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A summary of presentations from the weekly Summit partner webinars

October 16, 2025 – The latest Summit Summary

American Academy of Pediatrics (AAP) – Nivedita (Nita) Mohanty, MD, MS, Senior VP Child Health Finance and Quality (AAP)

Nita Mohanty, MD, MS gave updates about the process and status of vaccine recommendations.

American Academy of Pediatrics (AAP): Process and Status of Vaccine Recommendations – Nita Mohanty, MD, MS
The AAP has been making vaccine recommendations since the 1930s, including the single, harmonized vaccination schedule in collaboration with ACIP starting in 1995. With back-to-school and seasonality, fall recommendations are time sensitive. Recommendations need to take into consideration guidance regarding ordering of vaccines, hospitalization trends, alignment with payers, and — now — changes within ACIP.

Process: AAP Committee on Infectious Diseases (COID)
This committee — which includes pediatric infectious disease physicians, red book online editors, and liaisons from partner organizations — makes recommendations on vaccines, and

  • Had 10 members on the ACIP work groups who brought information back to committee.
  • Makes recommendations available through the Red Book and Red Book Online.
  • Reviews the annual immunization schedule.
  • Develops policy statements, including the Annual Influenza Statement, and publishes them in Pediatrics.

Due to the changes in the ACIP, AAP (which will stand in the gap without ACIP participation for as long as necessary); it:

  • No longer endorses the CDC immunization schedule; and released their own.
  • Develops their own clinical guidance.
  • Is planning for future processes for vaccine recommendations without ACIP work group participation.
  • Manages implementation considerations for vaccine access, liability, payment, EMR workflow at the point of care.

The AAP-branded immunization schedule is designed for clinicians and has three major points of variance from the CDC schedule:

  1. COVID-19 vaccination: AAP recommends routinely for 6 months to 23 months, for high-risk patients 2 through 18 years of age, and with access to anyone who wants to receive the vaccine.
  2. Thimerosal-containing products for influenza: AAP has all products eligible and does not have the restrictions that are on the CDC schedule.
  3. MMR and varicella vaccination: AAP includes an option that these vaccines are given in combination in the first year of life; CDC does not.

AAP Guidance Related to Influenza and RSV and COVID-19

AAP has multiple channels to relay guidance to clinicians and the public.

  • AAP statements regarding
    • Influenza
    • RSV
    • COVID-19
  • Parent-facing materials available through HealthyChildren.org — materials that are designed for parents to get a snapshot of what their children are due for
  • Policy statements in the journal Pediatrics and compiled in Red Book, published in print every 3 years
    • More rapid changes are reflected in Red Book Online
  • Bright Future periodicity schedule
  • AAP News
  • Vaccine Confidence Toolkit: to build vaccine confidence and fact check misinformation currently being disseminated

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American College of Obstetricians and Gynecologists (ACOG) – Joyce Cusack, MHS, Director, Public Health and Emergency Preparedness (ACOG)

Joyce Cusack, MHS gave updates about the process and status of vaccine recommendations.

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American College of Obstetricians and Gynecologists (ACOG): Process and Status of Vaccine Recommendations – Joyce Cusack, MHS
ACOG, a leader in maternal immunization, convenes the Maternal Immunization Task Force, comprised of organizations dedicated to bettering the health of patients and infants.

Recommendations for the 2025-2026 Season
ACOG is actively supporting and strongly recommending flu, COVID-19, and RSV vaccines for pregnant people.

  • ACOG’s clinical guidance includes practice advisories and FAQs for all three vaccinations (flu, COVID-19, RSV).
    • The focus is on the benefits of vaccination and the risks of not vaccinating [pregnant people], in light of higher risk of serious complications compared with non-pregnant people. Also, maternal vaccinations provide antibodies to infants, providing protection during the first 6 months of life.
  • ACOG worked with the Vaccine Integrity Project to affirm the safety and efficacy of all three of the vaccines above in pregnancy.
  • ACOG has developed their own Summary of Routinely Recommended Maternal Vaccines (chart) that includes information about timing and administration — and clarifies that co-administration of all three vaccines, with each other and other routine immunizations, is safe and effective.
  • ACOG provides information about the differences between RSV vaccine and monoclonal antibody, for timing, how they work, and benefits.

