A legislative committee on Tuesday reviewed the 1.1 draft of an act governing how the state issues and purchases recommended immunizations, spending most of its time on wording, procurement and who appoints advisory-panel members.

The committee chair (Speaker 1) opened the session by asking members to pull up the 1.1 version and noted that staffer Katie was preparing an amendment. The chair and members discussed replacing the word "vaccine" with "immunization" throughout the draft. Speaker 3 told the committee the terms are used interchangeably in statute and the change is intended to increase consistency; Speaker 6 cautioned there is a meaningful difference, saying, "Vaccination is what you get; immunization is what a public is providing to a population," and argued that the broader term allows the state to pursue public-health goals without creating a universal mandate.

Why it matters: Committee members said the wording will affect who is eligible under the program and which products the state can include. Speaker 1 said the body should avoid language that excludes people who "are seeking immunizations" in the state, and members agreed that substituting "individuals seeking immunizations" is preferable to phrases like "domiciled in the state" or "received care in the state," which could unintentionally limit access.

Committee members also examined how the department would buy immunizations. Speaker 3 raised a concern that purchasing "at the lowest available cost identified by the department" could create problems if the federal supplier (the CDC) offered lower prices tied to conditions—"strings attached"—that conflict with state goals. Speaker 5, a Department of Health staffer, said the CDC has generally offered the lowest price without conditions but confirmed the department could purchase outside the CDC if supplies were unavailable or federal terms conflicted with Vermont policy. After discussion, members said they wanted to keep a reference to the "lowest available cost" while preserving flexibility to ensure purchases align with the state's recommendations.

On funding, the committee clarified that the program as described would not be paid directly from general-tax revenues. Speaker 1 said the department obtains vaccines and then bills insurers; "Insurance companies, they'll be paying for it," Speaker 1 said. The committee discussed a department funding mechanism described as a per-member allocation to support administration of the program.

Membership and administrative support for advisory panels drew lengthy discussion. The bill references two panels: a funding advisory panel concerned with purchasing and a vaccine (medical) advisory panel comprised of health professionals. Members debated statutory language that would have the commissioner appoint specific representatives versus allowing organizations (for example, health insurers or professional societies) to appoint their own members. The group also discussed whether to include "or designee" language for executive roles and whether to specify that the Department of Health provide legal, technical and administrative support; Speaker 4 warned that removing explicit legal support could create gaps (for example, open-meeting-law questions), and Speaker 5 said the department would revisit that issue.

Speaker 5 also noted the draft's broader use of "immunization" would let the state include non-vaccine products that provide protection, such as "the RSV monoclonal antibody that's approved for use," which the speaker said is not technically a vaccine but could be covered under an immunization program.

Next steps: The chair asked staff to invite subject-matter experts back for clarification and suggested having Dr. Hildebrandt join by video for follow-up questions so experts would not need to appear multiple times. The committee did not record any formal motions or votes during this review; members indicated they will continue drafting and seek clarification from the Department of Health on several points.

Quotes

"Vaccination is what you get; immunization is what a public is providing to a population," Speaker 6 said, urging the committee to consider the terms' different implications. Speaker 1 said, "Insurance companies, they'll be paying for it," to clarify that the program is not funded directly from general-tax revenues. Speaker 5, Department of Health staff, said the CDC "would always provide the lowest cost" in their experience but acknowledged the department could purchase elsewhere if federal terms were inconsistent with state goals.

The committee set several items for follow-up, including inviting the immunization program manager, Meredith Plumpton, and staff policy director Jessica to clarify the department's intent about terminology, procurement and the scope of products covered by the program.