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A summary of presentations from the weekly Summit partner webinars

April 3, 2025 – The latest Summit Summary

Flu Vaccine Effectiveness – Tricia Nowalk, PhD, RD, Professor, Department of Family Medicine, University of Pittsburgh

Tricia Nowalk, PhD, RD, gave an update about the effectiveness of flu vaccines this season.

Flu Vaccine Effectiveness – Tricia Nowalk, PhD, RD
[Note: Dr. Nowalk presented slides prepared by Aaron M. Frutos, PhD, MPH on behalf of CDC Influenza Vaccine Effectiveness Collaborators.]

If you have any question regarding this presentation, please email info@izsummitpartners.org. We are currently awaiting permission to post slides.

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Vaccines and the American Dental Association – Rosie Wagner, DDS, Founder, Smiles by Rosie Family Dentistry, Founder, National Organization for Dental Immunizers

Rosie Wagner, DDS, gave an update about administration of vaccines by dentists and dental hygienists.

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Vaccines and the American Dental Association – Rosie Wagner, DDS
Dr. Rosie Wagner is a general dentist in private practice who administers flu, COVID, and HPV vaccines. She is not affiliated with any health care centers, but she worked on a one-year grant project to have an oral health component on oropharyngeal cancer and also recommends cancer prevention through vaccination, which reveals a growing interest in allowing dentists, who were recommending vaccination anyway, to be able to administer vaccines. There was little movement on the idea until the COVID pandemic created the need for all health care workers to be able to participate in the vaccination effort. Dentists and dental hygienists with appropriate training were given permission to give vaccination. Dr. Wagner started giving COVID vaccines then and has since offered flu and HPV vaccination, as well. In her experience, most patients say yes and appreciate the convenience.

Reasons to Allow Dentists to Be Vaccinators

  • Dental offices are quiet and small
  • Patients are familiar with the office
  • Infrastructure already exists for scheduling, handling sharps, sterile and aseptic techniques, medical emergencies, documentation, and laws and regulations
  • Vaccination can be part of routine appointments
  • Dentists have a relationship with their patients who they see at all ages and during two well visits per year
  • Everyone in the office is involved; dental hygienists can vaccinate
  • Vaccination is within dentists’ scope of practice: it is their responsibility to practice preventive health care

Coding, Claims & Reimbursements: Medical Versus Dental
There is a need for advocacy to help dentists get paid for vaccinating their patients. Dental codes are not being recognized yet by payors and the vaccine is included in the dental code so the fee must include the cost of the vaccine; this is unlike a medical code, where the vaccine would have its own code.

There are now dental codes for some vaccines:

  • HPV for doses 1, 2, and 3: D1781, D1782, and D1783
  • COVID: D1701-D1714
  • Flu: The creation of a dental code for influenza vaccine was approved recently by the ADA and that code will be in the 2026 Code Book

In Massachusetts, vaccinators cannot charge or submit a claim for state-supplied vaccines (for those under 19) but the dental code includes administration, so it is permissible; however, no dental payor is paying this code yet.

  • It often takes 5-10 years for dental payors to recognize a new code.
  • Although Dr. Wagner has gotten some payments, getting those payments has taken months.

There is a need for advocacy for Medicaid to start recognizing and paying for these codes.

  • In Massachusetts, dentists contracted with MassHealth (Medicaid) cannot bill under medical.
  • Dentists can bill medical insurance.
  • Dr. Wagner uses regular mail to submit claims as an out-of-network provider under medical insurance. Claims sometimes need pre-authorization and sometimes result in payments.
  • Note: If a dentist wants to use state-supplied vaccines, only, the sole cost is the refrigerator.

QUESTIONS & ANSWERS
Q: Do you participate in the Vaccines for Children Program (VFC), or do you only provide vaccines to those with private insurance? What is the youngest age you will vaccinate? And have you gotten any pushback from pediatricians regarding vaccinating children?
Rosie Wagner (Smiles by Rosie; Natl Org for Dental Immunizers): Yes, I am in the VFC program, and that’s how I get all of my vaccines for [people] under age 19. When I started, I was on emergency only, so I didn’t have a walkthrough and was not VFC. And I could only order flu and COVID [vaccines] – at the time, you could order COVID [vaccines] for adults through the state; once that stopped, though, I got the full walkthrough and VFC approval, which is how I was able to start administering HPV vaccines. For children, because I don’t have to pay for the vaccines, I just give them to all children under the age of 19, regardless of insurance. For people over 19, I haven’t been charging thus far, but I’ve only been giving flu vaccines because the cost to me was relatively low, and I would administer, maybe, 100 per season and essentially volunteered those vaccines to the community. This upcoming year, I’ll probably charge adult patients $20 for the flu vaccine and purchase a small number of COVID vaccines, and for all adults — including those with MassHealth with Medicaid, because I can’t access the medical side of Medicaid — I’ll need to charge those adults the cost for the vaccine. So probably about $130 for COVID.
 I have had no pushbacks from pediatricians. They’ve been thrilled, particularly when I let them know, “Here’s your kid for their next physical. They’ve completed their HPV series. It’s done.” I did it under nitrous oxide for a previously phobic patient who maybe wouldn’t have been able to get it. I do have nitrous, so I’ve had several appointments of just nitrous and vaccines. I start vaccinating [patients] when they are 6 months of age, because I only administer COVID and flu and HPV, so I don’t administer any vaccines for those younger than 6 months.
 There is another question: Do I report the doses to the state registry so that a primary care physician or pharmacy can see the doses? Yes, all vaccinators must register with the Massachusetts Immunization Information System (MIIS), which is our state’s registry, and within 24 hours you do need to report the vaccine given. So not only do we report that, but for every patient that comes in, we grab a screenshot of that day’s entry of MIIS to see what they might be eligible for. So, we look at what has been given, and then we record what’s being given. Interestingly, sometimes a patient will tell their physician they got vaccinated at the dentist, and I think they think we don’t know to upload. So, there have been some patients that got duplicate records, but then we merge them and such. I always just let the patient know we’ll be uploading that within one day. I also now have access to the Color website (Massachusetts’ Vaccine Clinic Management Platform), which uploads for me. So, when I vaccinate in school clinics, for example, our state has an agreement with Color that they do all of the documentation and contraindications, which has been good. So, there are several different ways to document.

