A summary of presentations from the weekly Summit partner webinars
March 17, 2022 – The latest Summit summary
Adult Vaccine Access Coalition (AVAC) Legislative Update – Abby Bownas (AVAC)
Abby Bownas, manager, Adult Vaccine Access Coalition, provided an update presentation on current legislative items.
The Adult Vaccine Access Coalition (AVAC) consists of 70 federal organizational leaders in health and public health committed to raising awareness of the importance of adult immunization with the goal of addressing barriers to this effective preventive service. Their mission is informed by scientific and empirical evidence that shows immunization improves health and protects lives against a variety of debilitating and potentially deadly conditions, saving costs to the healthcare system and to society.
AVAC’s core areas of work focus on improving infrastructure, which includes the workforce and reporting of vaccinations in immunization information systems (ISS), as well as promotion of vaccine equity and confidence to increase vaccination rates. AVAC also focuses on supporting the development and adoption of federal benchmarks and quality measures with the implementation of best practices, reporting, and improving equitable access to vaccines to increase vaccination rates.
AVAC’s policy goals for 2022 include:
- Supporting federal funding for immunization programs
- Explicitly and consistently addressing the need for increase in vaccine access for all adults
- Improving beneficiary access and alleviating financial barriers for vaccines
- Reducing provider barriers to offering vaccines
- Strengthening and increasing access to IIS across the life course
- Advocating for the implementation of immunization best practices
Supporting federal funding for immunization programs
FY22 Consolidated Appropriations Act (H.R. 2417) was signed into law on March 15. The Act included additional language about improving IIS infrastructure and data. The agreement directs CDC to provide an update on compliance with interoperability standards in IIS to the Committees within 180 days of enactment of the Act. The final bill did not include a COVID-19 emergency supplemental. The final Act offered funding support as follows:
- NCIRD $868,155,000
- Immunization $640,797,000
- Influenza $211,358,000
- Viral Hepatitis $41,000,000
AVAC is gearing up for FY23 to support immunization programming and report language. A sign-on letter is circulating.
Improving beneficiary access and alleviating financial barriers through first dollar coverage of vaccines in Medicare and Medicaid
AVAC has been working to eliminate cost-sharing under Medicare and Medicaid. The following two bills will help overcome financial barriers:
- Protecting Seniors Through Immunization Act (H.R. 1978/S. 912) – eliminates the cost-sharing for vaccines covered by Medicare Part D n
- Helping Adults Protect Immunity (HAPI) Act (S. 581/HR2170) – newer bill that came through last year to eliminate cost-sharing under Medicaid, and ensure Medicaid coverage of ACIP-recommended vaccines
Learn more at: https://adultvaccinesnow.org/reducing-financial-barriers/
Strengthening and increasing access to immunization information systems across the life course
- Immunization Infrastructure Modernization Act (HR550) – This was passed by the house in December of 2021. The bill was encompassed components that have been identified by CDC and Summit partners to best standardize the IIS.
- Senate PREVENT Pandemics Act (S. 3799) – This bill has been backed up by the Senate Health Committee. The bill addresses public health data modernization, addressing misinformation, and revitalizing the public health workforce.
- House CURES 2.0 (HR1600) – This bill was originally passed back in 2016. A section of this bill discusses the acceleration of vaccine discovery, development, and delivery. Section 104 of the bill includes vaccine awareness and immunization programs.
MACPAC Report to Congress
The MACPAC is a body of experts that provides recommendations to Congress on Medicaid policy. Over the last year, MACPAC has been working on diving deeper into the current state of adult vaccines. Their March report to Congress includes a chapter on access for adults in Medicaid (CH 2).
March 2022 report: Vaccine Access for Adults Enrolled in Medicaid (Chapter two)
The chapter highlights several policy considerations:
- Congress should make ACIP-recommended vaccines a mandatory benefit for all adults enrolled in Medicaid
- CMS should implement regulations for vaccine payment
- CMS should encourage the use of pharmacies and other providers in providing adult vaccinations
- HHS should provide technical assistance to improve vaccine outreach and education to Medicaid and CHIP beneficiaries
- Congress should require HHS to issue federal guidance to improve immunization information systems (IIS) and allocate funding to support these efforts
The Commission will continue evaluating these options and additional findings with recommendations to Congress in June 2022.