ACOG Guidance for Clinicians
ACOG emphasizes the following this season:

  • The importance of documentation, especially for maternal RSV vaccination
  • Ordering and offering immunizations in their clinics is a powerful way to improve vaccine confidence and increase immunization rates
  • COVID-19 vaccines have been difficult to access: If clinicians cannot stock and administer them, they should provide pregnant people prescriptions to get them at a pharmacy (including supporting patient advocacy that pregnancy is a high risk that qualifies them for vaccination)
  • ACOG has a health policy team and a Payment Advocacy and Policy Portal

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American Academy of Family Physicians (AAFP) – Margot Savoy, MD, MPH, FAAFP, FABC, FAAPL, CPE, CMQ, Chief Medical Officer (AAFP)

Margot Savoy gave updates about the process and status of vaccine recommendations.

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American Academy of Family Physicians (AAFP): Process and Status of Vaccine Recommendations – Margot Savoy, MD, MPH, FAAFP, FABC, FAAPL, CPE, CMQ, Chief Medical Officer
AAFP provides its most up-to-date information, including vaccine schedules/policies, social media resources, and patient-facing information on AAFP.org/vaccines. It has created its own vaccine schedule because it can no longer endorse the CDC schedule as it is currently written.

The AAFP Approach
The approach for vaccine recommendations is much the same as the approach to science in general at AAFP:

  • Science: review of data, confirming evidence, creating guidance by:
    • Staff, including the Health of the Public and Science team
    • The Commission on Health of the Public and Science, with members participating in ACIP working groups
  • Advocacy: within government to ensure access, collaborating with peers and within professional societies to stay aligned
    • AAFP members work with, for example, AAP, ACOG, IDSA, etc.
  • Education: guidance for family physicians to be able to use in their practices for implementation of vaccination recommendations, reduction of disparities, and patient education
  • Communication: both to the general public and to the government decision makers (what stories are needed to help policymakers understand the impact of vaccines) — and dispelling myths and disinformation

AAFP Vaccine Recommendations
For flu, COVID-19, and RSV, AAFP’s recommendations are in line with AAP’s and ACOG’s, which is reassuring because they were independently developed based on the available evidence. AAFP also makes adult immunization recommendations: that adults continue to be vaccinated. There is some nuance between one and two doses for those younger than 65 and those older [than 65], respectively, and AAFP will adjust recommendations, as necessary, based on evidence.

Regarding the status of healthcare workers — specifically, whether being a healthcare worker is an independent risk factor for having infectious disease — AAFP decided that it is an independent risk factor, so even healthy young adults should have access to immunizations, personal protective equipment, and pre- and post-exposure prophylaxis (including the COVID-19 vaccine).

QUESTIONS & ANSWERS

Q: Was the healthcare worker recommendation about seasonal vaccination mostly to identify healthcare workers at increased risk of exposure versus recommending a requirement for vaccination of healthcare workers?
Margot Savoy (AAFP): I’m not 100% sure I understand the question, but we are not mandating anyone be vaccinated. We are mandating that everyone have access to anything they need to protect their health. And so that would include vaccines, but it would also include things like pre- and post-exposure prophylaxis, or access to masks, or other protective equipment that you might need to be able to do your job safely. So, we’ve never recommended that people have to be mandated for anything, in particular, but we don’t think that just because you happen to be young and healthy, but you’re also a healthcare worker, should mean that your young and healthy status trumps your risk as a healthcare worker in determining whether or not you have access to vaccination.

Q: What are your thoughts about what you’re hearing from insurers about their ability to continue to provide coverage for vaccines based on the professional society’s recommendations?
Margot Savoy (AAFP): We were in a meeting with America’s Health Insurance Plans (AHIP). They have been great partners throughout this whole process, so as we’ve been doing our work, we’ve been working very closely with them — which is not new for any of the other organizations, either. So, we’ve worked with them even in other years, but we expressed early [in this current environment] our concern that, if there was a discrepancy between the recommendations, we wanted to be able to have the opportunity to talk to them about it before they just made a blanket decision. They were great partners, so even if, for example, ACIP hadn’t had the September meeting to change their COVID recommendations, they were already prepared to support, paying for the vaccine recommendations that were already put out by the professional societies, even when they didn’t align with what ACIP was saying.
 In the long run, there is still work that needs to be done, because we all must remember that the payments for some programs are baked into the Affordable Care Act legislation. And of course, issues like Medicare Part D and Medicaid are baked into the Inflation Reduction Act. And those laws create the opportunity for the vaccines to be covered but also creates some challenges, because it was tied directly to ACIP recommendations, so we have some work to do in the advocacy space and in the regulatory space to figure out other ways to do that. And ACIP is baked into the Vaccines for Children legislation. But it’s been wonderful to see how states and state coalitions, who often control their vaccine products for their states, are willing to lean into the professional society recommendations and use those as part of their guidance, which opens up a lot of doors for opportunities to continue to vaccinate, even if there’s not quite alignment. So, this is another space where people have done a really great job of collaborating. And it’s happened quietly and behind the scenes, and most people probably have no idea that it was going on, but it was actually a powerful — and very reassuring —space to hear that everybody was on the same page, and so that’s something to be grateful for.

