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A summary of presentations from the weekly Summit partner webinars

April 24, 2025 – The latest Summit Summary

Vaccine Legislative Updates – Erin M. Abramsohn, DrPH, Executive Director, Infectious Disease Prevention Network (IDPN) and Northe Saunders, Executive Director, SAFE Communities Coalition

Erin Abramsohn, DrPH, and Northe Saunders gave an update about pro-vaccine advocacy efforts in state-level legislative sessions.

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Vaccine Legislative Updates – Erin M. Abramsohn, DrPH and Northe Saunders
The political climate — including RFK, Jr. leading HHS, growing vaccine hesitancy among Americans, and more than 800 confirmed measles cases — is bleak. Although ACIP had a business-as-usual meeting in April 2025, the June meeting is to be confirmed. There is no acting director of CDC and things like the designee for signing off on ACIP recommendations are unclear.

Recent events are alarming and serious, including deaths attributable to measles and pertussis; falling vaccination rates; congressional committees being tasked with cutting $880B from public health programs, which could lead to hospital and provider offices closing and millions of Americans losing health insurance.

State-Level Legislative Session Trends
There have been more than 263 bills across the country during this legislative session, including more than 100 in the eight states IDPN is working in. Although there are fewer than at the height of COVID-19, the bills’ content is similar.

  • There is a well-coordinated and well-funded ($60M) anti-vaccine effort that has the potential to roll back long-standing protective vaccine policies. Without a well-resourced pro-vaccine advocacy effort, some of the anti-vaccine bills will pass and there will be increased morbidity and mortality related to decreasing vaccination rates.
  • The major categories of bills being introduced at the state level are:
    • Exemption (e.g., for immunization requirements for daycares and schools, religious or philosophical exemptions)
    • Medical freedom (e.g., prohibiting vaccine mandates, parental or vaccine recipient Bill of Rights)
    • COVID-19-specific bills, many of which prohibit the use of mRNA vaccines, some with broad language regarding the use of mRNA material
    • Informed consent, which generally exaggerates the risk of vaccines and underestimates benefits
    • Access (e.g., state scope or practice laws, vaccine costs and reimbursement
  • With the work being done to counter anti-vaccine efforts, many of the bills being proposed are not getting passed into law.

About IDPN
IDPN works in states where there is an urgent need to elevate pro-vaccine advocacy, using three strategies: state-based government relations (lobbying), state-based grassroots advocacy, and targeted communications campaigns. The model works: Since 2022, IDPN has successfully defeated more than 80 anti-vaccine bills in IDPN states.

Currently, IDPN works in eight states. Examples of activity in some of the states were provided, as follows:

  • Tennessee: A number of anti-vaccine bills were stopped at the end of the legislative session. One specific bill that would have affected the Tennessee Medicaid and CHIP programs. This bill prohibits health care providers from refusing to provide services based on the patient’s refusal or failure to get a vaccine. It was sent back to calendar committee, effectively ending consideration on the bill.
  • West Virginia: For two years in a row, there have been efforts to legislate religious and philosophical exemptions, despite West Virginia having one of the highest estimated kindergarten vaccination rates in the country and one of the lowest exemption rates for school vaccine requirements. As a result of lobbying efforts, advertising campaigns, and efforts by allies on the ground, in both years, these bills failed to pass. There is an expectation for another fight in West Virginia next year.
  • Louisiana: In addition to vaccine-specific bills in this state, IDPN is watching a number of bills that convey intentions to remove safeguards for evidence-based healthcare and access to broad public health infrastructure (e.g., organizing state human services district under the secretary and Surgeon General of the Louisiana Dept. of Health, transferring family and support programs, prohibiting water fluoridation, permitting off-label dispensing of ivermectin).
    • HHS Secretary RFK Jr. is also expected to visit the Louisiana legislature at the end of April 2025, but the focus may be on nutrition/MAHA and not vaccines.
  • Arizona
  • Florida
  • Idaho
  • Montana
  • Oklahoma

