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Dear Childhood Vaccine Program Providers and Immunization Partners,
The Washington State Department of Health (DOH) is committed to ensuring that everyone in our state, especially all children, has access to life-saving vaccines. Vaccines are one of the most effective tools we have to prevent illness, and we are grateful for the strong partnerships that make Washington’s universal Childhood Vaccine Program possible.
All providers enrolled in the program receive publicly supplied vaccines at no cost for every child they serve. This includes all current vaccines on the CDC’s Recommended Child and Adolescent Immunization Schedule, helping eliminate cost barriers for families and protecting communities statewide.
Because Washington operates a universal system, every child’s vaccine comes from one shared supply funded through the federal Vaccines for Children (VFC) program, Washington State Health Care Authority, and the Washington Vaccine Association (WVA). As the WVA pays for more than half of Washington’s childhood vaccines, its financial stability is essential to keeping vaccines accessible for all families in Washington.
Why We’re Sharing This Update
Over the past two years, several major challenges have put significant financial pressure on the WVA. As a reminder, the WVA pays upfront for vaccines and is reimbursed only when doses are administered and billed correctly. Any expired, unused, or wasted doses become unrecoverable costs.
The most significant contributors include:
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RSV (nirsevimab) rollout: To make this new product available quickly, the WVA used its own financial reserves before insurers were authorized to be billed. Millions of dollars in early costs could not be recovered.
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Unused RSV doses: Last season, about 18,000 doses went unused and remained in provider refrigerators statewide, 11,000 of them were WVA-funded. At $400 per dose, this tied up $4.4 million of WVA’s available cash needed for purchase of respiratory and routine vaccines this season.
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Rising waste and expired product: Weather-related outages, unpredictable demand, and other disruptions have led to higher waste across multiple vaccines.
Combined, these issues have resulted in over $35 million in unrecovered costs in just two years, which is a significant impact. To stabilize the program, DOH and WVA temporarily shifted to “just-in-time” ordering this season. This means smaller, more frequent shipments and tighter inventory controls for respiratory vaccines. We also required transfers to redistribute RSV doses more evenly across the state. These steps help ensure equitable access to vaccine and promote full use of all doses.
We Know “Just-in-Time” Ordering Has Been Hard
We want to acknowledge the challenges this approach has created for providers. Many of you have shared concerns about limited inventory on hand, irregular ordering windows, and the stress of planning care with tighter stock. Some clinics also experienced intermittent stock outages that led to missed opportunities to vaccinate. While difficult, these temporary ordering changes are necessary this season to help maintain our universal program.
The good news is:
- CDC has increased allocations for both COVID-19 vaccines and RSV products, allowing more doses to be ordered each week.
- Nearly 5,500 RSV doses were successfully redistributed to providers who could use them before expiration - an effort that directly protected product and funding.
- We are now processing orders daily, despite a reduction of DOH staff.
- We are comfortable with current supply.
- You may still see occasional lag, but we expect continued improvement.
Next season, we hope to open ordering as soon as we receive our CDC allocation, which determines product availability. We expect more flexibility and fewer restrictions once the WVA has rebuilt reserves and the CDC confirms supply.
Your Partnership Is Making a Difference
In our last message, we celebrated your tremendous effort in saving over 5,500 expiring RSV doses through transfers and redistribution - preserving $2.3 million in vaccine resources. Your collaboration, problem-solving, and feedback have strengthened statewide coordination, prevented unnecessary waste, and has kept the Childhood Vaccine Program in operation.
How We Move Forward, Together
Your partnership remains essential as we navigate this year’s funding and supply constraints. Please continue to support us by:
- Ordering responsibly - small amounts, more frequently.
- Prioritizing use of short-dated vaccine.
- Maintaining strict storage safeguards, especially during extreme weather.
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Advertising expiring doses for transfer at least four weeks before expiration.
- Transferring doses promptly when needed.
Your efforts directly protect the future of Washington’s universal vaccine program and help ensure long-term access to all recommended childhood vaccines.
We deeply value the dedication of providers, clinics, local health jurisdictions, Tribes, and staff across our healthcare system. Thank you for your partnership, your flexibility, and your unwavering commitment to Washington’s children.
Together, we are ensuring every child in Washington continues to receive the vaccines they need – today and for years to come.
With appreciation,
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