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A summary of presentations from the weekly Summit partner webinars

October 9, 2025 – The latest Summit Summary

Kaiser Family Foundation (KFF) Tracking Poll on Health Information and Trust — Tylenol/Autism and Vaccine Findings

Liz Hamel and Alex Montero, MA, gave an update about KFF’s tracking poll on health information and trust.

KFF Tracking Poll on Health Information and Trust – Liz Hamel and Alex Montero, MA
The Kaiser Family Foundation (KFF) is an independent nonprofit organization focused on health policy research, news, and polling. Health Information and Trust surveys shed light on where people get health information, who they trust, and what they believe. The latest KFF poll in this area was released on the day of this meeting; there was also a recent survey about parents’ vaccine attitudes.

KFF Tracking Poll on Health Information and Trust
The poll was fielded in September 2025.

  • It was a representative, probability-based survey of 1,334 U.S. adults.
  • It was conducted in English and Spanish.
  • It was weighted to match the sample demographics to the national U.S. adult population.
  • It had a Margin of Sampling Error of +/- 3 percentage points.

Survey Results
There is a declining share of U.S. adults who trust the CDC for vaccine information, and public trust in the CDC has dropped to its lowest level since the beginning of the COVID-19 pandemic.

  • Half of the public now say they have a great deal or fair amount of trust in the CDC to provide reliable vaccine information, down from 63% overall in September 2023.
    • This is reflective of both a double-digit decline in trust among democrats and independents and a slight rebound following Trump’s reelection and the appointment of RFK Jr. that has since dropped back to its 2023 level.

Other sources of information the public trusts include:

  • Personal doctors, who remain the most trusted source of vaccine information among the public.
  • The American Medical Association and the American Academy of Pediatrics (for parents) have higher measures of trust among the public than CDC or state government officials.

Partisan divisions across trust in these sources include:

  • One-third of the public says they trust Secretary Kennedy for vaccine information.
  • Two-thirds of Republicans express trust in Kennedy, close to the percent who say they trust their own doctor.
  • More democratic parents than republican parents say they trust the American Academy of Pediatrics.
  • People tend to be more trusting of state officials when they live in states that are governed by the party they affiliate with.

Public support of removing public school vaccine requirements displays a big partisan gap, which may inform messaging strategy:

  • Most parents say they are opposed to removing these requirements at the state level, but about half of republican parents support it and far fewer democratic parents.
  • The perception of vaccination for children as a personal choice versus a responsibility is split along partisan lines, with more republican parents viewing it as a personal choice and more democratic parents viewing it as a responsibility.

Survey on the Claim That Tylenol Can Cause Autism
Just one day after the Trump administration issued a warning that Tylenol during pregnancy can cause autism in children, many adults surveyed were uncertain whether the claim is true:

  • Very few adults said they think the claim is definitely true.
  • Many adults said they think the claim is probably true or probably false.
  • There were clear partisan differences: with most Republicans (57%) believing or leaning towards believing the claim.
  • These beliefs and the specific partisan divides have been seen in previous polls regarding, for example, the MMR or the measles vaccines and misinformation.

QUESTIONS & ANSWERS

Q: Does your polling strategy allow you to also ask the question about what it would take for people to move from ‘probably true’ to ‘probably false’ given their current belief system? For instance, if a republican believes that Tylenol used in pregnancy cases autism, what would it take for them to move past the bipartisanship and divisiveness?
Liz Hamel (KFF): This is something that we’ve been thinking about as the next step in polling on health information and trust, where we’ve seen this across the board: so many people falling in that middle category. We want to understand more about what that means, what is making people uncertain, and what type of messaging would resonate to help them move in one direction or another. I don’t think we have anything in this particular poll that speaks to that. Some of it goes beyond the scope of what we do in our polling: We do nationally representative polling, but others who really work on message testing and developing tailored communication for different audiences can take these nationally representative results and say, “Okay, how could we target messages that are going to resonate more with this group versus that group?

Q: You mentioned that you did the polling the day after the press conference: Are you planning on asking this question again, in your next poll, to see if there’s been a change, particularly with the acetaminophen and autism link? There has been a lot of social media about the data, and it would be interesting to see what that pattern looks like.
Liz Hamel (KFF): We call this our tracking poll, but we don’t necessarily track the same questions every month. It just happened that we were able to add this question about acetaminophen and autism. Our poll was ready to go in the field, and that happened, and we were able to add it, so we may continue to track it. One thing we try to do with these polls is to speak to the news of the moment or the policy debate of the moment. We are also looking at the government shutdown and the discussion of extending the ACA premium tax credits. I can’t say whether we’ll continue to track this exact question, but we will continue to be looking at trust and at perceptions and misperceptions on some of the information that’s getting high-profile platforms.
Alex Montero (KFF): There have been questions in the past that we have asked over time and the data can often be quite interesting. We’ve been asking this question about whether MMR vaccines can cause autism for a couple years. And oftentimes the share who believe this claim on pretty much any measure don’t change that much. On some other questions that may change, the share who have heard these claims sometimes increases, sometimes it’s remained steady over the years.
L.J Tan (Immunize, NAIIS): From our community perspective, when there has been a huge effort to debunk the autism issue with our autism advocate partners — people like Autism Science Foundation, the Autism Society of America — it would be helpful to know, a month from now, whether all that debunking landed.

