Officials defend New Hampshire Vaccine Association model; lawmakers press on possible impacts of bill to eliminate it

The Department of Health and Human Services outlined how the New Hampshire Vaccine Association (NHVA) finances vaccines for the state’s universal childhood vaccine program and warned lawmakers that restructuring the mechanism could create access differences among providers.

Tilley explained that NHVA is an independent organization created in statute to collect assessments from commercial payers through a covered‑lives methodology. The association transfers collected funds to the state, which purchases vaccines — often at the CDC’s negotiated prices — and distributes them to providers. The arrangement can lower per‑dose costs, help providers manage cold‑chain logistics and reduce administrative burden, Tilley and Nathan White said.

Committee members noted pending legislation (discussed but not voted on at the session) that would change or eliminate the association; lawmakers asked how that change could affect smaller rural providers and the state’s ability to bulk‑purchase newer products and distribute them quickly during outbreaks. Tilley said the association is a financing mechanism, not an immunization policy body, and does not direct vaccine policy; removing it could leave the state and smaller providers to negotiate purchases independently or to rely on disparate commercial arrangements, which could slow distribution and create inequities.

Members debated whether the association’s assessments create a perverse incentive for the state to expand the vaccine catalog to generate more rebate revenue. Tilley said the state does not set immunization policy to capture rebate revenue and that the association does not determine which vaccines are purchased; purchases follow clinical recommendations and public‑health needs.

Ending: Legislators signaled they would monitor language in the bill and requested additional analysis of how elimination of NHVA would alter procurement practices, cold‑chain logistics and rural provider access to vaccines.