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A summary of presentations from the weekly Summit partner webinars

May 29, 2025 – The latest Summit Summary

NAIIS Conference Highlights and Breakout Session Action Items – Iyabode (Yabo) Beysolow, MD, MPH, YB Consultants, LLC, Purnima Unni, MPH, CHES, Program and Member Services Director, Association of Immunization Managers (AIM), and Daisy Winner, Program Manager, Information Futures Lab, Brown University; Carolyn Bridges, MD, FACP, Director of Adult Immunizations, Immunize.org; Litjen (L.J) Tan, MS, PhD, Chief Policy and Partnerships Officer, Immunize.org

Yabo Beysolow, MD, MPH, Purnima Unni, MPH, CHES, and Daisy Winner gave an update about key takeaways from the most recent Community-Based Organizations and Sustaining Vaccine Confidence working group meeting; Carolyn Bridges, MD, FACP, gave an update about key takeaways from the most recent meeting of the Billing and Coding working group meeting; and L.J Tan, MS, PhD, gave an update about key takeaways from the most recent meeting of the Operationalizing Seasonal Vaccines working group.

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NAIIS Conference Highlights and Breakout Session Action Items
The following is a summary of the action items that came from the working groups’ in-person meetings at the National Adult Influenza Immunization Summit in May 2025.

Discussion Group: Community-Based Organizations and Sustaining Vaccine Confidence – Yabo Beysolow, MD, MPH, Purnima Unni, MPH, CHES, and Daisy Winner
Discussion focused heavily on communication: specifically, amidst an environment of funding and staff cuts and uncertainty about formerly reliable sources, there is a need to develop effective communication and outreach with fewer resources. There are significant logistical, operational, and time demands for communication processes and equity work with partners. And the increasing complexity in vaccine schedules and dosing is making effective messaging more difficult.

Key Challenges and Gaps

  • Shared messaging that is consistent but can be tailored to specific audiences/communities
  • Expanded, strengthened, and incentivized trainings for vaccine communicators and for those who conduct community needs assessments on vaccine concerns
  • Synthesized and centralized communication and engagement resources

Proposed Actions and Solutions

  • Resource coordination — e.g., central repository of sources, coordinated messaging, list of free training resources, calendar for anticipated CDC communications to identify gaps
  • Guidance on effective strategies — e.g., conducting needs assessment for communications, identifying organizations/stakeholders and partnerships, getting ahead of emerging issues

Challenges and Potential Responses

  • Challenge: Fear — Pending and potential cuts to funding and staffing may be creating fear that could lead to difficulty in bringing community-based organizations into partnerships.
    • Response: Health departments and partners can come together to identify themes and craft messages as they keep community partners engaged.
  • Challenge: Urgency in Messaging — There is a need for quick response/messaging that is consistent and thematically based but can be tailored to the community.
    • Response: Develop a repository of trusted, up-to-date information and resources.
  • Challenge: Uncertainty — There have been a lot of removals of information and resources that people have relied on and that has created both a lack of consistency and a hole where there used to be guidance.
    • Response: Create the tools, e.g., the repository, that allow people to access organized, reliable resources, perhaps including evidence synthesis, as they need them.

QUESTIONS & ANSWERS

Q: Should vaccine communicators also include non-healthcare people, i.e., trusted messengers in the community who are not healthcare professionals? And can we teach these people the basic concepts of motivational interviewing, but not such that they have to learn the entire process of what that means?
Yabo Beysolow (YB Consultants LLC): Yes, we totally agree. This was something that came up in several of the small groups and breakouts, and even with the panel: the need to co-create messaging from the onset with local community members, whether you call them health champions, trusted messengers, etc. All communication needs to be co-created from the get-go, so that it will be much better received and accepted, and relevant. We also talked about, with the “trusted messenger,” we have so many messengers who were trained over the last 4 years on COVID vaccine and vaccine principles, and they’re still out there — we want to make sure that we continue to reach out to them, connect with them, and see how we can further utilize some of their services and include them in discussions moving forward.