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Infectious Diseases Society of America – Eli Briggs, Director of Public Policy (Infections Diseases Society of America)

Eli Briggs gave updates about the process and status of vaccine recommendations.

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Infectious Diseases Society of America (IDSA): Process and Status of Vaccine Recommendations – Eli Briggs
IDSA is a community of more than 13K physicians and health professionals who treat patients with infectious diseases and work to prevent infections. IDSA has not, as of the date of this meeting, released recommendations yet for the 2025-2026 season. (Their recommendations, beginning with COVID-19, are expected as soon as mid-October.) UPDATE: These recommendations are now available at: https://www.idsociety.org/Seasonal-RTI-Vaccinations-in-Immunocompromised-Patients.

Focus on Immunocompromised Patients
IDSA’s process focuses on immunocompromised patients (who have different reactions and risk factors) and uses a panel of infectious disease physicians to consider flu, COVID-19, and RSV vaccines. The process:

  • Considers different groups of immunocompromised patients, including those with HIV infection, transplant recipients, those receiving chemotherapy, and more
  • Follows an evidence-to-recommendations framework
  • Publishes the recommendations (one for each vaccine for immunocompromised patients) in the journal Clinical Infectious Diseases and announces them on the IDSA website: IDSociety.org

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Vaccine Integrity Project – Bruce G. Gellin, MD, MPH, Professor of Medicine (Adjunct), Georgetown University School of Medicine, affiliate at Georgetown’s Center for Global Health Science and Security; Sherri Berger, MSPH, Founder and CEO, SB Strategies

Bruce Gellin and Sherri Berger gave updates about the process and status of vaccine recommendations.

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Vaccine Integrity Project: Process and Status of Vaccine Recommendations – Bruce G. Gellin, MD, MPH; Sherri Berger, MSPH
The Vaccine Integrity Project was begun in April 2025 to determine what could be done by non-government agencies and organizations to safeguard vaccine use in the United States.

Opportunities for Action
A report issued at the end of July by the Vaccine Integrity Project identified action steps the community highlighted as important. The Vaccine Integrity Project is providing these action steps to philanthropists who may want to invest in the issue.

  • Strengthen communication and information dissemination
  • Develop/disseminate clinical tools/guidelines
  • Build a coalition for strategy/alignment
  • Maintain national vaccine infrastructure
  • Stabilize vaccine safety system
  • Provide assistance to state and local health departments
  • Safeguard insurance coverage
  • Continue the flow of data for decision making

VIP Priority Focus Areas

  • Summarizing and disseminating scientific evidence
  • Rapidly communicating
  • Enhancing collaboration and visibility

Independent Review of the Evidence & Interactive Tool
The Vaccine Integrity Project recognized the need for an independent review of the evidence regarding immunizations for various diseases and various populations. An interactive tool organizes and makes available the literature that was reviewed for each of the diseases for which they evaluate the safety and effectiveness of the immunization(s).

  • As part of the process, 17K pieces of data emerged in the initial systematic review; this tool allows people to drill down to meet their particular needs for evidence-based information.

Near-Future Plans for the Vaccine Integrity Project

  • Consider the evidence for the hepatitis B first dose
  • Consider the need for more independent evidence review based on the ACIP working group findings (to support or refute recommendations that may come out of those)
  • Pilot a discussion with manufacturers, in the same way they have had discussions with ACIP
  • Think through the respiratory review for the next respiratory season
  • Complete the RFP process to build capabilities to respond to factual discrepancies that are common now and, also, to highlight the differences in policy, data, and evidence
  • Create guides for the media about how to ask questions
  • Collaborate with other groups to ensure coordination and awareness of “who is doing what.”

QUESTIONS & ANSWERS

Q: Which of your resources, your main recommendations, are open to the public or to other providers who may not be members of your organizations? Is part of the goal to make them widely available?
Nita Mohanty (AAP): All our statements are in a pre-publication form right now and are free to the public. You can access them through our link, Healthychildren.org. They’re not behind a member firewall. The same is true for our policy statements that will be published in Pediatrics for this respiratory season. They will not be behind a firewall. Healthychildren.org is completely free. Most of the people who access that are parents and that’s not behind a firewall, either.
Joyce Cusack (ACOG): Our Practice Advisories on the three respiratory season vaccines are available to the public at ACOG.org/programs, and the infectious disease program materials, tool, and resources are available as well.
Margot Savoy (AAFP): What I provided on the slide, AAFP.org/vaccines, is the link to the resource for AAFP, and it’s in front of the firewall.
Eli Briggs (IDSA): Our recommendations will be publicly available on IDSociety.org, as well as in our journal.
Bruce Gellin (Vaccine Integrity Project): We want to make sure everybody sees what we have, no firewalls, no paywalls: https://www.cidrap.umn.edu/vaccine-integrity-project.

