VaMX on itch.io includes VIP Extras that are not outdated. There are VIP Extra environments available through Patreon that are not part of VaMX on itch.io, but that is because they have become outdated and slightly broken when used with new versions of vamX. Once those environments are updated/fixed to work with the latest VaMX, they will be added for free for VaMX users. So, at least currently, all working VIP Extras are included in VaMX on itch.io. This isn't always guaranteed, though, there may be VIP additions on Patreon that don't get into VaMX. If you see something you absolutely must have, then you could always subscribe for one month on Patreon, but currently that isn't necessary unless you really love the VIP environments, even though they need some updating to work as they were originally intended to (with dynamic interactivity, for example things change when you move around the Space Station scene, etc., and to have the full set of vamX options).