Analysis: There is Significant Variation in State and Local Eligibility Criteria for Monkeypox Vaccines, and Vaccine Information is not Always Accessible

According to a new KFF analysis assessing monkeypox (MPX) vaccine eligibility across the United States, people who are exposed or presumed exposed to MPX are generally eligible to get a vaccine across the country. However, eligibility varies across the United States for certain workers, including laboratory staff and others who might be at increased risk.

The analysis examines MPX vaccine eligibility policies, compared to criteria recommended by the Centers for Disease Control and Prevention (CDC), in the 50 states, Washington, DC, and five cities that receive vaccines from the federal government (Chicago, Houston, Los Angeles, New York City, and Philadelphia) as of Sept. 12.

KFF finds that vaccine eligibility varies significantly across states, with several, including Illinois, Indiana, Maryland, and New Mexico, appearing to lack clear criteria or information about who is eligible or where to get vaccinated.

Key findings include:

• People in 52 of the 56 states and cities are eligible for vaccination after being exposed to the virus. However, Illinois and New Mexico do not detail eligibility criteria online. In addition, South Carolina and the District of Columbia do not explicitly say they are offering vaccination to people with known exposure, but both offer vaccination to those with suspected or likely exposure and go beyond what CDC recommends.
• People in 51 of the states and cities are eligible for vaccination not just after exposure, but also after presumed exposure because of their risk factors or recent experiences. This includes 37 that specifically identify gay, bisexual, and other men who have sex with men. As recommended by the CDC, some states and cities also include transgender and non-binary people who have sex with men.
• Certain laboratory workers and health care workers who may be exposed because of occupational risk are eligible for vaccination in 18 of the states and cities.
• Twenty-four of the states and cities provide broader eligibility for vaccination, going beyond CDC’s current approach, including 19 that offer vaccinations to anyone at increased sexual risk (not limited to men who have sex with men, transgender or gender non-conforming individuals), and 16 that offer vaccination to anyone engaged in sex work.

The significant variation in MPX eligibility across the country means that people who are at high risk of contracting the virus may have access to vaccination in one state or city, while someone with a similar risk profile in a different region would not. Further, information about who can get vaccinated and where to find vaccines is sometimes sparse. This kind of variation could have an impact on infection rates as well as how equitable the vaccine roll-out is, particularly as new MPX cases are more concentrated among men of color who have sex with men.