CHEST 2025 Highlights: Future of Respiratory Vaccines and the Impact of Federal Funding Cuts

The CHEST 2025 Annual Meeting, held in Chicago, Illinois, from October 19 to October 22, 2025, featured hours of innovative research, educational panels, and worldwide collaboration over the course of its run. Several panels looked toward the future of pulmonology, including the future of respiratory vaccines and how the decisions of the federal government could affect the practice going forward.

Future of Respiratory Vaccines Focuses on Compliance

With recent skepticism surrounding vaccines, specifically by the policies put in place by HHS Secretary Robert F. Kennedy Jr, the future of respiratory vaccines may look bleaker than before. However, a panel on the past 90 years of respiratory vaccines offered some positive outlook on how future developments could prevent respiratory viruses from spreading rapidly through the country.

Filiz Korkmaz, PhD, assistant professor of microbiology and immunology at Iowa University’s Carver College of Medicine, explained the different forms of adjuvants available, including aluminum, water-in-oil emulsions, and nanoparticle-based adjuvants, for the audience gathered for the panel. However, when looking toward the future of vaccines, there are some challenges that present themselves when it comes to development.

“Some of the challenges that I can see currently…was that eliciting the appropriate immune response, whether the appropriate immune response to eradicate a particular pathogen, cellular vs humoral, whether you really want to have that cytotoxic T-cell response vs the antibody-mediated immunity, I think can be modified based on some of the adjuvant designs that we work on in the future,” said Korkmaz.

Other challenges include protecting those who are immunocompromised, stability and durability, and long-lasting protection. Korkmaz believes that some factors that should be considered in the future include more personalized data, including the age, sex, and genetic background of the patient when giving treatment. Particular immune responses could be affected by environmental factors as well, such as asthma. Lastly, the location of delivery can also have an effect on patients in the future.

“We talk about respiratory infections, but predominantly we have intramuscular vaccinations. Some other considerations may be the development of oral or intranasal routes of administration, which may also improve your compliance in the patient population,” said Korkmaz.

There are some studies evaluating the use of alternative modes of delivery, including a 2023 study in mice that found a humoral and cellular immune response when delivered intranasally vs intramuscularly.¹ Genetic variations should also be taken into account, as some young men were found to have a genetic variation that made the COVID-19 vaccine less effective for them during the height of the pandemic. All of these considerations can help to elevate respiratory vaccines in the future to encourage compliance and, perhaps, increased efficacy.

Future of Pulmonary Medicine in Question With Federal Cuts

Although there are promising developments in so many aspects of pulmonary medicine, there are still some concerns about the future of the specialty going forward. In a panel held on the last day of the conference, experts discussed what the federal funding cuts mean for the medical field at large, a little less than a year since a new administration has been sworn into office.

Matthew Simpson, MD, BS, pulmonary and critical care fellow at Morehouse School of Medicine, began by stating that the proposed cuts to the National Institutes of Health (NIH) have wide-sweeping impacts on health care.

“First, there’s a projected 15.3% fewer new therapies entering the market. That’s more than 99% of all new drugs from 2010 to 2019,” he explained. "Also proposes a 0.24-year lower life expectancy per person in the United States over the next 25 years. And then a total of 82 million years of life lost value, conservatively about $8.2 trillion in lost health benefits, estimated about $48 billion drop in stock market value for biomedical companies…and then overall, just a reduction to the level would result in $51 billion in lost economic output nationwide."

These cuts to NIH would also result in lost grant money for different disease states, including HIV, vaccines, and diversity research, as well as the jobs that are linked to that funding slowly vanishing. The cuts to Medicaid could also affect children, as about 40% of all children are covered by Medicaid.²

Simpson was joined by other panelists to discuss how federal guidelines were going to affect them going forward. Specifically, the panelists called attention to the effects on education with less funding. William McDade, MD, an adjunct professor at Rush University, noted that the funding cuts would affect the ability to obtain funding for work prior to medical school, called supplements, that help expand diversity in health-related sciences by allowing younger individuals to join principal investigators on a trial to gain experience. This is especially valuable in neurosurgery, where residents need to do research with someone who is a neurosurgeon before they can apply to the specialty.

“What we realize is [with] the historically Black colleges and universities that have medical schools, is [that] not one has a neurosurgery program. You’ve got a large group of students who are almost ruled out for being neurosurgeons just by virtue of where they attend school,” he explained.

Similarly, the reduction in funding for medical school student loans can also be damaging when it comes to addressing clinician shortages. Virginia Caine, MD, director of the Marion County Public Health Department in Indianapolis, noted that the Association of American Medical Colleges has estimated a shortage of 86,000 physicians by 2036.³ With the limit of $200,000 for a government loan to go to professional programs, including medical school,⁴ this could cause a shortfall of $100,000 for many of those who wish to become doctors.

“What’s going to happen? You’re only going to have physicians that [have] money. Their families are wealthier… But if you’re looking at a first-generation person, it’s going to be very difficult to have someone make that huge commitment to medical school and everything when I can be an MBA for a year or 2 as opposed to now, [when] I can’t even get reasonable dollars to know whether I could even complete medical school…” said Caine. “[With] these Medicaid cuts, we’re going to be overwhelmed because of that shortage.”

They also pointed to rural hospitals potentially being affected by these cuts, which could put patients at risk of not getting the care they need. When it comes to those who are affected the most, rebuilding trust in physicians is important to helping their patients understand what is happening and work through these roadblocks.

Niva Lubin-Johnson, MD, FACP, chief health officer at SimPco Solutions, emphasized that physicians have a responsibility to become sources of information for their patients.

“It’s really taking the time to talk. I mean, [younger individuals] are raised now on texting and nonverbal communication, but they really need more verbal communication from us,” she said. “And encourage your patients to vote, because studies have shown if that recommendation comes from a physician, no matter who, it’s a greater chance that patient will vote.”

References

1. Jangra S, Landers JL, Laghlali G, et al. Multicomponent intranasal adjuvant for mucosal and durable systemic SARS-COV-2 immunity in young and aged mice. NPJ Vaccines. 2023;8(1):96. doi:10.1038/s41541-023-00691-1

2. Fact sheet: Medicaid. American Hospital Association. Accessed October 22, 2025. https://www.aha.org/fact-sheets/2025-02-07-fact-sheet-medicaid

3. New AAMC report shows continuing projected physician shortage. News release. Association of American Medical Colleges. March 21, 2024. Accessed October 22, 2025. https://www.aamc.org/news/press-releases/new-aamc-report-shows-continuing-projected-physician-shortage

4. Dickler J. New federal student loan limits are a ‘punch in the face’ for aspiring doctors: American Medical Association president. CNBC. August 7, 2025. Accessed October 22, 2025. https://www.cnbc.com/2025/08/07/trumps-big-beautiful-bill-sets-student-loan-caps-for-medical-school.html