Q: Public health communication often emphasizes tailoring messages to very specific local communities. While this approach has its merits, it is also highly resource intensive. Much of the misinformation circulating seems to be consistent across the United States. Given the current climate with shrinking budgets and the urgent need for timely repeated messaging, is hyper-local customization still the most effective strategy? Or should we be focusing more on scalable, unified messaging that can be reinforced broadly and efficiently.
Daisy Winner (Brown University): I rely on two pieces. One is the misinformation that we’re seeing around vaccines has always thematically been the same thing, for centuries, but how people respond to that misinformation and what their relationship is to it, including the reasons they decide to integrate it into their own knowledge, is unique to their own experience. So even though it’s thematic, it might seem consistent across communities. And thus, [with] the information that we have to respond with, the best strategy is to try to get ahead of it as much as we can by flooding the zone with good information. It does have to be tailored, and there are many different reasons for that, including on a cognitive level, our brains take in information that works on our existing knowledge structures so we can only really ingest it, or be even inclined to believe it, if it relates to stuff that we already know or is relevant to our life experience. So, there’s a strong argument for making it tailored. The other thing is — and hopefully the working group or the rest of our team at Brown can help with this — what are the tools to make that less resource-intensive? What are the pieces of information that you can rely on to quickly do that sort of [message]-tailoring.
Purnima Unni (AIM): I don’t think we should forget the importance of storytelling: that’s where the positive messaging can come from, as well. We’re always flooded with all this misinformation and this fear, and the way to get ahead of it is also sometimes not to counter that, but to say, “Hey, look at all the positive things that have happened because of this vaccine,” and you’re putting a face to that story. When you personalize it that way, and especially if you have people within your own communities that you can use as the storytellers, that resonates so much more. It can be a physician and a patient having a conversation about how it benefited, or it can be just someone coming and talking to their faith-based organization. It can be a conversation between the two of them. But those things play a pivotal role, because I think you do have to tug on that emotional string to make people understand why this is important. How did this save my family’s life? And that can play a great role as we think about how to touch each and every population out there.
L.J Tan (Immunize.org, NAIIS): The storytelling component is so important. With Daisy’s comment, some of this resource-intensive, hyper-focused messaging is still going to be needed, so it becomes incumbent on all of us to figure out how we continue to support that kind of effort.
Daisy Winner (AIM): Yes, and to lean on our community to understand the messages that folks have utilized in the past that have been effective, or strategies that they know that have worked. So [that] we’re not trying to recreate the wheel, but often there are shared messages that work for different communities. And to both questions, we must also trust [the] trusted messengers; we often choose or partner with folks but then are strict about how and what they [are allowed to] message. And that could negate the effect that they have as individuals that folks turn to as a reliable source of information. That also could relieve some of that intensity, the resource intensity, by saying, “Here’s what I can do.” But at the end of the day, this person knows this community best, and I must trust them to do that.

Discussion Group: Billing and Coding – Carolyn Bridges, MD, FACP
Discussion was grounded in several presentations, including those about PBMs and Medicare and Medicaid.

Key Challenges and Gaps

  • Delivery of parts B and D vaccines and part A stays for long-term care facility residents and staff
  • Plan-specific issues
  • Low margin on vaccine purchases
  • Limited networks carrying vaccines
  • Frequent appeals to payors for denied claims
  • Lags in payment increases
  • Inequity of payments among providers
  • Inability to negotiate with Medicaid
  • PBM system challenges that affect payments in pharmacies
  • Concerns that vaccine insurance coverage requirements may be repealed

Proposed Actions and Solutions

  • Continue to monitor and report concerns
  • Develop templates for providers for submission/justification of claims
  • Encourage providers to give some vaccines, if not all
  • Develop resources to promote “no wrong door” concept
  • Advocate for vaccination payment for part A stays
  • Advocate for payment at level that ensures financial stability
  • Understand implications of loss of ACA provisions
  • Advocate for Medicare rate to be the benchmark for all providers
  • Help public health understand how to become credentialed vaccine provider

