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A summary of presentations from the weekly Summit partner webinars

January 16, 2025 – The latest Summit Summary

Seasonal Influenza Updates – Katie Reinhart, PhD, MPH, Influenza Division, Centers for Disease Control and Prevention

Katie Reinhart, PhD, MPH, gave a seasonal influenza update.

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Seasonal Influenza Update – Katie Reinhart, PhD, MPH
A review of the influenza season data as of January 4, 2025 provides the following information.

Outpatient Visits for Respiratory Illness
According to the Outpatient Influenza-like Illness Surveillance Network (ILINet), the percentage of visits due to ILI has been above the national baseline for the past 6 weeks.

  • There was a slight decrease during the first week of 2025, which could be indicative of an actual decrease in activity or a holiday effect on healthcare-seeking or reporting behaviors.

The data shows the following trends by age group and by state.

  • Younger age groups are seeing more visits (both week-over-week and more than other groups) due to respiratory illness. However, the youngest two age groups both saw a decline during the first week of 2025.
  • Many states are seeing high or very high activity at this time: 19 with very high activity and 24 with high activity. States with low activity at this time may experience a later start to the season.

Virologic Surveillance

  • At clinical labs, the percentage of specimens that were positive during week 1 of 2025 was 18.6%, with influenza A dominating at 98% and influenza B representing 2%.
  • At public health labs, influenza A (H1N1) and influenza A (H3N2) are continuing to cocirculate, with about 45% influenza A (H1N1) and 55% influenza A (H3N2) during week 1 of 2025.

Genetic and Antigenic Characterization

  • For H1 viruses, 43% of the viruses that have been characterized fell into the 5a.2a.1 clade. The antigenic characterization is similar to the cell-grown vaccine, reference vaccine, or reference virus.
  • For H3 viruses, 98% have been in the same clade as the vaccine reference virus.
  • For B Victoria viruses, all fell into the same clade and were antigenically similar to the vaccine virus.

Influenza A (H5N1) Update
There are 67 confirmed human cases in the United States: 40 with exposures to dairy cattle, 23 associated with poultry farm and culling operations, 1 with another type of animal exposure, and 3 with unknown exposure.

A Health Alert Network (HAN) [https://www.cdc.gov/han/2025/han00520.html] was released on January 16, 2025 that advocates for accelerated subtyping of influenza A viruses in hospitalized patients, to allow for timely subtyping and response in the event of a novel flu virus.

QUESTIONS & ANSWERS

Q: Do you have any idea when we might see some early vaccine effectiveness data out of CDC?
Katie Reinhart (CDC): Toward the end of February.

Q: Regarding antigenic characterization, was the match different for egg-based dry versus cell-based dry vaccine?
Katie Reinhart (CDC): It was not: the antigenic match is similar for both the egg- and cell-based dry products.

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AIM’s Adult Immunization Activities – Emily Messerli, DNP, APRN, FNP-C, Chief Programmatic Officer, AIM

Emily Messerli, FNP, APRN, FNP-C, gave an update on Association of Immunization Managers (AIM’s) adult immunization activities.

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Association of Immunization Managers (AIM) Adult Immunization Activities – Emily Messerli, DNP, APRN, FNP-C
AIM is a nonprofit organization, partially funded by CDC, that works with partners to reduce, eliminate, or eradicate vaccine-preventable diseases (VPDs); promote allocation of resources and development of sound policies and programs; and provide a forum for information sharing among its members.

Member Assistance Program (MAP) Overview
AIM and CDC partnered with Mathematica to develop MAP, which is a technical framework designed to help adult immunization programs reach their goals, which include improving immunization confidence, increasing uptake of routine adult immunizations, and advancing health equity.

  • MAP’s key activities are affinity groups, webinars, feedback sessions, and toolkits. Online engagement has been critical to the success of the program, especially in light of the COVID-19 pandemic and in-person restrictions.
  • 2023 was the most robust year of the program and included six affinity group meetings, multiple action group meetings, and three spotlight webinars about Disproportionately Affected Adult Populations (DAAP). There were also feedback sessions, resource reviews, and committee and national partner meetings.

MAP Resources
Member feedback revealed a need for help with the business operation of an adult immunization program and how to operate within a health equity space. Resources developed by MAP included the following:

  • Business Operations Toolkit
  • Health Equity Toolkit
  • Goal Tracker Tool
    • The goal tracker tool, which helps programs determine what is necessary to advance their program, has been incorporated into the current pilot of the adult immunization framework at CDC.

MAP Evaluation
The evaluation looked at the full 3 years of the technical assistance program, including what worked, what did not work, and what adult immunization programs need in order to be successful. More than 67% of participating jurisdictions said the MAP assistance was helpful in advancing their adult immunization program.

