Update, 12:20 p.m. October 20: The San Francisco Department of Public Health has announced it will end the city’s state of emergency around monkeypox (MPX) on October 31.
SF health officials said that MPX cases “have slowed to less than one case per day,” and that more than 27,000 city residents have now received the MPX vaccine.
San Francisco originally declared this public health emergency for MPX back in July, and was the first U.S. city to do so.
Several public health organizations, including the California Department of Public Health, have chosen to refer to monkeypox as “MPX” (pronounced “em-pox”) with the aim of reducing homophobic and racial stigma surrounding the virus. For the rest of this story, we use “MPX” for these reasons, except in direct quotes or other cases where it would confuse readers.
The most recent update: San Francisco health officials announced last week that they were expanding eligibility for the MPX vaccine. As of September 6, all gay and bisexual men, and all trans people, in San Francisco can get an MPX vaccine. Additionally, all men who have sex with men or with trans people can get a vaccine.
Another update in San Francisco: The SF Department of Public Health’s vaccine sites are now moving forward with offering second doses of the MPX vaccine to people who are 28 days out from their first dose. Other Bay Area counties will also start offering second doses this week. Previously, second doses were strategically delayed to extend supplies of first doses, amid low vaccine supply from the federal government.
Regardless, we know this process can be a daunting or worrying one, especially if you’re trying to find a vaccine because you’ve been potentially exposed to the virus. We’ll update this guide to finding an MPX vaccine near you whenever we get new information.
Several public health bodies, including the California Department of Public Health and the San Francisco Department of Public Health, have chosen to refer to the virus as “MPX” to address concerns that the original name furthers both racist and homophobic stigma around the disease and those who contract it.
In speech, MPX is usually pronounced “em-pox,” or the initials “em-pee-ecks.”
You may often see “monkeypox” on first usage, and “MPX” thereafter throughout an article or a resource from a public agency. Some official resources may also use “MPOX”. Rest assured these names are referring to the same disease.
The MPX vaccine being offered in the U.S. right now is called Jynneos, and it’s produced in Denmark.
This vaccine is also used to prevent smallpox, because the MPX virus is related to the smallpox virus (although it’s generally less severe and far less contagious than smallpox). You might also assume MPX is related to chickenpox — it isn’t.
Jynneos was originally only available for people age 18 and older, but on August 9, the Food and Drug Administration (FDA) issued an emergency use authorization (EUA) that allows providers to also give the MPX vaccine to young people aged under 18 who are “determined to be at high risk” of MPX infection.
If you haven’t necessarily had a confirmed or suspected exposure to MPX, but you’re still considered high-risk for contracting it
In this case, the vaccine is given in the hope of preventing onset of MPX. Initially, Jynneos was only offered to people with a confirmed or suspected exposure, so this approach is a recent update to the Centers for Disease Control and Prevention (CDC)’s strategy for MPX vaccination. This approach is being called outbreak response MPX vaccine post-exposure prophylaxis, or PEP++.
The MPX vaccine is usually administered in two doses, 28 days apart.
Starting September 6, San Francisco will begin offering appointments for second doses to people who are at least 28 days out from their first dose. Other Bay Area counties may already be offering second doses. Check your county’s information in our list.
Previously, second doses of the MPX vaccine were held back and delayed by some health jurisdictions, due to the low supply of vaccine doses from the federal government. At San Francisco’s walk-in MPX vaccine clinic at Zuckerberg San Francisco General (ZSFG), some patients were originally told by hospital staff that their second shot could safely be delayed as long as two years.
SF Health Officer Dr. Susan Philip has said that there’s “no harm” in getting your second dose of Jynneos beyond that 28-day mark, and that delaying second doses for some people while supply is low “will allow us to use our vaccine most efficiently.”
Dr. Peter Chin-Hong, infectious disease specialist at UCSF Medical Center confirms that “it is indeed safe not to get a second dose of the vaccine at 28 days on time, and that “some data suggests that waiting as long as two years may be OK.”