QUESTIONS & ANSWERS

Q: Do insurance companies need ACIP approval?
Carolyn Bridges (Immunize.org): I would love to have some insurance companies weigh in. My understanding is those [ACA] provisions make it a requirement that they cover them. But a payor could make a decision to cover vaccines that are not HHS-approved but are currently still on the ACIP schedule. But I think that this just points out how important it will be for all of us to communicate with payors on some of these issues directly.
L.J Tan (Immunize.org): Just a reminder: The Affordable Care Act basically says that insurance companies need to cover ACIP-recommended vaccines. But, if you look at the fine print — and there was a discussion on this today because of what’s happening — it’s ACIP-recommended and CDC director signed-off. That’s part of the interesting debate that’s going to be coming up with some of the COVID vaccines, as well.
Carolyn Bridges (Immunize.org): With the PBM issue that came up, there’s kind of a lack of transparency, [and] just to remind everyone that the providers themselves can talk to the plans directly. So particularly if you’re a large health plan, you may have a lot of leverage in terms of looking at what kind of payment you’re going to get for a particular vaccine or set of vaccines. It’s just that the PBMs are not able to tell the providers what those payments are going to be. So, there’s a bit of a firewall there, but that doesn’t mean the provider can’t go directly to the payor.

Q: Despite what the HHS Secretary said or did, won’t the COVID vaccines be recommended for kids with health problems, so that insurance coverage without cost should continue for all ages who are eligible or recommended to get those vaccines?
Carolyn Bridges (Immunize.org): I think we all hope that that will be the case, but we’ll have to wait and see what happens.
L.J Tan (Immunize.org): The other thing is the idea that ACIP and CDC, at least as of right now, have said that for some of these high-risk conditions, self-report [of risk] is more than sufficient to merit vaccination. So, the hope here is that that will continue, and that will also open access for adults who have high risk conditions, as well. [Let’s share recent AAP statements about that.] The Summit has actually collected the releases that have come out from the press, the responses that have come up from multiple organizations, including AAP, ACOG, and more. We’ll collect it into one document and send it out by email to all participants in the Summit.

Discussion Group: Operationalizing Seasonal Vaccines – L.J Tan, MS, PhD
This discussion split into two paths: seasonal vaccines and year-round vaccines, with consideration of the need to continue efforts to provide vaccine guidance to providers year-round.

Key Challenges and Gaps for Seasonal Vaccines

  • Continued need to provide support to healthcare providers on fall respiratory viral season
  • Launch of self-administered flu vaccine (FluMist) in fall 2025
  • Coadministration of COVID/Flu/RSV vaccines
  • Communications schedule for fall on respiratory season, especially in light of planned CDC absence
  • Continued challenges in LTC setting

Potential Actions/Solutions for Seasonal Vaccines

  • Review/update seasonal vaccination resources
  • Accept that it is not Summit’s job to launch self-administered FluMist
  • Address coadministration challenges: provider recommendations should be stronger, overlapping vaccine recommendations is an opportunity, develop understanding of changing demographics and develop communications accordingly
  • Fill the communication void should CDC remain silent, including identifying a communication lead — NFID has agreed to start this process
  • Summit to collect existing resources from federal government
  • Summit to engage with coalitions to share social media resources
  • Follow up with PaltMed on current project in LTC and skilled-nursing facilities: One challenge, in light of various facilities and staff and residents is technology, e.g., EHR operability with various systems; another challenge is payment issues due to various levels of coverage for vaccinations; and another challenge is hesitancy, especially in this population where individual consent may be complicated by family involvement and there may be separate considerations for staff.

Key Challenges and Gaps for Year-Round Vaccines

  • Continued need to help providers remain aware of all ACIP-recommended adult vaccines
  • MPox vaccination implementation for MSM people
  • Hepatitis B implementation
  • Employer engagement on adult immunization activities

Potential Actions/Solutions for Year-Round Vaccines

  • Review/update adult immunization tip sheet
  • Summit to look at ways to re-energize collaboration between immunization and sexual health communities for MPox vaccination efforts
  • AMGA to look at their data on Rise to Immunize on hepatitis B implementation
  • Summit to engage with AIM, ASTHO, and business groups to explore collaborations for employee vaccination

QUESTIONS & ANSWERS
N/A

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Announcements

  • A survey was sent to attendees of the Summit. Please consider completing the survey; the conference organizers are especially interested in feedback and comments on the experience and any ideas attendees might have for future conferences.
    • A report on the survey results will be forthcoming after collection and analysis.
  • The next Summit webinar will be on June 5, 2025 and will be an update on the state of the immunization environment.

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