Q: Have you tried the ‘push-pull’ to ascertain what message might move the opinion? For example, if you asked the question, “Did you know that children who get measles may go deaf? Does that change your opinion?” Or, “Did you know that some people who get mumps might become infertile?”
Liz Hamel (KFF): We haven’t done that specifically on the topic of measles, but it is a technique we sometimes employ in our polls — often when we’re asking about support for policies: “What if you heard this would happen if this policy weren’t enacted?” But it’s not something that we have done around measles.

Q: The question is, “Will this information change behavior?”
Liz Hamel (KFF): One of the things that came out a lot in our survey of parents that we did with the Washington Post is that we do see these differences. And we think that this political dynamic to vaccine attitudes, or to trust in the CDC, even though we haven’t been tracking it since pre-COVID with the exact same questions, we do think that a lot of it is a hangover effect from some of the divisions that came out of the pandemic. But we also see it when we ask parents about the MMR and vaccines for MMR and polio, for example. We still have large shares of parents that are getting those vaccines for their kids who believe that they’re safe and who think that they’re important. But we are starting to see those cracks in some of the questioning: “Well, maybe I think the CDC recommends too many vaccines or maybe I think they should be spaced out or maybe I think they’re not safety tested enough. But I think it’s important to emphasize that those partisan divides that we see are at the margins. But for the most part, a lot of it is around COVID-19 and flu; vaccines for MMR and polio are where we see smaller differences.

Q: With many vaccine-preventable diseases being forgotten and so many parents questioning the need for vaccination, would you believe — based on your long-term tracking poll information — that a knowledge of the disease and its negative impact would inspire a shift in belief?
Liz Hamel (KFF): I assume that’s referring to measles and the MMR vaccine. It depends: Most parents are still very supportive of those vaccines. The ones that are choosing to opt out of those vaccines may think…we saw some of this anecdotally in Texas, where you saw even some of the families that were affected by it were still sticking by their decision not to vaccinate their children. So, yes, at a population level, most parents are going to be compelled by the idea that getting vaccinated is much safer than getting these diseases. But I think you’re always going to have a certain set of the population that’s going to be holdouts there.
Alex Montero (KFF): In April of this year, we had a poll where we did kind of gauge public worry over measles outbreaks. There was about half of adults saying they were worried about a measles outbreak in their community. A small majority of adults knew that measles cases were higher this year than in past years. So sometimes, adults may not have a great perception of the sort of risk or the rising cases or what’s going on about some of these things.

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Medicaid Update

Brenda Gleason, MA, MPH, gave an update about changes to Medicaid and likely effects on preventive care.

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Medicaid Update – Brenda Gleason, MA, MPH
This presentation gave context on current happenings in Medicaid and discussed what might happen to Medicaid in 2026. Medicaid cuts are the biggest part of HR1 (“The Big Beautiful Bill”) related to healthcare. Those cuts are made possible by reductions tied to work requirements. The changes to work requirements (i.e., the paperwork, eligibility requirements, state-level confirmations) mean that, potentially, one to tens of millions of people will no longer be covered by Medicaid, although they may be eligible. Having no insurance and having to pay out of pocket for vaccination makes vaccine uptake less likely.

Additionally, the ACA marketplace subsidies are set to expire at the end of 2025. This will result in millions of people losing coverage and premiums going up.

Government Advisors
Some advisors are arguing, essentially, that insurance does not equal health care so there is no need for insurance.

  • Paragon Health Institute: Advises the current administration and argues that there is rampant fraud around ACA premium credits:
    • They argue that there is improper enrollment (brokers enrolling people who are ineligible in plans).
    • They argue that the subsidy should not be continued due to the high percentage of zero-claim enrollees.
      • Paragon argues that ACA-subsidized plans have an abnormally high number of zero-claim enrollees, ergo the government is handing money to health plans to keep people on insurance who are not using the insurance.
    • Goodman Institute: They argue that losing insurance doesn’t mean losing health care.