 QUESTIONS & ANSWERS

Q: Anti-vaccine efforts are well coordinated and funded. How does that compare to pro-vaccine advocacy? Do you feel that pro-vaccine advocacy is on par with anti-vaccine efforts in regards to coordination and funding?
Northe Saunders (SAFE): They are well funded. They have really great grassroots, organizing efforts underway, and they are funded by passionate individuals who give them money every single month. There are also very wealthy anti-vaccine individuals who provide hundreds of thousands, if not millions, of dollars to advance these causes. Year over year, we’re talking about $60M. If you look at organizations like ICAN — which is run by Del Bigtree, Children’s Health Defense, formerly run by RFK. Jr. — and affiliated anti-vaccine groups, they spend that money to promote misinformation, to introduce and move legislation like the legislation that we fight, and continue to prop up the industry of anti-vaccine work. We have resources. We’re not anywhere nearly as deep pocketed as they are. Another question is [about contributing to and] funding our work, collectively. We take grassroots donations. Any dollar goes a long way, so if you’re interested in contributing, you can contribute to our grassroots work at: https://www.safecommunitiescoalition.org/.
Erin Abramsohn (IDPN): Yes, we’re more than happy to have that conversation if anybody is willing or able, because to Northe’s point, we do have funding. We have nowhere near the amount of funding as the other side and we do have coordination, including grassroots coordination. We’re working every day to strengthen that.
L.J Tan (NAIIS, Immunize.org) [follow-up]: Ten years ago there wasn’t [this effort], and [it is] because of the work by Northe and IDPN. Northe, you started SAFE right before COVID?
Northe Saunders (SAFE): Yes, it evolved out of the grassroots work that we did in Maine to strengthen our school immunization policy and remove the exemption loopholes. It felt like that was a different approach, it was really about bringing everyday people and having them stand on the shoulders of the experts, the immunologists, the pediatricians, saying, “We trust science. We trust these people to help keep our families safe. Lawmakers, you need to listen to us.” [Presenting slide/visual:] So, $63M raised in 2023; that’s the last tax year that we have a full picture: $23M from ICAN, $16M from Children’s Health Defense, Young Americans for Liberty (that’s the organization that was funding candidates in West Virginia to make the chamber more anti-vaccine). And so, they have tens of millions of dollars that are flowing to this cause.

Q: How are health departments in Louisiana responding to the prohibition of immunization promotion that happened a couple months ago?
Erin Abramsohn (IDPN): It is a gag order. I think it is coupled with the claw back of funding too, and a lot of that funding was around education and vaccine equity work. I don’t have a direct line of communication to them anymore, because I am now outside of CDC. That is a question for the health departments in Louisiana, but it’s something that we should definitely look into and see how our other folks on the ground can support. They’re working hard in Louisiana because they do different work and complementary work. So, it’s not taking the place of what the health departments are able to do, and what they’re funded to do.
L.J Tan (Immunize.org, NAIIS): The final comment is about the Vaccine Integrity Project. That’s a new project coming out of CIDRAP, Dr. Michael Osterholm’s group. This is a topic that we can come back to, either on a Summit call or in some other fashion as the project evolves.

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ACIP Updates – Kelly L. Moore, MD, MPH, President and Chief Executive Officer, Immunize.org

Kelly Moore, MD, MPH, gave an update about votes and information from the latest ACIP meeting.

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ACIP Updates – Kelly L. Moore, MD, MPH
The most recent ACIP meeting was business as usual, with few technical issues and all votes unanimous (abstentions were not based on conflict). There will be a written summary of the ACIP meeting in the April 23 issue of the IZ Express newsletter (https://www.immunize.org/news/iz-express/issue/1810/).

Votes on Key Issues
Meningococcal Vaccine (MenABCWY)

  • ACIP voted unanimously (15-0) to recommend that GSK’s MenABCWY [Penmenvy] vaccine may be used when both MenACWY and MenB are indicated at the same visit.
  • In a separate vote, ACIP voted to include the pentavalent GSK vaccine in the Vaccines for Children program.

Meningococcal Vaccine (Information)

  • MenQuadfi (Sanofi) anticipated FDA decision in May to lower licensed minimum age from 2 years to 2 months (like Menveo by GSK).
  • There is equivalent immunogenicity and safety compared to Menveo.
  • There is potential for a vote in June.

RSV Vaccine in Older Adults (Vote/Info)

  • ACIP voted (14 yes, 1 abstention) to recommend that adults age 50 through 59 years who are at increased risk of severe RSV disease receive a single dose of RSV vaccine.
  • Definition of increased risk will be provided by CDC in the Clinical Considerations (likely to match those for 60 through 74 years).
  • RSV vaccination remains single dose (no revaccination recommendation yet).
  • Use of RSV vaccines in high-risk adults younger than 50 years of age to be discussed in June.

