by the fact that Denmark has some of the highest vaccination rates in the world, and yet also currently has some of the highest transmission rates in the world.

Of course being vaccinated as an adult plays a very significant role in how bad your experience with the virus is likely to be. Proportionally, there are 4x as many unvaccinated people with covid in the hospital in Denmark as there are vaccinated. But again, that's for adults. All reports continue to be that kids are extremely unlikely to have a bad case of corona, particularly if they don't have other underlying health issues.

Take the CDC report for the youngest kids (0-4) where there's been a total of 245 deaths with covid over the two years since the pandemic began in the US. Contrast that with 347 deaths in the same age group for the flu season of 2019-2020. And contrast that with the fact that over 600 kids age 1-4 die in America every year from drowning.

Kids have been far less likely to die from covid than from a range of other causes up until now, and they seem to spread the virus just as much – whether they're vaccinated or not (at this stage in the pandemic). Those are reasonable factors to consider when trying to answer the original question here of whether to vaccinate your kids or not!

Anyway, that's essentially a digression. What fascinates me the most is that Denmark is able to have this sober public debate at all while America largely can't. That the people there who advocate for vaccinating kids have the capacity to not just tolerate but respect those who advocate against it. Maybe that's part of the reason that the Danish health authorities generally enjoy such high trust! Tolerating dissent and discussion is a sign of strength, not weakness.

I know this debate isn't squarely one between the US and Denmark. Plenty of other European countries are taking far less lenient stances towards the question than does Denmark. Talk of forced vaccinations in Austria, for example. But these are the two countries I'm spending the majority of my time in, and the contrast is illuminating. How we conduct the public debate is not a given!

I just wished the American left in particular would take some inspiration from what is in most other ways a role model for a modern, socially democratic state. If Denmark can have a reasonable debate on a highly contentious topic like whether to vaccinate your kids or not, why can't America?

About David Heinemeier Hansson

Made Basecamp and HEY for the underdogs as co-owner and CTO of 37signals. Created Ruby on Rails. Wrote REWORK, It Doesn't Have to Be Crazy at Work, and REMOTE. Won at Le Mans as a racing driver. Fought the big tech monopolies as an antitrust advocate. Invested in Danish startups.