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MPX Vaccine Pre-Registration Form

This page is to preregister for Monkeypox (MPX) vaccine. Vaccine supply is currently extremely limited. If you do not meet current eligibility requirements but would like to be vaccinated, please complete the following form.

Vaccine eligibility is currently limited to Cecil County residents 18 years of age or older who also meet the following criteria:

  • Known contacts who are identified by public health via case investigation, contact tracing, referrals, and risk exposure assessments; OR
  • Healthcare and laboratory workers who have been inadvertently exposed

As more supply becomes available, we will expand the eligibility criteria based on the latest public health guidance.

Anyone may pre-register for a vaccine, however, you may not receive an appointment unless you meet the eligibility criteria. Pre-registration does not guarantee an invitation to book an appointment. Invitations may be sent out based on individual risk level and equity of access and will not be based on the date of registration. Once you have been selected for an appointment, you will be contacted.

Your protected personally identifying information about your request for vaccine will be considered confidential.

Visit the Cecil County Health Department's website for more information about monkeypox.

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Please read carefully before starting:
Please doublecheck ALL information after you enter it. Mistyped email addresses, phone numbers, or birthdates may result in a form that cannot be processed.

Submission of this form will NOT generate an email confirmation.  After you complete the acknowledgment section and press submit, please watch for the "YOUR RESPONSE HAS BEEN RECORDED" message on the screen as your confirmation that we received your form.
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