Monkeypox Vaccine Equity Pilot Program

Equity-focused vaccine projects present an opportunity to pilot creative ways to reach populations who are most affected by monkeypox virus, while contributing to our knowledge of best practices in this current outbreak. Dedicated efforts may reach populations who face barriers to awareness, education, and prevention measures like vaccination. Barriers could include differences in language, location of vaccination sites, vaccine hesitancy, mistrust of government, and lack of access to on-line scheduling technology. Additionally, affected individuals may avoid accessing vaccination at events oriented toward specific sexual or gender identities or sexual activity out of fear of being stigmatized. The Monkeypox Vaccine Equity Pilot Program was developed to demonstrate new, innovative, and non-traditional ways to address vaccination disparities within populations who are most affected.

Who Can Apply?

Projects may be developed by a state, territorial, or local health department, a tribal government or tribal organization, or a local non-governmental organization seeking to address vaccination disparities among one or more priority population groups most affected by monkeypox.

In order to streamline communication and the approval process, proposals must be submitted by the following “submitting jurisdictions”:

Proposals are expected to describe collaborative vaccination projects to be implemented in a local area and designed to reach disproportionately affected populations experiencing vaccination disparities. Multiple proposals can be submitted per submitting jurisdiction, and CDC will consider each proposal separately; however, CDC prefers that submitting jurisdictions submit proposals at the same time when possible. Any organization receiving a vaccine shipment will need to comply with the HHS Provider Agreement. CDC will confer with the Administration for Strategic Preparedness and Response (ASPR) on logistics of allocation and delivery of vaccine vials for each submitting jurisdiction with an approved request.

How Much Vaccine Is Available?

10,000 vials of vaccine (enough for up to 50,000 intradermal doses) have been set aside for this national pilot program. For each project selected, submitting jurisdictions can request an advance of vaccines based on planned events and approaches. Initially, CDC recommends requesting up to 100 vials (300–500 doses) upfront per project; this may be reevaluated once the project begins.

What Are the Criteria for Participation?

  • Successful proposals will demonstrate new, innovative, non-traditional ways to reach populations who are most affected by monkeypox as defined by the applicant and supported by local context and data.
  • Projects should prioritize groups with risk factors that increase their chances of getting or spreading monkeypox, who are over-represented among monkeypox cases and less likely to be vaccinated, and whose barriers to vaccination may be addressed by the activities proposed. Special consideration will be given to projects addressing disparities among Black/African American and Hispanic/Latino gay, bisexual, and other men who have sex with men (MSM) and transgender and gender-diverse people who have sex with men.
  • The submitting jurisdiction, with its local partners, commits to collaborating with CDC to implement these vaccination projects to reach affected populations not currently being reached, and to collect data to increase our knowledge on best practices.
  • Prior to submitting a proposal, the submitting jurisdiction must have utilized at least 50% of the non-pilot supply of vaccines it received through the SNS, calculated according to current ASPR guidance.
  • If a project successfully reaches its stated goals, the submitting jurisdiction should consider using vaccines from its non-pilot supply of vaccines to adapt the project model for more widespread implementation.
  • The submitting jurisdiction should plan to use all vaccines allocated as part of the pilot program as first doses and commits to ensuring access to second doses to all project participants from its non-pilot supply of vaccines received through the SNS.
  • Plans to complete the project within 30 days of receipt of vaccines should be in place. Alternate timelines for completion can be discussed with CDC as needed.

Examples of Equity Projects That May Qualify:

  • Pop-ups and other events associated with community-based organizations (CBOs) or clinics that work with MSM and transgender and gender-diverse people who have sex with men, especially those who are Black/African American and Hispanic/Latino, who are not reached by current allocations or vaccine administration channels
  • Small events reaching priority populations (e.g., concerts or parties catering to the population of disproportionately affected, underserved individuals including house and kiki balls from the local LGBTQ+ ballroom community)
  • Other activities in settings where monkeypox is known to be spreading (e.g., venues at which intimate or sexual contact might occur, nightclubs, and bars frequented by the priority population)
  • ‘Vaccine clinics’ at pharmacies, especially independent pharmacies in rural areas or areas with demonstrated vaccination disparities based on Social Vulnerability Index or other local data

What Must Be Included in the Proposal?

  • Date of submission
  • Proposed project start date
  • Contact information for participating health department(s) and organizations, where relevant
  • Demonstrated coordination between the submitting state or territorial health department and a local health department, CBO, or other community partner involved in the project
  • For tribal governments or federally funded tribal healthcare facilities, demonstrated coordination with a vaccine provider involved in the project (proposals will be reviewed in coordination with Indian Health Services, as appropriate)
  • For each local project (100-200 words per response):
    • Briefly describe the priority population and any epidemiologic data or other evidence used to identify the groups most affected by monkeypox that would benefit from equity-focused projects.
    • Provide a brief overview of the project, including how the priority population will be engaged. Describe events or approaches to be used to provide vaccination opportunities.
    • Briefly describe both resources available (e.g., staff, supplies) and resources needed to conduct the project.
    • Indicate estimated number of doses needed to complete the project (initially 300–500 doses but can be reevaluated once the project begins).
    • Describe data collection efforts to include, at a minimum, a brief CDC-provided “onsite” anonymous electronic survey for vaccine recipients to assess the equity impact of the project.
    • Describe how any unused doses will be redirected to other equity-focused vaccination efforts in the jurisdiction.
    • Verify:
      • Vaccine administration will be intradermal unless contraindicated.
      • The submitting jurisdiction commits to providing second doses from its non-pilot supply of vaccines received through the SNS.
      • Any jurisdiction receiving a vaccine shipment will comply with the HHS Provider Agreement.
      • The submitting jurisdiction has already utilized at least 50% of its non-pilot supply of vaccines received through the SNS, calculated according to current ASPR guidance.
      • The submitting jurisdiction will be responsible for submitting a CDC-provided post-project survey that assesses the project’s overall ability to achieve the stated goals, which will include narratives and challenges from the project.

How to Submit a Proposal

All proposals must be submitted through state or territorial health departments, tribal governments, federally funded tribal healthcare facilities, or cities currently receiving monkeypox vaccines through the SNS. Organizations interested in applying should reach out to their submitting jurisdiction. Applications will continue to be accepted until the vaccine supply has been exhausted.

For More Information

Submit any questions you may have about the pilot program proposals, including who to contact in a submitting jurisdiction.

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