Clone of Monkeypox Vaccine Waitlist

Montana's supply of the monkeypox vaccine is limited but we do have doses available for those most at risk. Please answer the question below to assess your risk.

IMPORTANT: If you have been exposed to someone with a confirmed or probable monkeypox infection, please call us at 406.247.3396. You do not need to complete this form.

If you are experiencing any symptoms of monkeypox, please isolate and contact your primary care provider immediately or call 406.247.3396. These symptoms include a rash that may be located on or near the genitals (penis, testicles, labia, vagina) or anus (butthole) and could be on other areas like the hands, feet, chest, face, or mouth. You may also experience fever, chills, swollen lymph nodes, exhaustion, muscle aches or backache, headache, or respiratory symptoms (e.g., sore throat, nasal congestion, cough).

People currently eligible to receive the monkeypox vaccine include:

o People who have had a close contact with a person who has monkeypox.

o People with certain risk factors that make them more likely to have been recently exposed to monkeypox.

o People who have recently had multiple or anonymous sexual partners.

o Partners of people who have had multiple or anonymous sexual partners.

o People experiencing homelessness with high-risk behaviors.

o Sex workers.

o Staff at establishments where sexual activity occurs (e.g. bathhouses, saunas,
sex clubs).

o People who were diagnosed with gonorrhea or early syphilis within the last 12 months.

o People on HIV pre-exposure prophylaxis.

o People deemed to have high risk based on individual risk assessments.

Do any of these eligibility criteria apply to you? *

Yes No

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Preferred method of contact:

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If none of the above criteria apply to you, you are not currently eligible to receive the vaccine. Vaccine eligibility criteria may change so check back frequently to see if you may be eligible in the future. If you have questions about your eligibility to receive the vaccine call 406.247.3396 for additional information.

Monkeypox Vaccine Request