Universal vaccine purchase programs are created by state legislatures. Creating a universal purchase program involves:
Passing state legislation authorizing assessments on payers, including insurers and third-party administrators.
Gathering the support of stakeholders (payers, providers, state health officials).
Assembling a vaccine board (either dependent or independent) to govern, provide transparency in fund collection and assessment setting as well as set policy.
Selecting an administrator to provide operations and communications.