To increase Vermont’s adult immunization rates, the immunization program created a “universal vaccine program” to make all adult vaccines (except flu) available at no-cost to primary care practices. Modeled after the VFC program, the Vaccines for Adults (VFA) program targets adults ages 19-64. The main implementation activities to launch the VFA program included a statutory requirement, an advisory committee with representation from the three largest insurers to determine how vaccine costs would be assessed; advance purchase of vaccine; a contract with KidsVax for collection of funds from insurers and for guidance on how to set annual per member per month rates; and outreach to primary care and OB/GYN providers to encourage participation in the program. Other partners engaged in the process included Vermont AAP and AAFP, commercial insurers and Medicaid. Currently, insurer assessments fund all costs except for the 317 funds used for uninsured adults; Medicaid pays into the assessment system, as all other insurers. Evaluation data shows a significant increase in zoster vaccine. The VFA Program is fully compliant with CDC requirements.