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A summary of presentations from the weekly Summit partner webinars

March 5, 2026 – The latest Summit Summary

Let’s Vaccinate: Kentucky’s Approach to Building Immunization Confidence Through Nursing Education – Daphne Spalding, BSN, RN, Clinical Section Manager, Kentucky Department for Public Health (KDPH), Immunization Branch
National Rural Health Association (NRHA) Vaccine Update – Carrie Cochran-McClain, DrPH, Chief Policy Officer, NRHA
American Immunization Registry Association (AIRA) Update – Rebecca Coyle, MSEd, Executive Director, AIRA
Announcements

Let’s Vaccinate: Kentucky’s Approach to Building Immunization Confidence Through Nursing Education – Daphne Spalding, BSN, RN, Clinical Section Manager, Kentucky Department for Public Health (KDPH), Immunization Branch

Daphne Spalding, BSN, RN, described the results of adapting Kentucky’s Let’s Vaccinate clinician education program to reach nurses in training.

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Core Contents of Let’s Vaccinate Training
Faced with challenges of declining vaccination rates, rapidly changing vaccine guidance, limited time and preparation for counseling patients, and misinformation, Kentucky developed the Let’s Vaccinate program for clinicians, with the following core contents:

Practical training on pediatric immunization delivery and vaccine-preventable diseases
Pediatric schedules and catch-up guidance
Best practices for vaccine administration and documentation
Post-vaccination care and infection control
Communication with parents and caregivers

It became clear that students training to be clinicians had a lot of uncertainty around vaccines and often came into practice lacking confidence in their ability to counsel about and administer vaccines. Kentucky thus adapted the Let’s Vaccinate program for nursing students, maintaining the core contents but tailoring the delivery for students—for example, by:

adding practical, skills-based learning;
integrating storytelling to connect science to real impact;
introducing motivational interviewing for real conversations; and
refining content based on disease trends and student feedback.

Student Nurse Training Results
More than 200 nursing students were trained at four technical and community colleges, mostly in person. Evaluation indicated that 91% found the training effective in enhancing their knowledge and skills, and 98% said they would recommend the training to other nursing students. Post-training surveys indicated that most participants achieved:

increased confidence in immunization knowledge;
improved understanding of immunization schedules and timing;
reduced uncertainty around vaccine recommendations; and
greater preparedness to support vaccine conversations.

The project reflects important tenets:

Education is a core vaccine confidence strategy.
Confident nurses deliver stronger recommendations.
Nursing education is a public health investment.
Early training strengthens long-term outcomes.

Notably, adapting the training for students did not dilute the message. The core contents can be reshaped for any healthcare workforce once the educational needs of the audience are determined.

QUESTIONS & ANSWERS

Q: I applaud KDPH for this educational work focused on nursing students and those considering careers in healthcare. Focus has long been overdue given my experience with the influence of nurses regarding vaccination. Can the Kentucky program curriculum be shared with the Summit’s nursing organization partners, with the potential goal of creating a nursing school curriculum?
Daphne Spalding (KDPH): We will share anything that we have (see the TRAIN Kentucky: Let’s Vaccinate program.) Most things that we do put out there, we go through an approval process so that we can share, because best practices are so important. This is how we learn. Most of our slides are exactly the same as what you will see in the training course, we just change what we say when we present the slides. Like, we don’t say we’ve got to focus on making sure you know this is 2, 4, 6 months or at certain spaces. We just change how we talk about the information, because they’re not doing a post-test in the sense of [determining] if they can recall the information. It’s more about, “How do you feel about it? Do you know the resources you can use, and who you can reach out to?” So, we’d be happy to share that.

Q: The Summit is happy to facilitate connections with the nursing organization partners if there is interest in talking more about this.

Q: Love the Kentucky program. There may be challenges in many states, given that the state controls what’s on the curriculum for nurses. What would your advice be for other states who are interested in including more immunizations in [nursing education]?
Daphne Spalding (KDPH): I want to make sure that I’m clarifying that we are doing this not as part of a nursing curriculum in the colleges. So, when we are at health fairs, when we are reaching out, the nursing students and instructors are usually part of that, so we like to make sure they’re involved, so they’re getting some experience with our educational efforts. They come to our table. But when we’ve seen a gap—you know, they’re starting the work, we were getting lots of entry workforce questions—we decided to reach out to those colleges and offer a 4-hour program that went through all the vaccines and then the motivational interviewing. So, the instructors made it mandatory. We had the community college setting, so it was a rural area, and for everybody, they would come together to one college that was within an hour’s drive, and then they would just participate in this. And they would do it instead of having clinicals that day, during the week. It’s just supplemental education, but it’s so important because there was less pressure, and it was more involved. We played games, like bingo, where they had to listen for certain keywords and give us an immunization fact, and they could win a prize. They really were participating in it. We played games about communication, like you do almost like a telephone game. You tell somebody something, and at the end, you heard that the message was different, which showed how communication gaps happen, and this is misinformation. We tried to involve them at that level, but it was not part of the formal curriculum. We’re not at that level yet.

National Rural Health Association (NRHA) Vaccine Update – Carrie Cochran-McClain, DrPH, Chief Policy Officer, NRHA

Carrie Cochran-McClain, DrPH, summarized some pilot projects to understand what works to improve vaccine uptake in rural communities.

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NRHA partners with state rural health associations, practitioners, students, public health departments, private health systems, and others to improve health outcomes among people in rural areas, bolster the rural health workforce, and support investment in a strong rural health safety net. In recent years, NRHA has conducted several vaccine-related projects.

Rural COVID-19 Vaccination Communications and Education Campaign
Following surveys and pilot projects in rural hospitals in Minnesota, Illinois, Missouri, NRHA developed tools for education and communication that reflected key findings:

Healthcare providers are the most trusted sources for rural communities.
Mistrust of national institutions persists.
Storytelling is effective for communication, and video stories grab attention.
Communication materials should establish a sense of “place” with recognizable locations and people.

Rural Adult Immunization Pilot Project
A partnership of NRHA, the Centers for Disease Control and Prevention (CDC), and the Extension Collaborative on Immunization Teaching and Engagement (EXCITE, a nationwide initiative of cooperative extension programs), the project convened experts with experience serving rural communities. They categorized common strategies according to effectiveness:

Ineffective
- Solely focusing on vaccination among people facing other, more pressing problems, including other healthcare conditions
- Appealing to trust in national experts or national data
- Large mass-vaccination clinics, which can require travel and lack privacy
- Focusing on protecting the larger community, which is perceived as “preachy”
Mixed
- Social media posts can disseminate vaccine messages but also be a conduit for misinformation.
- Incentives for vaccination might attract some but can also decrease vaccine confidence.
Effective
- Trusted messengers, including healthcare providers, community leaders, and clergy members, are crucial to encouraging vaccination uptake and confidence.
- Meet people where they are; provide services at churches, in the workplace, or at long-term care facilities.
- Effectiveness increases with the frequency of “touch points” and consistent messaging.
- Focus on whole-person health.

Protecting patient privacy is increasingly important, as vaccination has become a polarizing issue. People need opportunities to express concerns and get information in public forums but also need private settings for more in-depth conversations. The ideal vaccine intervention for rural health communities would include partnering with pharmacies and community organizations and providing more specific provider education, among other components.

The lessons learned from the first phase of the project were implemented in pilot programs in Virginia, Minnesota, and Tennessee that included train-the-trainer models with nurses on vaccine confidence. This second phase found the following, consistent with those of the first phase:

The trusted messenger approach was highly effective.
Strong partnership infrastructure created value.
Resource constraints were the most significant barriers.
Tailoring to local community needs was essential.
Mission alignment and shared values sustained commitment.
Interpersonal relationships and shared commitment to rural health equity were facilitators.

Recommendations from the pilot program included allowing longer project implementation timelines, providing technical assistance for smaller organizations with limited resources, and securing funding for long-term sustainability.

QUESTIONS & ANSWERS

Q: When you implemented some of your earlier rural health interventions, did you see an increase in vaccination coverage rates in the rural health population?
Carrie Cochran-McClain (NRHA): Yes. So, the first phase, the pilot, was in a hospital setting, and then in the second phase, the pilots were in more specific clinic settings. But we did see, to some level, a degree of positive uptake. So, let me find that data for you and follow up.
Contact info@izsummitpartners.org if you have questions about the data.

Q: On the NRHA map, what is the difference between the states in blue and the states in gray?
Carrie Cochran-McClain (NRHA): The blue are the states that have a state rural health association. The gray are the ones that don’t have one yet, although Nevada does have one that just started. I should also add that every state has a state office of rural health that is funded by the federal Office of Rural Health Policy, so most of those sit in a state health department of some sort, and they are another really great partner for people as you’re thinking about your vaccine efforts in rural communities.

American Immunization Registry Association (AIRA) Update – Rebecca Coyle, MSEd, Executive Director, AIRA

Rebecca Coyle, MSEd, explained how clinical decision support (CDS) tools for making vaccine recommendations may be affected by changes to the CDC’s Advisory Committee on Immunization Practices (ACIP) recommendations and CDC protocols.

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CDS is integral to electronic health records (EHRs), pharmacy systems, immunization registries, immunization information systems (IISs), and more. CDS tools are used by providers and patients to help with decision-making. For immunization, a CDS tool can compare an individual’s vaccination history with current recommendations to forecast needed vaccines. All current immunization CDS tools follow ACIP recommendations. CDS tools:

standardize vaccine recommendations across all settings;
identify populations at risk in the face of an outbreak of a vaccine-preventable disease;
match an individual’s vaccine history with recommendations quickly and accurately; and
improve patient safety and confidence.

Currently, once the ACIP makes vaccine recommendations, the CDC translates them into technical rules that are used to program CDS tools into EHRs, IISs, and other systems. However, because of concerns about the ACIP recommendations, some jurisdictions and providers are choosing to follow other vaccine schedules. Updating technology is expensive. Without the uniform, consolidated approach that has guided the field for the past 10-plus years, the consistency of recommendations across systems suffers, which could lead to more mistrust and confusion.

All systems currently use the technical rules developed by the CDC. One way to support systems that move away from ACIP recommendations is to focus on the supporting data that are an essential component of the technical rules and that may be modifiable. AIRA is committed to preserving/archiving recent CDC resources that outline the supporting data, as well as the logic specifications and test cases that make up the technical rules. AIRA may update the supporting data tables to reflect recommendations made by other organizations. All of this work around vaccine recommendations hinges on the outcome of legal challenges to the ACIP schedule.

QUESTIONS & ANSWERS

Q: So, AIRA is going to step in with the data component, making those [CDC] artifacts available. If that’s done, at this point in time, is there a critical crisis with immunization CDS? Going forward with recommendations from, let’s say, AAP [American Academy of Pediatrics], and then, let’s say, if AAFP [American Academy of Family Physicians] drops their own schedule, and so on?
Rebecca Coyle (AIRA): Let me try and address that in a couple of different ways. So, right now, we know that what ACIP has released, what’s in the November [2025] edition of that supporting data, is different than what AAP, AAFP, and others have recommended. Some examples of that are COVID and HPV [human papillomavirus]. They do differ slightly, but it’s not that difficult to update those. It does require some work and some resources to do that. If we go forward and there are significant changes to the other pieces, it’s definitely more work involved. But right now, what is being leveraged by most systems, that we’re aware of, is still that November CDC update for their supporting data. And then I think the other question is what happens if maybe nothing happens. I think a lot of it depends upon legal outcomes. If we go back to something that’s pre-June of 2025, I know that there are existing editions of that that we can obviously go back to. I assume CDC might have to go back to that based on legal outcomes, but I really don’t know. I’m purely speculating here.

Q: So, there are those slight differences between the November 2025 [CDC schedule] and the current AAP 2026 schedule. Say an EHR uses that November 2025 version—for COVID, let’s say, the prompts that pop up are going to be based on the November 2025 version, so they will not reflect what AAP is recommending at the 2026 level. Have you heard whether there’s discomfort with that, or is that okay, in the broader sense?
Rebecca Coyle (AIRA): That’s such a great question. I don’t know that I could really answer that question. I’ve heard a little bit across the board. I’ve heard some providers that are like, “Absolutely not; I want to follow AAP’s recommendations.” So, I think that it could potentially create an issue. Whether they want to go through the cost and the hassle of trying to update and create their own CDS to support that, I don’t know.

Q: How does this look for the upcoming respiratory viral season, when there are all these new vaccines coming out?
Rebecca Coyle (AIRA): Great question. I think right now the recommendations largely match. So, I think that’s the good news, particularly for most of the respiratory virus vaccines. RSV [respiratory syncytial virus] is there. COVID, there’s a little bit of difference. AAP [recommends that] every kid should get it, as opposed to the shared clinical decision-making components. But in general, they are okay. But if, for example, there’s a removal of any of those, and I think that gets to be a little bit different situation.

Q: Is there a connection between how CDSi [CDC clinical decision support for immunization] changes will impact vendors and billing systems?
Rebecca Coyle (AIRA): Great question. I don’t think there is, as of right now, but I can verify that, because billing is strictly based on what was administered. I think there’s a lot of speculation about how that could shift over time, but as of now, there’s not.
Contact info@izsummitpartners.org if you have questions about the data.

Announcements

There will be no weekly meeting on Thursday, March 19, 2026 (because of the rescheduled ACIP meeting).
Registration is open for the 2026 National Adult and Influenza Immunization Summit, May 19-21, 2026, at the Crowne Plaza Atlanta Perimeter at Ravinia, 4355 Ashford Dunwoody Rd, Atlanta, GA 30346 (https://www.izsummitpartners.org/2026-naiis/). Once registered, please follow the link to reserve a hotel room so that NAIIS gets sufficient credit toward its room requirements.
The Summit includes a poster session for scientific abstracts. Posters can be submitted at the same website as registration. Attendees interested must submit their abstract for consideration by March 20, 2026. Submitters will be notified if their poster is accepted by April 3, 2026.