AVAC always wants to partner so if you would like to join you may contact AVAC at:
- Abby Bownas: firstname.lastname@example.org
- Katie Pischke: email@example.com
Advocates like the National Viral Hepatitis Roundtable (NVHR) and others historically have estimated $134M needed for viral hepatitis work; can you comment on the mismatch for $41M appropriated by Congress to DVH?
AVAC has been asking for a higher dollar amount, as according to our strategic plan, new estimates show a higher cost for what is needed. Congress doesn’t have a ton of money so things get level funded. A lot of advocates need to keep sharing why additional funds are needed.
Is the funding line of 2022 for viral hepatitis going to the CDC?
Yes, that is a CDC program.
I believe there was a lot of pushback on the IIS infrastructure bill. Maybe that is a reflection of anti-vax sentiment. Could you comment on why and how this backlash is coming up and what might be the solutions moving forward?
We did get a lot of pushback on IIS, which often comes from a place of confusion. IIS can be a confusing system, especially when words like vaccine passports are being thrown around and not explained in a cohesive way. AIRA is partnering on educating on what the IIS is and is not. They are explaining how the data is important to individuals as well as public health.
It is about breaking it down. We are on the right path with the Immunization Infrastructure Modernization Act (HR550). It will be good to see how the federal partners come together to support the IIS.
Can you give a little more information on what the HAPI Act is doing for Medicaid?
HAPI has three parts:
- Coverage for vaccines by all states
- Elimination of cost sharing for vaccines
- Includes and a FMAP bump so providers offering vaccines from Medicaid receive more reimbursement
How do prenatal immunizations that are paid for under Medicaid fall into HAPI?
They would fall into HAPI and we also have some standalone legislation that AVAC is advocating. The Maternal Immunization Coverage Act is one that specifically offers coverage. This standalone bill would eliminate cost sharing and provide coverage for pregnant individuals to receive vaccines under Medicaid. If HAPI moves forward, it would take care of that provision and the standalone maternal coverage bill would not be necessary.
There is also the Maternal Immunization Enhancement Act that has more of the quality measures, support, education, and outreach.
Does HAPI include minimums in terms of provider payment for vaccine administration? It’s a big barrier for some states that reimburse very low for administering vaccines to Medicaid patients.
There is a component on the FMAP increase that basically would translate to there being additional funds for those providers offering those vaccines. This would help providers wanting to stock and offer those vaccines.
Is there any talk about whether the “all-vaccines-platform” could become an essential component of COVID recovery? Would that be useful?
AVAC is working on a new “vaccine catchup” fact sheet talking about that pivot of framing the discussion about all vaccines and how important it they are, especially missed doses due to the pandemic. The sheet will also explain how important the vaccines are to public health. This is a way to shift the conversation.
We are also trying to tie the legislative acts to this. We can do things like eliminate cost sharing, strengthening infrastructure, promoting education, and awareness campaigns. If we get these bills passed and do these fixes, this will help strengthen the platform. A lot needs to get do to get back to where we were, and we would like to leave the pandemic stronger than where we came in in terms of routine vaccines.
1. The 2022 Influenza Vaccine meeting, What’s Up with Flu in ’22! Surveillance, Vaccines, Policy, and Communications Last Year and Next, will be held virtually on May 19, 2022, from 2:00–4:45 p.m. (ET). Pre-meeting registration is required by 5:00 p.m. (PT)/8:00 p.m. (ET) on May 18, 2022, to attend. For more information and to register, visit: https://www.izsummitpartners.org/2022-naiis/.
2. The HHS Office of Infectious Disease and HIV/Policy announced a public comment period for the updated “Vaccines Federal Implementation Plan”. This new draft document talks about federal agency actions in support of our overall national vaccination goals. You can review the draft and provide comments up to 5:00 p.m. (ET) on March 29. You can find the Vaccines Federal Implementation Plan, a companion document to the Vaccines National Strategic Plan 2021-2025, at: https://www.hhs.gov/vaccines/vaccines-national-strategic-plan/vaccines-federal-implementation-plan/index.html. You may send comments to firstname.lastname@example.org.