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A summary of presentations from the weekly Summit partner webinars

September 25, 2025 – The latest Summit Summary

Vaccination Community Learning Program (VCLP)

Barry Wilhelm gave an update about the Vaccination Community Learning Program, a flagship course at VYF.

Vaccination Community Learning Program – Barry Wilhelm
Vaccination Community Learning Program (VCLP) is the flagship course in Vaccinate Your Family University and is designed for all learners, from community healthcare workers to healthcare providers, vaccine advocates, and the interested public. This and other courses are free and can be taken on a desktop, tablet, or mobile device.

The presentation included a demo of VCLP, which launched in August 2025 and includes 4 modules, each designed to take about 1.5 hours to complete:

  • Vaccination Foundations
  • Vaccine Science and Safety
  • Building Vaccine Confidence
  • Overcoming Vaccination Barriers.

The program is interactive and self-paced; organized by chapters and lessons; and has videos, self-assessments, practice opportunities, and discussion prompts. Opportunities for practice with VCLP include scenarios that offer feedback based on responses throughout the experience.

Vaccine Preventable Diseases Library
There was also a review of the courses from the Vaccine Preventable Diseases Library, which includes three mini courses on COVID-19, influenza, and RSV. These mini courses are designed to be 30 to 60 minutes long and are written in plain language with videos and ways to practice with the content, as well.

Vaccinate Your Family University has a powerful combination of a strong foundational program and mini courses that dive into more specific topics. The courses can be used for professional development or personal growth and by organizations, communities, or individuals.

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Seasonal Influenza Updates

Alicia Budd, MPH, gave an update about seasonal influenza.

Seasonal Influenza Updates – Alicia Budd, MPH
The 2024-2025 influenza season saw predominantly influenza A, with very little influenza B, and nearly equal amounts of A/H1 and A/H3. Timing of illness was considered “regular” (increasing in November, peaking in February, and declining through May) and there were record levels of activity. Notably, the FluSurv-NET hospitalization system reported the highest cumulative rate of flu-associated hospitalizations since the 2010-2011 season. And there were more influenza-associated pediatric deaths reported than during any non-pandemic flu season since 2004. The season was classified as high severity across all age groups.

Estimated Cumulative Influenza-Associated Burden for the U.S. 2024-2025 Season

  • Symptomatic Illnesses: 47M to 82M
  • Medical Visits: 21M to 37M
  • Hospitalizations: 610K to 1.3M
  • Deaths: 27K to 130K

Highly Pathogenic Avian Influenza H5
There were 70 cases of HPAI A(H5) infection in the U.S. between March 2024 and September 2025 — the last human case was in February 2025. The public health risk remains low because the biggest risk factor is exposure to an infected animal, which is rare in the general public. Cases are identified through targeted surveillance and the routine national flu surveillance system.

H5 Human Cases – Virus Characterization to Date

  • The viruses maintain primarily avian genetic characteristics and lack changes that would make it better adapted to infect or spread among humans.
  • Existing flu diagnostic kits continue to identify these viruses.
  • Candidate Vaccine Viruses (CVV) are a good match, so if there is a need for an H5 vaccine, that will be helpful.

Variant Influenza Virus Infection
There was a variant virus — flu viruses that normally circulate in pigs — infection among humans during the 2024-2025 season. Usually, variant viruses are the majority of the novel flu A viruses circulating, but this year there was just one in addition to the H5 cases. It’s important not to lose sight of the need to monitor variant viruses to maintain preparedness.

Starting the 2025-2026 Influenza Season
Flu activity currently remains low for the start of the 2025-2026 season, according to data from clinical labs, emergency departments, and hospitalization records.

  • Influenza-like illness activity increased during September 2025 before stabilizing again, although that doesn’t always — or even usually — signal influenza illness. Influenza-like illness activity can also signal percent positivity in rhinovirus, enterovirus, COVID-19, and others.
  • Although the 2024-2025 season was influenza A predominant, there is a near even split in September 2025 between H1 and H3, so that is something to watch.
  • In countries in the Southern Hemisphere there was a lot of variability and perhaps too much to offer much in the way of predictability for the United States for the 2025-2026 season.

