On August 1, the Senate Appropriations Committee released its fiscal year 2025 (FY25) Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) appropriations bill. The bipartisan bill was favorably reported out of the Committee by a vote of 25-3 on August 2.

 

The bill provides $231.34 billion, which is almost $9 billion more than FY24. For HHS, it provides $122.8 billion which is an increase of $5.8 billion or 5% above FY24. The Centers for Disease Control and Prevention (CDC) total of $9.4 billion is an increase of $200 million or 2% above FY24. The National Center for Immunization and Respiratory Diseases is funded at $934 million, which includes $469 million in transfers from the PPH Fund, an increase of $15 million over FY 2024. The 317 Immunization Program received an increase of $15 million or 2% over FY24 for a total of $696.9 million.

 

The report includes the following language relevant to the 317 Program:

 

• 317 Immunization Program.—The Committee recognizes CDC’s immunization program plays a fundamental role in achieving national immunization goals and sustaining high vaccination coverage. In addition, this program underpins the protection of all children being vaccinated, even those fully insured, by providing Federal, State, and local resources to investigate outbreaks, conduct surveillance, and provide public awareness campaigns to address vaccine hesitancy that continues to be the root cause of outbreaks for measles and other preventable diseases. The Committee continues to expect funding be used to promote health equity related to protection from vaccine preventable diseases [VPDs] as well as address vaccine hesitancy. CDC is encouraged to expand the existing immunization infrastructure, including implementing new strategies for hard-to-reach populations, such as those who may be vaccine-hesitant, those who are members of racial and ethnic or other minority groups, and those who are underserved due to socioeconomic or other reasons. The Committee requests an update in the fiscal year 2026 CJ on the achievements of the ongoing ‘‘Vaccinate with Confidence’’ campaign and the rate of routine vaccination across all ages, as well as a forward-looking plan to administer missed doses.

 

• Accelerate the Elimination of HPV-related Cancer and Disease.— Human papillomavirus [HPV] -related cancers remain an alarming public health concern in the United States, impacting nearly 40,000 Americans each year. HPV is the leading cause of cervical cancer, which disproportionally affects communities of color and underrepresented populations. Each year, nearly 200,000 women are diagnosed with cervical pre-cancer, 11,000 women are diagnosed with cervical cancer caused by HPV, and approximately 4,000 women die from cervical cancer in the United States. The evidence shows that HPV vaccination is extremely effective at preventing over 90 percent of HPV-related cancers when given between the recommended ages of 9 and 12. Yet, CDC data from 2022 shows that only 63 percent of children ages 13–17 were up to date with HPV vaccination, which is significantly less than the ‘‘Healthy People 2030’’ goal of 80 percent. While all childhood and adolescent vaccinations declined during the pandemic, the HPV vaccine rates experienced the largest decrease and have been the slowest to rebound to pre-pandemic levels. The Committee urges CDC to take immediate action to expand access to HPV vaccination, including by: updating the immunization information system at the Federal level to enable standardized forecasting of HPV vaccination at age 9 across the country; supporting providers and trusted voices to engage patients with a strong recommendation for HPV vaccination as cancer prevention; and continuing to reduce health disparities and barriers to care for underserved communities.

 

• Cost Estimates.—The Committee requests that the report on estimated funding needs of the Section 317 Immunization Program be updated and submitted not later than February 1, 2025, to the Committees on Appropriations. The updated report should include an estimate of optimum State and local operations funding, as well as a discussion of the role of the 317 Program, as coverage for vaccination under public and private resources continues to evolve. The Committee also requests that the report include specific information on the estimated cost to fully address evidence-based public health strategies that could be funded through CDC to improve coverage for HPV and influenza. The Committee directs CDC to provide a professional judgment budget estimate to the Committee that specifically outlines the cost to fully fund an uninsured adult immunization program that includes the cost of purchase, storage, and administration of all ACIP-recommended adult vaccines and allows for provider choice of product, outreach, and counseling grants to providers and community-based organizations. Estimates should also be included to address the needs of outbreak investigation and response, particularly as measles cases are increasing. Additionally, the Committee requests CDC to provide analysis on how the addition of new adult vaccine recommendations and increased vaccine costs have reduced the number of vaccine doses administered to uninsured adults with available resources. This should include estimates of how much additional vaccine purchase funding would be needed to reach both half and all of the uninsured population with a complete series of recommended vaccines.

 

• Increasing Adult Hepatitis B Vaccination.—The Committee urges CDC to promote hepatitis B vaccination among all adults ages 19 through 59 as recommended by ACIP. The Committee urges CDC to provide leadership to ensure the recommendation is implemented, and to coordinate implementation activities with the HHS Assistant Secretary for Health and HRSA and engage providers and community-based organizations as necessary. The Committee reiterates the request for a report as requested in Senate Report 118–84.

 

• Long COVID.—The Committee encourages CDC to monitor and track incidence of Long COVID among children and adults, including developing a patient registry for Long COVID.

 

• Promoting Routine Vaccination.—The Committee is concerned by the continued lag in vaccination throughout the life course, with underserved populations affected to a greater degree and adolescents affected disproportionately. The 2023–2024 respiratory season saw continued stagnation in immunization rates coupled with significant increases in COVID, flu, and respiratory syncytial virus [RSV] cases. If not addressed, these trends will increasingly expose Americans of all ages to VPDs, outbreaks, including measles, and exacerbate existing health disparities. The Committee requests CDC provide an update in the fiscal year 2026 CJ on the vaccine education efforts and the rate of routine vaccination across all ages, as well as an update on the plan to administer missed doses, prioritizing areas with the largest reduction in routine coverage rates. CDC should include updated recommendations about what other tools it could employ to address this issue, as well as a plan to strengthen efforts to combat misinformation about vaccines and vaccination, which are contributing to confusion, hesitancy, and overall fatigue.

 

• Respiratory Viruses.—The Committee recognizes the importance of a strong capacity at CDC to address respiratory viruses and supports CDC’s work to address respiratory illnesses holistically, with the capacity to identify and assess characteristics of viruses to inform vaccines and therapeutics, quantify the burden such viruses place on the health of Americans, and the effectiveness of vaccines and other preventive measures.

 

 

Other funding related to immunization capacity and infrastructure includes:

• level funding at just over $231 million for CDC’s Influenza Planning and Response program.

• $195 million for Public Health Data Modernization efforts, an increase of $20 million over FY24.

• level funding for the Preventive Health and Health Services Block Grant program at $160 million.

 

The text of the FY25 Senate Labor-HHS bill text can be found here, and the bill report can be found here.