Search:

A summary of presentations from the weekly Summit partner webinars

August 21, 2025 – The latest Summit Summary

Community Health Center Updates

Sarah Price, MSN-Ed, BSN, RN, gave an update about community health center immunizations.

VIEW SLIDES

Community Health Center Updates – Sarah Price, MSN-Ed, BSN, RN Director
This update included an overview about work the national organization is doing with health centers across the country, including press initiatives and current and future initiatives.

NACHC IZ Work from 2018 to 2024
With funding from CDC secured in 2018, NACHC sought to leverage results from a prior inventory of capacity that was taken about immunization practices in community health centers (CHCs). Over the course of 6 years, the project expanded, including working through the COVID-19 pandemic:

  • Year 1: Started small, looking at immunization practices in CHCs
  • Year 2: Project expansion, the COVID-19 pandemic began, NACHC co-created a white paper about policy barriers around immunization and FQHCs, and the role of pharmacies in immunization practices.
  • Year 3: A deep dive into data and expansion of work to identify best practices and solutions for increasing the capacity of CHCs to input data and retrieve data about immunizations
  • Year 4: All about people, and exploration of the role of vaccine ambassadors in messaging and human-centered design to improve vaccine uptake
  • Year 5: Back to the basics with a learning community and CHC-focused curriculum and tools for implementing standards of adult immunization practices
  • Year 6: An unexpected extra year and a deep dive on standing orders practices and documentation of declinations; we also updated the white paper on policy issues impacting vaccination in community health centers

Current & Future Initiatives
The NACHC approach to a clinical practice guideline breaks down into four main areas:

  • People
    • The NACHC Pharmacy Subcommittee: consists of pharmacy technicians, pharmacists, and nurses; convenes 4x/year to discuss 340B and immunizations; reports to the Clinical Practice Committee
    • A co-publication from the National Healthcare for the Homeless Council and NACHC about vaccine ambassador work — https://dx.doi.org/10.1353/hpu.2025.a967349 — was recently released.
  • Processes & Tech and Tools
    • Pharmacist touch-points, including office hours and an online conversation space, via Noddle-pod
    • Standards for Immunization Practice Curriculum, still available and being used in the field
    • Proposal for Business Case Project (seeking partnership): What does it take, from a business lens, to run an immunization program for pediatric or adult immunization? This includes a tool that was piloted and included procurement, administration of the vaccine, and documentation.
    • Proposal for Vaccine Declination Documentation: To explore a way to document the many, non-standard ways that vaccine declination occurs
  • Policy
    • NACHC is partnering to share information about new Medicare reimbursements for vaccines, which started July 1, 2025.
    • Reviewing the Uniform Data Set (UDS), which is data that CHCs are required to input annually, for vaccine trends (e.g., state vaccination rates, whether rates are tied to prenatal care)
    • Continued connection and work with the AIDS Vaccine Advocacy Coalition (AVAC)
    • Continued connection and work with the Association of Immunization Managers (AIM)

Priorities in the Next 6 Months

  • People: Communication between vaccinators, advocates, stakeholders, and policy players to be able to report and amplify what is happening on the ground with vaccinations
  • Processes: What are the changes that are affecting the vaccine process and how can CHCs prepare for and carry those out — that is, to still immunize as the statute requires but also remain in preventive health
  • Tech & Tools: Keep data and reporting robust to be able to report that out for practice and policy
  • Policy: Continued connection with AVAC and AIM and formalizing relationships with other partners

CHC Statute
NACHC is leaning heavily on the statute that names vaccination as part of the clinical care requirements for a CHC that is federally funded. All CHCs are legally required to give vaccinations. NACHC’s standard is anyone who needs vaccination, gets vaccinated — and the CHC may have to eat that cost. So, when more people are uninsured, there is a harder hit on CHCs regarding cost. This has always been the case with CHCs and they are thoughtful and good at partnerships to address the issue of vaccination needs and costs, including working with partnerships. The standards for immunization practices are administer or refer, so CHCs may rely heavily on partners to refer patients for some vaccinations — and also track the referral.

July 1 Change in Reimbursement for Vaccinations
In the past, vaccines for Medicare patients had to be included in the cost report, which resulted in delayed payments to CHCs for up to 18 months. . (This was a significant burden because CHCs work on about a 1% financial margin every day.)With the Medicare changes for some vaccines, CHCs are able to keep those outside the cost report and get reimbursed more quickly.