  • Key Findings
    • The business operations aspect of running an adult immunization program in a public health setting is challenging or extremely challenging.
    • Closing health equity data gaps is a challenge.
  • Priority populations, i.e., those that are most challenging to reach, are people who are homebound; unhoused; refugees, immigrants, or migrants; or rural populations. These populations are difficult to reach due to geographic location, economic challenges, and reduced health care access.
  • For health equity activities, respondents were most challenged by documenting and tracking coverage data. Respondents also find it challenging to recruit and retain a workforce that represents the community in which they work.
  • For strategic partnerships, securing strategic funding to support partners is the most challenging activity. Respondents said activities related to managing partnerships, including staffing, and monitoring goals were among the most challenging.
  • Up to 30% of participating jurisdictions are implementing the CDC adult immunization framework pilot and are receiving extended funding to address these challenges.
  • Barriers to health equity identified by jurisdictions are funding, staffing, policy barriers, and community engagement. These barriers are being addressed, in part, by partners and CDC with projects like the partnership framework and adult immunization framework.
  • Members rated the following publicly available resources as the most helpful:
    • Partnering for Vaccine Equity Program (P4VE), including the P4VE Learning Community
    • Vaccine Resources Hub
    • MAP Minute

Lessons Learned & the Future of MAP
High priorities for Adult Immunization Projects (AIPs) over all 3 years were:

  • Reaching immigrants and refugees
  • Hiring and retaining staff
  • Sustaining funding: CDC has offered an extension on COVID-19 supplemental funding to maintain staffing through 2026

Although funding ended in 2024, AIM continues to promote MAP resources and toolkits, host monthly Adult Immunization Committee (AIC) meetings, and collect adult-focused best practices for AIM’s program practice database. The AIC is the main support for AIPs; the in-person meeting as part of the 25th anniversary meeting of AIM was well attended, as are the committee calls.

AIC Goals are to:

  • Share potential gaps between supply and demand for adult 317-funded vaccines.
  • Collect and host AIPs operations guides for younger programs to use as they mature.
  • Work together to determine how states set priorities for vaccine purchases with 317 funding according to local demographics or disease.

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Introduction and Update on VICP Program – CDR R. Paul McClung, MD, Associate Director for Science, Division of Injury Compensation Programs, Health Systems Bureau, HRSA; CAPT Reed Grimes, MD, MPH, Director of the Division of Injury Compensation Programs, HRSA

CDR R. Paul McClung, MD, and CAPT Reed Grimes, MD, MPH, gave an overview of the Vaccine Injury Compensation Program (VICP).

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Introduction and Update on the Vaccine Injury Compensation Program (VICP) Program – CDR R. Paul McClung, MD, and CAPT Reed Grimes, MD, MPH
VICP was created through the National Childhood Vaccine Injury Act (NCVIA), which was signed into law in 1986, and included other vaccine-related systems and programs. The VICP was established to provide a no-fault alternative to the traditional tort system by providing compensation to people found to be injured by certain vaccines; this limited manufacturer liability and stabilized the vaccine supply and costs associated with vaccination.

The VICP Process
VICP follows a judicial process.

  • The claimant/petitioner files with the US Court of Federal Claims.
  • The petition is reviewed by HHS, including medical review by HRSA staff, and a recommendation is made to the attorney from the Department of Justice representing HHS.
  • A Special Master reviews the case and makes a determination related to compensation.

Compensation Details
The Vaccine Injury Compensation Trust, created by the Vaccine Act, is managed by the Department of the Treasury and provides funding to administer the VICP and to compensate eligible petitions. It is funded by a $0.75 excise tax imposed on each dose of vaccine for which an excise tax has been passed by Congress.

Eligibility and Coverage
Not all vaccines are covered in VICP; there are 3 criteria for coverage, including recommendation by CDC and excise tax approval by Congress. Generally, what is covered is a category of vaccine and not a specific name or formulation.

Compensation coverage can include medical expenses, lost wages, attorneys’ fees, pain and suffering, and death benefits. Awards can be large: on an annual basis, VICP has paid out between $150M and $300M in awards, most of which goes to petitioners, as opposed to attorneys. Seasonal influenza vaccines are the most common vaccines included in petitions, and most petitions (80%-90%) are filed on behalf of adults.

Advisory Commission on Childhood Vaccines (ACCV)
ACCV has nine members, with stipulations that membership be comprised of health professionals with expertise in the health care of children, members of the general public, and attorneys, each group with additional stipulations. Nominations for the commission are accepted on an ongoing basis at ACCV@hrsa.gov.