Influenza Surveillance
Weekly reports — the static report and the online interactive tool content — come out on Friday mornings. The first report for the 2025-2026 season will come out on October 10, 2025.

  • The national influenza surveillance system will add long-term care facility data for the 2025-2026 season. This data began being reported again in January 2025 as part of a CMS requirement (after having stopped at the end of the public health emergency declaration for the pandemic).

Resources: Monitoring Activity
Details about seasonal influenza activity

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COVID-19 and RSV Updates

Fatimah Dawood, MD, gave an update about COVID-19 and RSV.

COVID-19 and RSV Updates – Fatimah Dawood, MD
The presentation began with a summary of the epidemiology of COVID-19 during the past year.

Estimated (Preliminary) Cumulative COVID-Associated Burden for the U.S. from October 2024 through September 2025

  • Illnesses: 13.4M to 20M
  • Outpatient Visits: 3.2M to 4.7M
  • Hospitalizations: 370K to 530K
  • Deaths: 42K to 61K

COVID-19 hospitalization rates were highest in adults 75 years of age and older, followed by infants less than 6 months of age and adults ages 65 to 74.

COVID-19 Seasonality or Periodicity
During a 4-year period — from October 2020 to September 2024 — SARS-CoV-2 activity, fairly consistently, showed peaks in late summer (July – September) and in winter (December – February). The pattern is thought to be driven by rapid viral evolution and cyclical diversity of the S1 region of the viral spike protein.

Current SARS-CoV-2 Activity
According to data from the National Respiratory and Enteric Viruses Surveillance System (NREVSS), there was a late summer increase in SARS-CoV-2 activity, but that activity is likely declining and in almost all regions across the United States.

  • The most recent Nowcast estimates, through August 30, 2025, indicate that XFG is the predominant circulating SARS-CoV-2 variant in the United States.
    • XFG is a descendant of the JN1 variant, and this season’s vaccine includes an update to the JN1 component.

RSV Update
Estimated Cumulative RSV-Associated Burden for the U.S. 2024-2025 Season

  • Outpatient Visits: 3.6M to 6.5M
  • Hospitalizations: 190K to 350K
  • Deaths: 10K to 23K

According to data from NREVSS, RSV detection in the United States followed a consistent pattern pre-pandemic, but that was disrupted by COVID-19 and the season [following] occurred much earlier. As of last season, RSV detection appears to be returning to pre-pandemic patterns.

Currently, weekly positivity for RSV remains low and is within the 10-year pre-pandemic range for this time of year. It is also stable and low in all U.S. regions and has been below the epidemic threshold for 20 consecutive weeks.

RSV Immunization Recommendations for Children and Adults
The potential public health impact is underscored by data that show that, among infants 0 to 7 months of age (universally eligible for RSV prevention products), RSV hospitalization rates were reduced by 38% and 31% in two CDC population-based surveillance systems last season. For infants 0 to 2 months of age, hospitalization rates were reduced by more than 50%.

Recommendations for children born during or in their first RSV season. Protection by either:

  • Maternal RSV vaccine given during pregnancy at 32 to 36 weeks’ gestation

OR for infants less than 8 months of age, one of the following long-acting monoclonal antibodies

  • Clesrovimab, licensed in June
  • Nirsevimab

Recommendations for children in their second RSV season at increased risk for severe RSV:

  • Nirsevimab, for children 8 to 19 months of age

Recommendations for adults, currently, for RSV vaccination — which has been shown to decrease the likelihood of RSV-associated hospitalization in adults 60+ over two seasons by 69% in the season when they received the dose and by 48% in the second season after vaccination — is a single, lifetime dose for:

  • All adults ages 75 years and older
  • Adults ages 50 to 74 years with certain high-risk conditions that increase their risk for severe RSV disease

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CDSI and IIS when Vaccine Recommendations Differ

Rebecca Coyle, MSEd, gave an update about the current state of vaccine recommendation systems.