Chikungunya Vaccine (Vote)
Travelers

  • ACIP recommended use of virus-like particle chikungunya vaccine (CHIK-VLP) for people age 12 years and older traveling to a country or territory where there is a chikungunya outbreak. CHIK-VLP vaccine also may be considered for people age 12 years and older traveling…[to a] country or territory without an outbreak but with elevated risk for US travelers…for an extended period of time….
  • ACIP recommended use of live attenuated chikungunya vaccine (CHIK-LA) for people age 18 years and older traveling to a country or territory where there is a chikungunya outbreak. CHIK-LA vaccine also may be considered for people age 18 years and older traveling…[to a] country or territory without an outbreak but with elevated risk for US travelers…for an extended period of time…. Use of CHIK-LA in people age 65 and older is identified as a precaution.

Laboratory Workers

  • ACIP recommended use of CHIK-VLP vaccine for laboratory workers with potential for exposure to chikungunya virus. [Note: CHIK-LA vaccine is already a recommended option for this population.]

Information on Key Issues
Chikungunya Vaccine and Pregnancy
Vimkunya (CHIK-VLP) is not studied during pregnancy, thus pregnancy is a precaution. CDC has outlined guidance in light of risk of serious disease in neonates.

  • Avoid risk of chikungunya virus exposure.
  • Defer vaccination until after delivery.
  • Consider vaccination to avoid intrapartum transmission (if exposure risk is high).
  • If considering vaccination, when possible, avoid 1st trimester and, ideally, administer at least 2 weeks before delivery.
  • Non-live CHIK-VLP is preferred if both vaccines are available.

Influenza Vaccine (Information)
There was a review of preliminary VE estimates and discussion of the live attenuated influenza vaccine for home administration. A June vote is planned for updated recommendations.

COVID-19 Vaccine (Information)
There has been relatively low COVID-19 activity since October 1, 2024. Twenty percent of adults 18+ received the 2024-2025 season vaccination.

  • No increased risk of myocarditis/pericarditis has been observed in vaccine recipients.
  • Moderna has plans for next gen mRNA vaccine.
  • ACIP will vote for fall 2025 recommendations in June.

Mpox Vaccine (Information)
The outbreak that began in May 2022 continues at a low level.

  • There is currently a low 2-dose coverage of 26 percent.
  • FDA is considering lowering Jynneos® licensure from 18 years of age to 12 years of age.

CMV Vaccine (Information)
There was a detailed discussion of congenital CMV disease and epidemiology, including the potential to reduce CMV if a vaccine could be given before childbearing for protection through childbearing age. An investigational CMV vaccine from Moderna was presented.

RSV monoclonal antibody (Information)
Clesrovimab (Merck), for prevention of RSV disease in infants, is expecting a licensure decision by June 2025.

  • This would be approved for infants younger than 8 months of age.
  • Work is ongoing around payment.

Pneumococcal and Lyme Workgroups
These workgroups will be considering recommendations and reviews for the following:

  • Pneumococcal conjugate vaccine during pregnancy (recommendations)
  • Stem cell transplant recipients (recommendations)
  • Data on pipeline vaccines for Lyme disease (review)

QUESTIONS & ANSWERS

Q: There are sometimes issues with insurance coverage when ACIP does not explicitly recommend a vaccine for a particular group. What avenues are there to advocate for continued universal recommendation for COVID-19 vaccines?
Kelly Moore (Immunize.org): People can submit for public comment and make people on the committee and on the work group aware of their concerns and questions. It’s still an open question. I got the sense that there is going to be a pullback on those recommendations. It’s unlikely to continue to occur.

Q: Has anyone signed off on the ACIP recommendations?
Kelly Moore (Immunize.org): No, that has not happened yet. There is conversation about who has the authority to sign it. Nothing’s been signed yet. But the woman who was acting CDC director is currently the nominee; she can’t be acting and the nominee. The Chief of Staff was supposed to sign off on the recommendations. That didn’t happen. And we think it’s because, probably legally, there’s some review around who is responsible in this unique situation to sign off and approve. But we have not heard any credible threats that they are not going to sign off on it for policy[-based] or philosophical reasons. We think that this is just a legal question of who’s allowed to do it right now.

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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.
  • The next ACIP meeting will be June 25-26, 2025.

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