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IQVIA Respiratory Viral Vaccine Coverage Data – Nandini Selvam, PhD, MPH, VP & GM, IQVIA Government Solutions

Nandini Selvam, PhD, MPH, gave an update about trends in vaccine coverage data for this season versus last season.

IQVIA Respiratory Viral Vaccine Coverage Data – Nandini Selvam, PhD, MPH
The data presented was from the National Prescription Audit (NPA), an IQVIA data asset, from March 14, 2025. The data come from the pharmacy front end.

NPA 2025 Season Versus 2024 Season
The data represents raw volume administered for the following vaccines and shows percent change from the prior year (note that some percentages seem high because the vaccination numbers are very low), listed below:

  • COVID: -12%
  • Influenza: -0.2%
  • Tdap: 37%
  • Shingles: -22%
  • Pneumococcal: 22%
  • RSV: -65%

NPA Data Analysis by Vaccine
For each vaccine, data are visible by weekly volume, which allows for trends and spikes to show. And, looking at each vaccine by age group allows for age-related differences to show.

COVID by Weekly Volume

  • There was a -12% decrease in the number of COVID vaccines administered in the 2025 season versus the 2024 season.

COVID by Age Group

  • Vaccine administration rates for people age 60+ is consistently higher than the younger population.

Influenza by Weekly Volume
This vaccination peaks between August and mid-November.

  • There was a -0.2% decrease in the number of influenza vaccines administered in the 2025 season versus the 2024 season.

Influenza by Age Group
This vaccination peaks between mid-August and October.

  • Vaccination administration rates for older people are higher than those for younger people.

Tdap by Weekly Volume
The rates are for Tdap vaccinations, in general.

  • There was a major increase in the fall of 2024, but otherwise it’s roughly the same across the trend line.
  • Across the board, for Tdap, the greatest numbers are in 20-39 females, possibly because they’re offered the vaccine during pregnancy.

Tdap by Age Group

  • Vaccination rates are higher in the 60-74 age range than the 75+ age group.

Shingles by Weekly Volume
Vaccine administration for Shingles has decreased, overall.

  • There seem to be upticks around late November, possibly due to holidays and a sense of communal responsibility, but this trend may also reflect seasonality.
  • People age 60+ are getting vaccinated for Shingles at a higher rate than those ages 40-59.

Pneumococcal by Weekly Volume

  • This vaccine has shown increases this season: about a 22% increase, overall.

Pneumococcal by Age Group

  • People age 60-75 are getting vaccinated for pneumococcal at a higher rate than other age groups
    • The difference versus younger age groups may be due to advisory, as it is not recommended for them.

RSV by Weekly Volume
There seems to be a decrease, overall; this could be because those who really wanted this vaccine got it when it first came out. Adoption rates may increase as people age into the recommended group.

RSV by Age Group

  • Vaccination rates for RSV are highest among 20-39 year old females.
  • For people age 75+, there are not any significant differences after the first year in terms of those 60+ versus even older adults.

QUESTIONS & ANSWERS
Q: The National Prescription Audit (NPA) data, the prescription data, is that retail pharmacy only? WHO says that they have access to your NPA data, and it represents pharmacy vaccinations only. So is the presentation with the NPA data all settings, including pharmacy, or is it just pharmacy retail?
Nandini Selvam (IQVIA): I think it’s just pharmacy retail.
L.J Tan (Immunize.org, NAIIS): So it is just pharmacy retail data. But there’s another module, right, that you look at for provider data, as well?
Nandini Selvam (IQVIA): Correct. So provider data is different, that is at the patient level. So this is much more the audit trail data where we look at just volume data.
L.J Tan (Immunize.org, NAIIS): Got it. We probably would want to bring you back to talk a little bit about the medical provider numbers, too, because there’s obviously interest in those, too. But it looks like there’s a general declining trend, for almost all the vaccines, in vaccination coverage, based on the NPA data.
Nandini Selvam (IQVIA): Yes, it looks like it’s definitely declining. We should have an update in terms of our patient-level data from provider billing, as well, in the next 2 weeks. In fact, I will have that for the Immunization Summit. So it will be updated in the next couple of weeks with the quarter-end and the other data, which is why I chose to present the NPA view, which has less of a lag at the moment than the way we’re updating the other ones.
L.J Tan (Immunize.org, NAIIS): I will point out that Dr. Nowalk says that the RSV data is more likely because the recommendation changed to 75+ for RSV, with shared clinical decision making for ages 60 to 74. And there’s probably a transition period with regards to some of that.
Nandini Selvam (IQVIA): Yes: That’s why I was saying that there are a variety of reasons that it could be that, plus it’s not a yearly vaccine.

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Announcements
  • Registration is open for the Adult and Influenza Immunization Summit: Looking Back, Moving Forward, May 13–15, 2025. This summit will be held at the Crowne Plaza Atlanta Perimeter at Ravinia.
    • Registration is open at https://www.izsummitpartners.org/2025-naiis-registration-form/.
    • Registration requires a case-sensitive password from NAIIS. Registrants for the meeting must be members of the Summit; a membership form is available at the Summit website.
    • Please book a room at the Crowne Plaza Ravinia hotel within the Summit rooming block to help defray costs for the meeting.
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