CDSI and IIS When Vaccine Recommendations Differ – Rebecca Coyle, MSEd
For the last 30+ years, the United States has had one immunization recommendation schedule that is based on evidence. Clinical Decision Support (CDS) operates in the background of systems, such as immunization information systems or electronic health records systems, to aggregate information and help provide recommendations. For example, it can provide a recommendation considering a patient’s age, medication history, underlying medical condition(s), and evidence-based rules. CDS can be likened to a GPS system for navigating vaccine.

The CDC Clinical Decision Support Immunization Project translates recommendations into technical rules that can be built into IIS EHRs and pharmacy systems. The process:

  • ACIP develops immunization recommendations
  • CDC publishes and maintains the immunization schedule
  • CDC’s CDSi project translates ACIP recommendations into technical rules
  • Rules are programmed into CDS tools within IIS and EHR systems
  • Immunization recommendations are provided at the point of care

CDS is more than just a tool: It’s a broad set of resources that help prevent missed or unnecessary vaccinations. From a national perspective, it provides rapid outbreak response, including population monitoring, identification of risk, determination of action (including number of doses needed, ordering, and making recommendations to providers).

CDS Is Currently Unraveling
As various groups make decisions about which recommendations to follow, updating the systems (e.g., IIS, EHRs, pharmacy systems) becomes difficult and costly and budgeting for it is challenging. Also, some systems allow for multiple schedules to be followed (e.g., ACIP recommendations and state school requirements) which may cause confusion.

  • States/groups of states and jurisdictions are deciding which recommendations to follow. This may be a blend of recommendations from ACIP, AAP, and other organizations.
  • Health systems may be choosing which recommendations to follow.
  • Individual providers may be choosing which recommendations to follow.

As a result of the confusion, providers will likely be spending more time manually interpreting the recommendations from the system. This will lead to a higher risk of errors and delayed protection for individuals, along with difficulty helping patients stay on track. Ultimately, the unraveling will lead to difficulty planning at responding at the national/federal level.

Dissemination of Technical Resources
There needs to be clarification of who will host the central repository for technical resources. Currently, CDC hosts all the CDSi specifications, but the multiple organizations with different schedules must also be accounted for. Additional complications will occur when jurisdictions or states, that are expected to incorporate ACIP recommendations into their IIS, have cooperative agreements with CDC and recommendations that don’t match.

This is a complex topic, and the American Immunization Registry Association is working to help provide clarity. To that end, they will be posting a one-sheet on what CDS is and why it’s important on their website (https://www.immregistries.org).

QUESTIONS & ANSWERS

Q: When does CDSi start working? Is it after the ACIP meeting? Do we have to wait for the CDC director to sign off and for the MMWR? How does that timing go?
Rebecca Coyle (AIRA): That’s a great question but there is not necessarily a consistent answer across the board. In general, once ACIP makes those recommendations — and often the recommendation isn’t known until the wording is actually in front of you and it’s voted on, so whatever pre-work can be done or, up until this point, could be done was typically done —  but ultimately, once that decision is made, it then goes to the CDC director for sign off. And at that point, the team at CDC and the Informatics and Data Analytics Branch (IDAB) branch are actively working to update that information, but there’s a good four- to six-week lag between the time ACIP recommends something and when that CDSi support information is available. It just takes time to get through all those different pieces. I know they’re currently working on the things that came out of last week’s ACIP meeting, but expect at least four to six weeks for that technical specification information to come out. And then it also takes time for systems to incorporate that into their systems and push it out in an update to all of the different systems out there.

Q: Is there any role for AI to help support providers navigating vaccine recommendations in light of this fragmentation?
Rebecca Coyle (AIRA): We’ve been looking at that. Within the team at CDC and within AIRA, as well, people have been looking at how schedules can vary and differ [and have been thinking about whether] this an area for AI to really make a difference — can they code the same things? I know it’s underway and it’s being reviewed, but I think it’s possible, it’s just not out there yet.

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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.
    • Recommendations for items for the agenda for this meeting are welcome, by email to NAIIS.
  • There was a talk given by Michelle Rogers on August 21 about the EXCITE program that gives good information to keep in mind during “fair season” in the United States. That talk and summary are available at Immunize.org.

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