by Dave Soulia, for FYIVT.com

A new bill before the Vermont House would give the state health commissioner broad authority to decide which vaccines Vermonters should receive, how they’re delivered, and who pays for them — while expanding legal protections for providers and eliminating out-of-pocket costs for patients.

House Bill H.545, introduced by Rep. Theresa Wood (D–Washington-Chittenden) and Rep. Alyssa Black (D–Chittenden-24), would shift the power to set immunization recommendations from federal agencies to the Vermont Department of Health. It would require all insurers to cover any immunization recommended by the commissioner with no copayments, coinsurance, or deductibles, and grant immunity from most civil and administrative liability to health professionals who administer those vaccines in accordance with state guidance.

Current framework

Under current law, Vermont’s immunization policy largely follows recommendations from the federal Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention. The Department of Health runs a universal vaccine program, purchasing vaccines primarily through the CDC at discounted rates and distributing them to providers.

Insurers reimburse the state through a per-member, per-month assessment set by the Immunization Funding Advisory Committee. A separate Vermont Immunization Advisory Council reviews safety, efficacy, and school-entry schedules and advises the commissioner, but does not currently set policy on its own.

What H.545 would change

H.545 would make the Health Commissioner the final authority on Vermont’s immunization policy. The commissioner would be empowered to issue state-specific recommendations identifying which vaccines children and adults should receive, at what ages, how many doses, and any other measures “necessary to ensure the maintenance of public health and disease prevention in the State.”

The commissioner would be required to consult the Vermont Immunization Advisory Council and consider recommendations from national groups such as ACIP, the American Academy of Pediatrics, and the American College of Physicians. But those outside recommendations would no longer be binding. Final decision-making would rest solely with the commissioner.

The bill also creates standing-order authority allowing the commissioner to permit licensed health care professionals — including pharmacists — to prescribe, dispense, or administer any recommended immunization within their existing scope of practice. That could make it easier for pharmacies and community clinics to deliver vaccines without individual prescriptions.

Liability protections

A central provision is expanded legal protection for providers who follow state recommendations. Health care professionals would be “immune from civil and administrative liability for immunization-caused adverse events” so long as they act within the commissioner’s guidance and do not engage in gross negligence, recklessness, or intentional misconduct.

Supporters will likely frame this as reassurance for providers and a way to avoid deterrents to participation in the universal vaccine program. Practically, however, the provision would narrow Vermonters’ ability to pursue vaccine-related claims in state court. Most such claims would likely fall under the federal Vaccine Injury Compensation Program, which already handles the majority of vaccine injury petitions nationwide.

Insurance and purchasing changes

The bill keeps Vermont’s goal of “universal access” to vaccines but adjusts implementation. The Department of Health would continue purchasing vaccines in bulk but would gain explicit authority to buy directly from manufacturers if they offer better pricing than the CDC.

Health insurers would still reimburse the department for vaccine costs and pay an administrative surcharge. All insurers — including commercial plans and self-insured employers — would be required to cover every immunization recommended by the commissioner, regardless of whether it appears on federal lists, with no cost-sharing for patients.

If the commissioner recommends additional vaccines or more frequent dosing schedules, insurers and self-insured employers could face higher costs, likely recovered through higher premiums or assessments.

Revised advisory roles

H.545 would update Vermont’s immunization advisory bodies. The Immunization Funding Advisory Committee would continue calculating the per-member, per-month vaccine assessment, but its statutory language would shift from federally defined vaccines to “recommended immunizations” under state policy.

The Vermont Immunization Advisory Council would expand to include additional public-health and education officials, with duties explicitly covering the commissioner’s full immunization recommendations for children and adults. The council’s role would remain advisory rather than regulatory.

Implications

Economically, the bill rebalances cost control and policy flexibility. Allowing purchases outside CDC channels could save money, but may expose Vermont to more complex negotiations without federal backing.

On coverage, insurers would lose discretion in designing vaccine benefits — any immunization on the commissioner’s list would automatically become fully covered. That simplifies access but consolidates financial and clinical decision-making in a single state office.

From a public-health perspective, supporters will argue H.545 allows Vermont to respond more quickly to emerging diseases and tailor recommendations to local conditions. Critics may warn that shifting authority from a broad federal advisory process to one state official could make vaccine policy more sensitive to political pressure, while the expanded liability shield may weaken recourse for those experiencing adverse events.

What’s next

If enacted, H.545 would take effect July 1, 2026, giving the Department of Health, insurers, and employers roughly a year to adjust contracts and coverage policies.

As the House Human Services Committee reviews the bill, debate will likely center on how much authority the Legislature should delegate to the commissioner — and how the resulting costs, coverage mandates, and liability protections would operate in practice.