QUESTIONS & ANSWERS

Q: Regarding reports of concerns about getting COVID-19 vaccine shots (although I don’t think that any of them are licensed for 2025-2026, yet, or I don’t see the updated package inserts), what are you hearing about the availability or challenges with getting the 2024-2025 vaccine for people who want to be protected now, while they wait for the 2025-2026 vaccine to be available? And, particularly, what about challenges for people who may now no longer meet the HHS-stated criteria.
Sarah Price (NACHC): I was just on a call with a group talking about this, right before this call, and it is complicated. Current COVID vaccines: I have not heard, yet, about community health centers not being able to get old versions. I think there are probably not a ton around. As you know, COVID vaccines are expensive to purchase, if you must purchase them, so the health centers that I know of, they’re not stocking. There’s also not a huge demand yet for COVID-19 vaccines. It’s not impossible to get, but with pharmacies and others, there’s some stock.
 For the future, we’re playing the wait-and-see game. There is concern, and I’ve heard it from health centers and from other people in this mix: “What if a child or a pregnant woman wants a COVID vaccine? How do we give it? Are we at cost, because it’s not going to be covered?” So there’s a lot of advocacy going on around that, whether that’s especially for community health center patients. Is every community health center patient considered high risk? Are there other risk factors that maybe that’s the angle, that we can do? Or if the supply chain gets cut in any way for this, could community health centers partner with other entities to get vaccines in? But I think we don’t have the answer yet for “What if it’s not covered?” — whether the patient has insurance and it’s not covered, or whether the patient doesn’t have insurance, then eating that cost. So that’s a wait-and-see game. But we’re trying to hear from the field what they’re worried about, and then go the advocacy lens to tell stories, to get that data to see. We’ll know much more come end of September, or October, when we see what this whole process is looking like: from any issues with procurement to boots on the ground.

Q/Comment: There is a question in the chat about liability concerns if you’re a provider administering a vaccine for an off-label indication or non-ACIP approved indication. But we will have you back soon to answer those remaining questions. Thank you, Sarah!

BACK TO TOP

Excite Extension Program

Michelle Rodgers, PhD, gave an update about the EXCITE program.

VIEW SLIDES

EXCITE Extension Program – Michelle Rodgers, PhD and Jacqueline Wilkins, PhD
EXCITE (Extension Collaborative on Immunization Teaching & Engagement) is a partnership between CDC and USDA/National Institute of Food and Agriculture (NIFA) run through the Cooperative Extension Programs based in U.S. land grant universities. The partnership has faculty and staff in every county or parish across the country and trusted messengers to deliver information. The main audience is rural and medically underserved individuals.

COVID-19 Example
Formed in spring 2021, the partnership and trusted messengers addressed mis- and disinformation about the COVID-19 vaccine and delivered credible, science-based information to increase confidence and demand.

  • Since 2021, they have reached over 51M people and had over 194K events/activities/engagements across the county, including 1K clinics and administering 52K+ immunizations.

Current Landscape & Future

  • Pilot Projects: Minnesota, Virginia, Tennessee: These projects are wrapping up this month after partnering with the National Rural Health Association to explore the delivery of immunization education together. Evaluation is beginning.
  • Integration of Immunization Education into Ongoing Educational Programs for Extension: Programs are working to integrate immunization education into existing health and wellbeing programs, such as using immunization supplements in programs like the Expanded Food and Nutrition Education Program (EFNEP) or a diabetes prevention program. There are 10 pilot projects wrapping up this month and preparation is underway to roll them out across the country through extension educators.
  • Integrative Model of Sustainable Health Decision Making (IAA): This is a new interagency agreement with CDC that allows for the hiring of 20 new extension immunization educators; funding carries them for 3 years and allows efforts in immunization education to scale. This new model includes educators at historically black colleges and universities and in four geographic regions, and also through training of staff in states that currently do not have an educator.