“Of course we will likely not have to wait that long,” said Chin-Hong, but he encourages you to think of that second MPX vaccine more as a booster. “The first dose is really good (85%-90% protection after four days) and equivalent to two doses of an mRNA vaccine for COVID.”
If you’re immunocompromised, you still might be eligible to receive a second dose even if your county is still prioritizing first doses. The San Francisco Department of Public Health (SFDPH), for example, continued to offer this second dose to people “who have moderate to severe immune compromise as they may not develop immunity after just one dose.” SFDPH says this group includes “people on active cancer treatment, people who are taking medicine to suppress the immune system, and people with advanced or untreated HIV infection, among other conditions.”
Who can get an MPX vaccine?
As of September 6, the San Francisco Department of Public Health has expanded access to the Jynneos vaccine to all gay and bisexual men, and all trans people. Additionally, all men who have sex with men or with trans people can get a vaccine. Previously, folks in these communities had to attest to having had multiple sexual partners in the previous 14 days.
The Jynneos vaccine is also being offered in SF to San Franciscans who:
Are sex workers of any sexual orientation/gender.
Have been identified as a close contact of someone who has MPX (suspected or confirmed).
Have received a notification from a venue or event of a potential exposure to someone who has MPX (suspected or confirmed).
The vaccine is also being offered to SF lab workers who routinely handle MPX virus samples or any clinician who has a high risk of occupational exposure.
Eligibility for the MPX vaccine may differ from county to county. Check your county’s current MPX vaccine guidelines, but bear in mind that some counties have more robust information and resources available around MPX than others:
If a person gets the vaccine between four and 14 days of being exposed, the vaccine may reduce the symptoms of MPX , but may not prevent the disease altogether. Timeliness is thus another reason it’s important to stay vigilant for possible exposure to MPX and watch for symptoms — and to act quickly.
If you’ve been to an event or a party recently where you had close contact with other attendees, it’s important to look out for any messages from organizers or other people present about potential MPX exposure.
Getting a first shot of the MPX vaccine after you’ve been exposed to the virus can both help prevent the disease from developing and reduce symptoms if it does develop — but how effective the vaccine is can depend on how quickly you get it after exposure.
If I’m eligible, where can I find an MPX vaccine?
Supplies of the MPX vaccine in the Bay Area are distributed directly from the California Dept. of Public Health, who get their supply from the federal government.
If you’re experiencing the symptoms of MPX, or you’ve been informed you could have been exposed to MPX, you should contact a health care provider right away. A health care provider can (hopefully) help you navigate this process, talk about any additional risk factors you might have and also tell you whether you’re eligible for some of the MPX treatments currently available.
If you have health insurance, reach out to your provider as soon as you can.
You can now make an appointment for an MPX vaccine, whether it’s your first or your second dose, through the state of California’s My Turn site. (You may be more familiar with My Turn as the place to make appointments for COVID-19 vaccines — and now the California Department of Public Heath has added the MPX vaccine to the list of vaccines you can use the site to obtain, which also includes the flu vaccine.)
In the Bay Area, Kaiser Permanente has received MPX vaccines and is currently offering them to both Kaiser members and nonmembers. You can make an appointment by calling the health provider’s direct monkeypox vaccination line at (415) 833-9999. A staff member will take your call and ask whether you are experiencing symptoms or were recently in contact with someone with a confirmed case.
UCSF is also offering vaccines to those who are currently eligible — and you do not need to be a UCSF patient or have insurance to schedule an appointment. You can visit the UCSF MPX vaccines webpage for instructions on how to make an appointment using UCSF’s MyChart portal. Vaccines are administered at the 3333 California Street site in San Francisco.
If you don’t have health insurance, contact your county’s public health department to ask for their guidance:
San Francisco: The city’s public health department says residents can make an appointment for an MPX vaccine, as supplies allow, at sf.gov/mpx. Uninsured residents can also go to the walk-in vaccination clinic at ZSFG, more information on that below.