Q: What are your thoughts about what you’re hearing from insurers about their ability to continue to provide coverage for vaccines based on the professional society’s recommendations?
Bruce Gellin (Vaccine Integrity Project): I think they’re hearing from the front lines about what they’re dealing with and some of the pragmatic issues. I’ve talked to a pharmacist as my one-person focus group, — we probably all have — but I think it’d be worth hearing those things, because surfacing these issues can help to iron them out.
L.J Tan (Immunize, NAIIS): I’m going to plug our webinar that we’re holding Thursday, November 6th. The Alliance for Community Health Plans and AHIP will be coming on, along with Avalere Health, the Common Health Coalition, and the National Association of Community Health Centers to talk about coverage and payment and how payers are reacting, how medical services are reacting as this continues to evolve. Register at https://us06web.zoom.us/webinar/register/WN_76h9zvrmSMus1NOgwrxLSg.
Carolyn Bridges (Immunize, NAIIS): I’ll just elaborate on the co-administration code. [NAIIS would like people to keep reporting (https://www.surveymonkey.com/r/RGZBG8V) to the system so they can keep working on it.] We learned through a bunch of our partners that they were seeing claims denials when COVID-19 vaccination was given with other Part B vaccines. For patients who were on Medicare, Medicaid, and Medicaid Advantage, or Medicare Advantage plans. We received notice from CMS last night that that’s largely been resolved, although there may be some delays in having those claims reprocessed. AAFP, ACP, pharmacy organizations, manufacturers, a whole lot of people weighed in, so thanks so much for that. And again, for people who are having problems with payment issues or reimbursement issues, there’s a site on the Summit webpage for reporting claims challenges with adult immunizations. We get people who report billing and coding and reimbursement issues that they’re having. We refer pediatric issues on billing and coding to the very able staff at AAP who manage that. But that’s one way we’re trying to keep track of challenges that may arise, in particular because of the non-harmonization between some of the professional medical society recommendations versus those coming from CDC.

Q: Is anyone aware of any alliances with governors’ offices, with the professional societies, maybe state and local public health that you’re working with?
Bruce Gellin (Vaccine Integrity Project): I think a lot of us are talking to a lot of people about that, some of the individual states, some of these other alliances, and pointing out to them both the evidence base and what recommendations are being made. It seems ad hoc to me (I don’t know if anybody wants to talk about that), but clearly you’re starting to see some of the policy people step forward to make recommendations, and they’re going to have to rely on expert opinion from the clinicians and the evidence base by which those are made.
Margot Savoy (AAFP): I know that we’ve had the opportunity to speak with folks directly who wanted to hear more about how we [arrived at] our recommendations and what evidence we used to reach our evidence-based recommendation, why our recommendations differed from the CDC, so could we explain why there was a difference. And then on the other side of it, all the states that we’ve met with ultimately added the professional societies as an alternative to ACIP as a valid authority for an immunization schedule for their state. And what I’m understanding is that that is continuing into the alliances and the coalitions that are forming, so that my expectation is that they’re going to allow people the opportunity to do an either-or, so in the places where there is a discrepancy, the clinicians have the opportunity to choose the recommendation between the two, which would be the best of a bad situation, because ideally we’d all be on the same page with one set of recommendations, but it’s better to at least have the choice than it is to not.
Bruce Gellin (Vaccine Integrity Project): Margot made really a critically important point, which is why we all need to be together and we shouldn’t all have a different rationale for why our recommendations are different. I think that’s [important], a place of putting those together because the recommendations are all going to [need] be the same, based on our interpretation of that evidence — and different from what the ACIP is doing. So having that be clear, how we’re talking to that, is going to be important, so that we’re not inadvertently picked apart by talking about that differently.
Nita Mohanty (AAP): To your question about how we interact with states, AAP has state chapters and we’re very active in communicating with our chapters but also in state-level advocacy. We also were asked to speak at the National Conference of State Legislators so that we could have some opportunities to talk to individuals in different states, understand vaccine-related policies, and the variants of those, state to state. [This] has also been a very valuable experience.

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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.

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