  • Two notable duties of ACCV are to advise the HHS Secretary about VICP implementation and to recommend changes to the vaccine injury table, a listing of specific injuries or conditions associated with VICP-covered vaccines and established time periods for injuries.
    • Petitions that allege injuries that meet the criteria established on the table are entitled to presumption of vaccine-caused injury, unless an alternate cause is proven; petitions that allege injuries that don’t meet the criteria can be made but, in those cases, the petitioner has the burden of proof that the vaccine caused the injury.
  • Changes to the vaccine injury table can be made when ACCV makes a recommendation to the HHS Secretary, who then follows a federal rule making process that includes publishing a notice in the Federal Register and a public comment period.
  • The next ACCV meeting is January 29-30, 2025. Meetings are open to the public and meeting information and registration can be found at https://www.hrsa.gov/advisory-committees/vaccines/meetings.

Countermeasures Injury Compensation Program (CICP)
CICP was established under the Public Readiness and Preparedness (PREP) Act to be an accessible forum for compensating individuals seriously injured by covered countermeasures, specifically those used in a public health emergency or threat. There are currently nine PREP Act declarations, including COVID-19, smallpox, and pandemic influenza.

  • CICP covers vaccines, medications, medical devices, test kits, PPE, and other items (i.e., items used to prevent, diagnose, or treat a public health emergency or threat).
  • Payments authorized in CICP are secondary to obligations of third-party payers and may cover medical expenses, lost employment income, and death benefits; unlike VICP, pain and suffering and attorneys’ fees are not covered.
  • CICP uses an administrative process to review cases and make decisions about the type and amount of compensation.
  • CICP does not have a vaccine injury table, but does require the HHS Secretary to establish a covered countermeasures injury table specific to given threats, when made possible by sufficient evidence.
  • COVID-19 changed the CICP program from a small staff and no direct appropriations to an expanded program, including a surge in staff and the processing of more than 3,500 claims (10,000 or so claims remain.)

QUESTIONS & ANSWERS

Q: You talked about COVID vaccines being for children and pregnant patients, but they’re also for adults in certain circumstances, correct?
Reed Grimes (HRSA): The criteria for coverage for a vaccine category is that it meets those three criteria. So the recommendation from CDC for routine administration to children or pregnant women and then an excise tax placed on the category of a vaccine and then a notice of coverage that’s put out by the HHS secretary once that vaccine category is covered and is codified. So, for example, any vaccine to prevent seasonal influenza, then anybody that receives that seasonal influenza vaccine within that category can file a claim within the VICP. So, it’s not specific to someone’s age or pregnancy status or whether they received the vaccine and are pregnant or a child. It’s more that the coverage gets initiated once that category of vaccine meets criteria.
Q [follow up]: So, a vaccine that is only recommended for the adult population, for example, probably it’s not covered?
Reed Grimes (HRSA): The shingles vaccine is a good example, where it’s only for adults and there’s no specific recommendation for pregnant people for the shingles vaccine, it doesn’t have VICP coverage.

Q: Are there time limits for filing in either of these programs? How long do you have after the vaccine was administered?
Reed Grimes (HRSA): There are two different filing deadlines for the program. For the VICP, generally, the filing deadline is, for an injury, a claim must be filed within 3 years after the first symptom of the vaccine injury. In the event of death, the claim must be filed within 2 years of the death or 4 years after the start of the first symptom of the vaccine-related injury for which the death occurred. [VICP Information and Data: https://www.hrsa.gov/vaccine-compensation] CICP has a different filing deadline, which is codified in statute or by law, and that deadline is within 1 year of administration or use of a covered countermeasure. And, in the case of COVID-19, the overwhelming majority of claims that have been filed is for COVID-19 vaccine; however, we also see claims in that CICP program for things like ventilators, medications, other countermeasures that were deployed to combat the COVID-19 pandemic. [CICP Information and Data: https://www.hrsa.gov/cicp]

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Announcements
  • The NAIIS in-person meeting is scheduled for May 13-15 at the Ravinia, Dunwoody in Georgia.
    • The Summit’s Immunization Excellence Awards will be presented at the awards luncheon on May 14, 2025. Nominations for the Excellence Awards must be received by February 1, 2025. https://fs29.formsite.com/uI8uzs/2024NAIISAwards/index
    • All partners are invited to submit an abstract for consideration for the Summit’s poster session at https://www.izsummitpartners.org/submission/. Attendees interested in submitting an abstract for consideration must submit their abstract by March 1, 2025. Submitters will be notified if their poster is accepted by March 15, 2025.

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