However, one of the reasons for the establishment of the ACA was the knowledge that preventive care is less likely to be something people do if they don’t have coverage for it, and vaccines are preventive care.

Increasing Vaccine Hurdles
With cuts to Medicaid, people losing insurance, loss of premium subsidies, the ACIP making recommendations for vaccine decisions to be based on shared clinical decision-making, states telling insurers they still have to cover preventive services…all this confusion will lead to consumers facing increasing vaccine hurdles. Additionally, the potential move by this administration towards catastrophic coverage will mean fewer people with coverage for preventive services.

What Can Advocates Do?

  • Remind policymakers that catastrophic coverage does not include preventive care.
  • Look for opportunities to increase provider reimbursement (e.g., for shared clinical decision-making time).
  • Remind states about state-regulated health insurance and preventive services, including vaccines, and what is happening at the federal level.
  • Make sure your local health department can bill Medicaid or insurers.

QUESTIONS & ANSWERS

Q: On what factual basis is the claim about a high percentage of zero claims accounts being made? Is that an accepted metric for fraud? And is this something that’s been talked about by other experts, other than Goodman and Paragon?
Brenda Gleason (M2HCC): You can go to Paragon Health Institute and it’s one of the first articles that will pop up. We read a lot of material out of Paragon — we have for years; they’ve been around a long time. They’re thought of as health policy experts. So, I don’t question, necessarily, their methods or their expertise, but whether the percentage of zero-claim enrollees is a useful measure of fraud, I think, is an excellent question. I don’t know where that, exactly, is coming from. I can tell you that, in the material that they present, which is very in-depth, that in the ACA-subsidized group, the zero-claim enrollees are about 35% of enrollees and the standard in private health insurance is about 15%. So, the Paragon team is basically arguing that, for the ACA-subsidized group, the number of zero-claim enrollees is much higher on average than we would see in a similarly insured pool. Whether or not you then can make the leap to “and therefore those enrollees are fraudulent” is a different question. The improper enrollment has a lot to do with brokers. That is a little bit easier to claim where there’s fraud, because it’s much easier to confirm a broker-enrolled [person], and then, when they went back and double-checked the paperwork, it’s like, “Oh, well, you had access to a plan somewhere else,” or something like that. But the zero-claim enrollees is an interesting comparison.
Q (follow-up): Can you give some clarification as to how they are making that presumption that, because we have 35% of zero-claiming enrollees, these are people who are enrolled but never made a claim. How are they making that jump?
Brenda Gleason (M2HCC): The paper is very in-depth, it is public, people can go and read it for themselves. I’m not trying to represent Brian and his team, but the jump that they’re making is that at least a number of these people are not using that insurance. So, the two pieces kind of go together. Think about a situation where a broker came to you and said, “Hey, you might be eligible for this ACA claim.” And you say, “Okay, sounds good.” And you take it, but you’re actually covered elsewhere. You might have had claims in that year, but you claimed it through your employer or through your spouse’s employer or something like that. So that zero-claim enrollee is essentially…the federal government is paying for this subsidy to the health plan but the health plan is basically getting that monthly premium knowing — that’s part of the issue is knowing that — that person is never going to use that insurance because they have other insurance access. So that’s the connection that they’re making. It’s not that all zero-claim enrollees in any circumstance would be fraudulent. It’s more that, very specifically, because there’s a push to enroll people in the ACA plans by brokers, the fraud is happening because the insurance plans are getting the monthly premium knowing that those people are probably not going to ever have a claim because they’re covered somewhere else or in some other way. [Regarding the confounder that maybe these enrollees tend to be healthier young adults and don’t seek medical care in this year], they did try to control for that. So, very elaborate charts and data that they pull state-by-state where they actually look at exactly that issue, like what percentage of the ACA-subsidized enrollees fall into different age cohorts and [those data] don’t account for this much higher rate of zero-claim enrollees.