EXCITE Staffing Project Objectives

  1. Increase the public’s confidence in vaccinations
  2. Increase extension staff’s knowledge of and ability to educate communities about vaccines
  3. Expand and strengthen community partnerships
  4. Integrate vaccine education across other health program areas

H5N1
EXCITE has been working on H5N1 prevention education since January 2025, allocating $500K for it. The work has been done in partnership with the National Center for Farm Workers Health and has been linked with work from CDC and USDA. The primary focus has been on dairy farmers: owners and workers. The objectives include:

  • Increased knowledge and understanding of H5N1 and enhanced skills in behavior change communication among Cooperative Extension Dairy Agents and the EXCITE faculty and staff
  • Increased knowledge of the potential for transference and the impact on human and animal health among Cooperative Extension Dairy Agents and the EXCITE faculty and staff
  • The adoption of prevention practices by dairy producers on farms to reduce human and animal health risk of H5N1

H5N1 Education Resources

  • A new website: H5N1.extension.org
  • A monthly update session between USDA and CDC, including top educators, researchers, and practitioners; registration at the website
  • Materials for producers of health information
  • Resources and fact sheets for state fairs and exhibitors, for organizers and the public
  • PPE recommendations that are more specific to particular activities in the hopes that best practices are more likely to be followed — available in English and Spanish and including tiered levels of PPE recommendations based on realistic and task-based necessities, one-pagers, and banners
  • Social media campaign focused on consumers
  • Testing of communication materials, including handouts and signage, for effectiveness and impact — including some results that indicate that icons are more effective than photos for conveying important information.

QUESTIONS & ANSWERS

Q: Can you provide the link for the materials for Spanish speakers?
Michelle Rodgers (EXCITE): https://h5n1.extension.org/print-media-resources/. And, since our goal is education, we’re very happy for people to reproduce, share, and use any of our materials. Sharing and repurposing of the materials  only augments what we’re all trying to do, so any and all of those things are available for anybody to use.

Q/Comment: Shout-out from GSA that the Balanced Living with Diabetes is a great program.
Michelle Rodgers (EXCITE): The new version will have vaccines incorporated into the diabetes education. And they’ve tested the new materials, and it’s been successful for educating about both diabetes and about immunization — that we can do both at one time.

Q: How are you working with people to address misinformation?
Michelle Rodgers (EXCITE): From the beginning, EXCITE has utilized the evaluation tools that have been developed by CDC around immunization measurement, competence, and behavior changes. In the integration work with our curriculum, we now have evaluation tools for every one of those programs. Everyone who uses those programs will be asked to use those questions on evaluation, and most of them are pre-/post-; not all of them, but many of them. And defining when that post- will be is different for some of them because of the kinds of behavior change we might be asking for or hoping to get. But they all will measure some level of change of attitude or practice around those programs. We have been doing that [evaluation] more in the past 3 years — more around awareness and knowledge gain. And now, we’re at a position where we can raise the bar on what we’re measuring and get more information on practice change after program participation.
 In these programs, our focus is moving to, “Are you going to get a vaccine?” We want to know what questions aren’t we answering? What questions do people have that we can address? And we’re trying to use a technique in our educational programming that uses the motivational interviewing skill set. Most of our sessions, though, are not one-on-one, they’re in a group setting. We’ve spent the last 3 years trying to learn how to use that motivational interviewing skill set in a group setting, and we’ve learned a lot about that. Our focus is to have our educational settings [enable us to listen] and adapt our materials to identify what people are still concerned about, what are the barriers to getting vaccinated? We’ll be making changes as we move forward. But we have a toolkit that is on the excite.extension.org website that’s called “Getting to the Heart and Mind of the Matter.” And you’re all welcome to that training, which includes motivational interviewing techniques in a group setting. And the training for these 20 new educators will include developing this skill set. It really helps us get at understanding what the real issues are, and is a better way for us to find out if people engaging in that dialogue and discussion will see a difference in their willingness to consider changing practice or becoming vaccinated.

Q: Could you share that link that’s specific to this motivational interviewing training and toolkit that you’re doing?
Michelle Rodgers (EXCITE): The site is excite.extension.org/portfolio-item/a-toolkit-to-build-confidence-as-a-trusted-messenger-of-health-information/. Again, all the materials that are on that site are things that we’re learning around immunizations and prevention of H5N1. Existing and new materials are available to everyone. We’re planning to provide that motivational interviewing training by mid-September in an online course format. We currently have the information in this toolkit with activities and practice on the website.

BACK TO TOP

Announcements
  • Save the date for the 2026 National Adult and Influenza Immunization Summit in-person meeting: May 19 – 21, 2026 at the Crowne Plaza Atlanta Perimeter at Ravinia in Atlanta, GA.

BACK TO TOP

Search: