The Vaccine Integrity Project - Interim Update

Published June 17 2025

A Call to Action

The Vaccine Integrity Project is committed to ensuring that vaccine use in the United States remains anchored in the best available science (safety, efficacy, epidemiology, and feasibility), focused on safeguarding individuals, families, and communities from vaccine-preventable diseases. In May, we convened a series of structured discussions and deep dives with a range of professionals across the US vaccine and vaccination ecosystem to better understand how non-governmental organizations can contribute to this effort. This work is far from over, and no single organization can carry it alone. The scale and complexity of the challenges ahead require collaboration and coordinated action across the ecosystem. 

Start where you can, collaborate, and let’s move forward together. The time to act is now.

Recommendations 

With the “diagnostic” phase now complete, this interim update summarizes the most urgent and high-impact recommendations that emerged—highlighting areas where immediate attention is critical to protecting public health and the healthcare system. A more detailed report will be released by the Vaccine Integrity Project later this summer.

The high-level recommendations identified include: increasing communication, developing and disseminating clinical guidance and tools, maintaining the nation’s vaccine infrastructure, stabilizing the vaccine safety system, supporting state and local health departments, safeguarding insurance coverage, continuing the flow of data for decision-making, and building an overarching coalition for strategy and alignment. Among these high-level recommendations, the following action items have been identified as critical next steps and are intended for execution across a wide range of collaborative stakeholders:  

Increasing Communication and Improving Information Dissemination

Substantial and wide-reaching efforts are urgently needed to counter the spread of inaccurate and confusing vaccine information. Actions include:

• Rapidly responding to inaccurate information through various media platforms (see callout box) 

• Launching both locally relevant and large-scale social media campaigns to emphasize the evidence supporting the safety and effectiveness of vaccinations and their value to individuals and communities

• Equipping frontline health workers, public health officials, and professional societies with the information and tested messaging they need to help individuals make informed decisions about vaccination, as well as identifying and training other trusted messengers at the regional, state, and local levels

• Providing tailored education about the entire vaccine and vaccination ecosystem to a wide range of audiences, now and in the future, recognizing the changing landscapes, so the impact—the true benefits, limitations, and risks of vaccinations—are better understood

Developing and Disseminating Clinical Tools and Guidelines

The growing complexity and recent confusion in the information landscape highlights the urgent need for user-friendly tools that distill immunization facts and guidance—based on the ever-evolving science—into clear, actionable information for frontline healthcare and public health professionals. Frontline health workers—from pharmacists and nurses to public health and community health workers—play a critical role in rebuilding trust in the safety, effectiveness, and need for vaccines. Actions include: 

• Convening a coalition to develop a unified process and templates to review/update/issue user-friendly clinical guidelines in a transparent and timely fashion (see callout box 2)

• Creating new distribution channels to provide guidelines, toolkits, emerging data, etc., to reach frontline and allied health workers quickly

Maintaining the Nation’s Vaccination Infrastructure 

Today, state and local health departments—and the United States as a whole—depend on HHS to provide the essential infrastructure and funding to support vaccine operations and programs, including purchase and distribution, administration tracking, Vaccine Injury Compensation and Countermeasures Injury Compensation Programs, and the Vaccines for Children (VFC) program. Recent HHS actions to rescind the existing COVID-19 vaccine recommendations for pregnant women and children, coupled with unclear coverage implications, suggest that states, localities, and the American public at large, may need to assume partial or full responsibility for related costs and operations in the future. Actions include: 

• Assessing the pros and cons of establishing state- or regionally-based expert immunization committees

• Evaluating whether group purchasing organizations could be leveraged or created to buy vaccines in bulk at a discounted rate; assessing if the private sector (e.g., pharmacies or large health provider networks) can assist with subsidized vaccine access programs to support public health 

• Exploring options and feasibility of continuing the collection of vaccine administration data; securing data currently held by states and the US government

• Analyzing state laws and exploring legislative changes that may be required to ensure all providers can legally provide immunizations absent the Advisory Committee on Immunization Practices (ACIP)— a Federal Advisory Committee of the US Centers for Disease Control and Prevention (CDC)— recommendations, if it benefits patient care

Stabilizing the Vaccine Safety System 

In order for a vaccine to be licensed in the United States, the Food and Drug Administration must find that it is safe and effective for use. The evaluation of a vaccine's safety does not stop at licensure; the United States has a robust infrastructure of post-market vaccine safety surveillance in place.  Anchoring these safety monitoring activities is essential to maintaining public trust and continued confidence in the safety of vaccines. Actions include: 

• Improving understanding and better communicating information about the current US safety monitoring systems 

• Working with manufacturers to enhance the uninterrupted flow of safety data

• Expanding the number of Vaccine Safety Datalink sites across the United States, and evaluating the merits of initiating state-based systems to collect, report, and analyze vaccine safety signal data 

• Advocating for funding and new federal legislation to codify vaccine safety monitoring; offering state-based legislative solutions as well 

Supporting State and Local Health Departments 

States and localities have relied on HHS to provide guidance, funding, and infrastructure to sustain their immunization programs. Federal agencies have played a central role in shaping policy, establishing standards, and supporting operations in and across jurisdictions. As the landscape evolves, a broad network of entities committed to protecting health may need to collectively take on these responsibilities (e.g., developing and disseminating clinical tools and best practices). These groups will also need to partner more directly with states, territories, and localities to bolster capacity and address emerging challenges and respond to community needs. Activities include: 

• Developing a checklist for state and local health departments and state insurance commissioners on what they could be doing now to prepare for potential impacts on state and locally-led vaccine operations and budgets (see callout box #5)
• Providing educational materials to each state on the current vaccine payment landscape (e.g., Children’s Health Insurance Program, VFC, Employee Retirement Income Security Act (ERISA), etc.) 
• Developing model legislation and/or creating a state-based legislative strategy and framework to assess needs and opportunities to fill potential gaps 
• Initiating new communication channels to share information and experience across states and supplement the flow of information in real time (see callout box #6)

Safeguarding Insurance Coverage 

Shifting vaccine recommendations have raised questions about the future of guaranteed coverage through both public and private insurance. States, localities, and payors must begin planning now for possible changes and their implications, including Medicaid and Medicare, ERISA plans, and private insurance. Changes to vaccine recommendations could also have implications for the VFC program, which provides immunizations to over half of the children in the United States.  There is an urgent need for stakeholders to come together to identify where coverage may be at risk and to develop actionable solutions that protect and sustain access to vaccines, including updated analyses of the economic benefits of vaccinations. Actions include: 

• Working with insurers/payers on opportunities for coverage and reimbursement under a scenario in which the ACIP is limiting or no longer recommending vaccines for use

• Analyzing state laws and exploring legislative changes that may be required to continue coverage for under and uninsured, including implications for those covered by the Vaccines for Children program

• Developing and broadly disseminating informational materials about vaccination coverage and Medicaid/Medicare, ERISA, state insurance commissions, and private insurance so there is a baseline understanding of what exists today

Next Steps

Immediate steps are needed to safeguard the progress made in protecting public health and reducing healthcare costs through the United States’ long-standing immunization programs. Americans deserve continued access to clear, credible, and evidence-based information about vaccines. The public health and healthcare communities must be ready to act swiftly and decisively in defense of science, access, and trust.

To meet this challenge, stronger collaboration and coordination across the vaccine and vaccination ecosystem are urgently needed. Consistent, unified messaging must be developed and distributed in real time. Organizations should convene to identify and prioritize emerging threats, and to maintain and update a landscape analysis that can clarify roles, reduce duplication, and improve alignment. The Vaccine Integrity Project has begun to work with partners toward building this unified infrastructure—but we cannot and should not do it alone. There’s no need to wait, the time to act is now. 

We want to hear from you 

We want to hear what you and your organizations are doing now to protect vaccines across the United States. Please complete the short form below so we can catalog current initiatives and begin to identify where both synergies and gaps exist. 

Vaccine Activity Tracker

For additional comments or questions, please email the Vaccine Integrity Project at vaxintegrity@umn.edu. 

   

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