New Jersey is no longer considering gender or sexual identity a factor in a person’s eligibility for the monkeypox vaccine.
The change went into effect last week. A Murphy administration official told Gothamist the state’s criteria for vaccine eligibility was updated to match similar guidance from the Centers for Disease Control and Prevention.
The eligibility requirements apply at the state’s 10 community vaccination sites, and the new language defining them was first reflected last week in an announcement of sites opening in Hudson, Middlesex, Morris, and Passaic counties.
Monkeypox is not currently considered a sexually transmitted disease by the classic definition, mainly because spread through intimate touching can’t be separated from other skin-to-skin transmission. Globally, the World Health Organization has recorded sexual transmission in 91% of cases this year where exposure details were reported by patients — which leaves about one in 10 infections spreading non-sexually.
Recorded exposures have largely been centered around LGBTQ populations, but the virus can infect anyone, regardless of their sexual or gender identity.
Until last week, New Jersey advisories specified that the vaccine would be made available through the state-designated community sites to “individuals that identify as gay, bisexual, or men who have sex with men, and/or transgender, gender nonconforming, or nonbinary and who have a history of multiple or anonymous sex partners within the past 14 days.”
Gov. Phil Murphy’s administration has said its outreach is focused on those communities — though that could change in the future if other groups are disproportionately impacted.
But the state’s eligibility language has been replaced. The vaccine is now available at the community sites to “people who had multiple sexual partners in the past 14 days in areas where monkeypox has been reported.”
New Jersey also makes the vaccine available through the community sites to anyone who attended an event over the last 14 days where a known exposure occurred, even if that individual didn’t personally have a known exposure. That qualifier for eligibility was never tied to sexual or gender identity.
And someone who experienced a known exposure directly can get the vaccine through a local health department, regardless of identity.
State advisories also stress vaccination should be considered a priority for immunocompromised individuals or those who have a history of skin conditions like atopic dermatitis or eczema, if they otherwise meet the criteria. Those skin ailments can increase the risk of monkeypox embedding itself in the body.
This guidance differs from New York City’s vaccine eligibility criteria. The five boroughs continue to specify gender or sexual identity — in addition to a requirement that an individual had anonymous or multiple sex partners in the last 14 days. New York City also requires vaccine recipients to be 18 or older, while New Jersey does not specify an age requirement for high-risk individuals.
Christian Fuscarino, executive director of Garden State Equality, said he understands broadening eligibility, especially as the school year is about to begin. But with limited vaccine supplies available, he said “we must follow the data and ensure that the most vulnerable populations have the easiest access.”
Jay Lassiter, a writer for InsiderNJ and an activist who focuses on topics including LGBTQ issues, said the change to New Jersey’s criteria is a welcome one. A gender or sexual identity requirement increases stigma toward LGBTQ communities, he said.
“And it also left straight people vulnerable, because they're running around convinced that this is not something that you need to worry about,” Lassiter said.
Lassiter has been critical of the Murphy administration — and of groups like Garden State Equality that advise it — for its response to monkeypox. He said both the state administration and the federal government alike have been too passive in their social media, in press conferences, and in other messaging — leaving at-risk communities vulnerable. He would have liked to see an aggressive public health response going on for months.
He said a slow response cost the administration trust, compromising the effectiveness of outreach now, even with what he sees as more appropriate criteria in place. He said the response was particularly disappointing from an administration that’s otherwise displayed strong allyship for LGBTQ communities.
At any point, Lassiter said, the administration could have told people: "This caught us off-guard, this caught us flat-footed, but we’re working on it." But he said there was "none of that."
Fuscarino, by contrast, commended the state for prioritizing LGBTQ communities during early vaccine availability. He noted Murphy, U.S. Sen. Cory Booker and U.S. Rep. Mikie Sherrill have written letters to federal authorities seeking more vaccines and tests — and said every federal representative should be doing the same.
“The silence has been deafening from those who have not written letters as New Jersey still has not received the full state population percentage vaccine allotment,” Fuscarino said.
Christi Peace, a spokesperson for Murphy, said the administration has taken the possibility of an outbreak seriously since monkeypox emerged in the United States. It continues to work with the state Department of Health to develop and adapt New Jersey's response, she said.
"When we were first advised of this public health crisis, the (state) Department of Health alerted statewide stakeholders including local health departments, health care providers, primary care clinics, clinics throughout the state serving special and vulnerable populations, long-term care facilities, correctional facilities and relevant officials, to share information about the spread of this virus and the presenting symptoms, and the process to follow to secure appropriate testing and treatment," she said.
That work included engaging with hundreds of representatives of constituencies including disproportionately affected groups, like the LGBTQ community, Peace said. New Jersey has also worked with local health providers and departments on testing, treatment and vaccination, worked with community groups on outreach and vaccine distribution, and made updates to the monkeypox page on its website, she said.
Garden State Equality has been running a campaign asking residents to call on their legislators to push federal authorities for more vaccines and test kits. He said his group has been “sounding the alarms since June 2022 to ensure monkeypox stays under control.” New Jersey recorded its first confirmed case of the virus in mid-June.
Murphy has argued New Jersey should receive a disproportionately large share of doses, given that its population density means more opportunities for monkeypox to spread, and it neighbors New York City, which leads the nation in cases.
As of August 17th, New Jersey has confirmed 367 cases of monkeypox. The CDC is reporting approximately 12,600 infections nationwide — with about 2,600 in New York state and most coming from the city.
At the end of last week, New Jersey had reported receiving about 11,000 doses of vaccine. The state expects to receive several thousand more in the coming weeks.
This story has been updated to include comment from Gov. Phil Murphy's office.