Q: Why would someone purchase an Advantage plan if they’re already covered elsewhere?
Brenda Gleason (M2HDD): I think the issue is they’re not purchasing it: A broker is contacting a person, or the person calls in a broker and says, “Oh, I’m looking at my options.” And the broker enrolls the person into an ACA-subsidized plan, and that person either doesn’t realize that they have access elsewhere, or they forgot, or they didn’t tell the broker. I’m trying to be very generous in mind and spirit that brokers aren’t just out there illegally and fraudulently enrolling people. But you could imagine a scenario where, let’s say you’re 25 years old and you didn’t realize you had coverage under one of your parents, so you sign up for the plan. Maybe you have a full subsidy. So you are like, “Sure, I’ll sign up for the plan.” But this is part of the reason I’m presenting the Paragon information, because there has been — for almost a year — a very specific push by Paragon to get rid of [these subsidies]…not to let these subsidies be re-upped. I want to try to represent the perspective: Why would we not maintain these subsidies? Whether it’s actually as many people as Paragon thinks it is who shouldn’t have this coverage is an interesting health economics research question. But, conceptually, they have enough people’s attention that it’s important that we don’t ignore it. This is the argument that is winning lots of hearts and minds. So, by understanding the argument, we in the vaccine community can show up and say, “We recognize that maybe not everyone on an ACA-subsidized plan should be on it, but let’s not throw the baby out with the bathwater: Let’s not have zero support for insurance. We still want to have some support for insurance; maybe the better approach is to root out the fraud. I’m trying to present an argument that is dominant right now — especially with this administration and what’s happening — and then, hopefully, we as advocates can be a little more precise in our arguments to say, “Yes, of course, we don’t want there to be people who are fraudulently enrolled, but let’s acknowledge that, when people don’t have access to health insurance; preventive services, and vaccines in particular, are one of the first things that they stop doing.”

Q: Isn’t the simplest explanation that a lot of people don’t make claims if they’re healthy? Can we do a comparator, like if you look at the number of people who have employer-sponsored insurance who don’t make claims, do we see that at 35% or close to 35% — is that a way to adjust for that confounder?
Brenda Gleason (M2HCC): That is the comparison. The way I remember it is it says private insurance (and I do think they’re comparing it to employer-sponsored insurance). Yes, Paragon is comparing it, and the numbers are about 15% in private insurance and about 35% in the subsidized ACA population. And they do some adjusting by age and make all this available so you can go and see it.

Q: Do you see any state Medicaid leaning more on professional society vaccination recommendations rather than the ACIP for coverage decisions in Medicaid?
Brenda Gleason (M2HCC): Yes, generally. Two states, so far, have passed bills in the past year and a half, basically, that ask and allow their Department of Insurance, as well as other entities in the state, which would include their state Medicaid, state employees, that sort of thing, to use professional societies’ recommendations. Those two states are California (just passed a bill about a month and a half ago) and Maryland (also passed a bill doing that). So, the short answer is yes, some are making it very formal and going through a legislative process to do that.

Q: Do we have robust data about what access to care before the Affordable Care Act could be brought to bear here?
Brenda Gleason (M2HCC): We definitely do. Those are all open [data], they’re not in journals, so you can just go to their websites and read what studies they’re pointing to. I think just today MedPage published something that looked at Medicaid and cancer, maybe looking at cancer survival rates, that shows pretty clearly that in the states that did expand Medicaid that you did have — and I’m going to use a lazy term like ‘better cancer outcomes.’ You’d have to go and look at the studies and [see] exactly what they’re measuring. But we have robust data about what kind of care you get when you have access to insurance. My focus in bringing this to people’s attention is, especially now, it’s easy to operate in bubbles, and we talk to who we know and mostly those who agree with us. So, I’m trying to bring to bear, partly, that we do work in all 50 states, we work across the political spectrum and try to help people see that these are the arguments that are being used. These are [arguments being made] by prominent researchers, people who know what they’re doing. And it’s better to go read what they have to say and then say, “Here’s the counter data,” especially at this level. I’m not talking about how you might talk to a regular person about how to get vaccinated or whether to get vaccinated…[that] is very different than some of us that are doing policy or government affairs: bringing the evidence to bear is at least part of what we can do. So, yes, we have robust data; we need to brush it off and/or get new data so that we can be out there talking about it.

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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 will be awards and poster sessions at this meeting. Nominations and applications, respectively, will likely open at the beginning of 2026.
  • The payment working group has noted a challenge with co-administration of influenza and COVID-19 vaccines and reimbursement out of a G0008 code. Providers were only getting reimbursed for one vaccine administration code when they were co-administering COVID-19 vaccine with any other Part B vaccine. NCPA has provided a weblink (https://ncpa.org/newsroom/qam/2025/10/08/urgent-part-b-vaccine-claims-info) and explanation for a workaround on this issue. (This information was also distributed via email to Summit partners.)
  • The updated tip sheet with the new ACIP recommendations, which compares vaccine recommendations between professional societies versus ACIP, has been updated and is either posted at at IZSummitPartners.org.
    • The Summit Billing and Coding Working Group (https://www.izsummitpartners.org/naiis-workgroups/billing-coding-payment-taskgroup/) has developed a smart vaccine purchasing guide that has a lot of definitions and a glossary to help provider organizations have an idea about what their vaccine purchase costs are, relative to what they may get reimbursed, so they could be mindful of trying not to be underwater with providing vaccination services.

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