Santa Clara County: Santa Clara has set up an electronic vaccination form for residents to request an appointment at county vaccine clinics. Access the form here. You can also contact the county’s MPX call center at (408) 970-2200, from Monday to Friday, 8 a.m. to 5 p.m. Uninsured residents can request treatment with the county’s community clinics.
The San Francisco Department of Public Health recommends that if you live in the city and you don’t have a provider, or have difficulty scheduling an appointment, you can be seen at SF City Clinic at 7th Street (628-217-6600) or at Strut at 470 Castro Street (415-581-1600).
Currently, there is only one walk-in vaccination site that doesn’t require an appointment in San Francisco, located at ZSFG Learning Center at 1001 Potrero Avenue. Its usual hours of operation during the week are 8 a.m. to 4 p.m. If you’re visiting the ZSFG site on a day it’s open, look for Building 30; the clinic will be on the second floor.
Please note that this walk-in clinic has frequently been closed at short notice due to lack of supply, so it’s important to check that the site is still open before you visit. You can usually find the latest updates about the ZSFG clinic’s status on the San Francisco Department of Public Health’s Twitter feed.
The San Francisco AIDS Foundation has a waitlist to receive the vaccine with Magnet, the organization’s sexual health clinic. You can call (415) 581-1600 or access the waitlist here.
If I got a smallpox vaccine years ago, am I protected from MPX?
Routine vaccination against smallpox in the U.S. ended in 1972. But if you received a smallpox vaccine before that time, you may be wondering whether it now affords you any protection against MPX, given that the MPX virus is related to the smallpox virus (although it’s generally less severe and far less contagious than smallpox).
Dr. Susan Philip, San Francisco’s health officer, says that being vaccinated against smallpox “would have some cross-protection” against MPX, and that “it does seem that people who have been vaccinated against smallpox in the past have partial protection, so they may not have as severe a case” of MPX.
Philip stresses that since a historic smallpox vaccine “may not be full protection” against MPX, the San Francisco Department of Public Health and the CDC recommend that even if you got a smallpox vaccine as a kid, you should definitely seek out an MPX vaccine if you’re exposed to MPX, to get “the fullest protection possible.”
TPOXX (also known as Tecovirimat or ST-246) is being used to treat those experiencing severe MPX. The FDA approved Tecovirimat to treat smallpox in 2018. (Yuki Iwamura/AFP via Getty Images)
What other forms of treatment are available?
The MPX vaccine can act as a sort of treatment, but only when someone receives it shortly after exposure, says Dr. Peter Chin-Hong, an infectious disease specialist at UCSF.
“If you got a vaccine shortly after exposure — some people think within four days — it can impact and stop you from getting disease, even though you might have been exposed to an infection,” he said. “If you get the vaccine within 14 days of exposure, even though you might get the rash or disease, it will reduce your symptoms.”
But the MPX vaccine is not the only treatment currently available. Some physicians are administering the drug TPOXX (also known as Tecovirimat or ST-246) to patients experiencing severe monkeypox symptoms. Tecovirimat is usually a two-week treatment and can be administered either through a capsule or an intravenous injection. The drug works by making it harder for the virus to infect new cells, therefore limiting the infection growth.
“Most people will get better on their own, but some people will require treatment,” said Dr. Chin-Hong of UCSF. Those considered for treatment include immunocompromised people, pregnant people and children younger than 8 years old.
People who don’t have those particular risk factors but still develop severe MPX also can receive treatment, Chin-Hong says. This includes those who develop extensive oral disease, as that makes it very difficult to eat and drink. “It’s like having a bunch of ulcers in your mouth,” he said. Those who develop the disease extensively in the rectal area or near the eyes also can receive treatment.
TPOXX works by making it harder for the virus to infect new cells, therefore limiting the infection growth. Physicians point out that immunocompromised people, pregnant people and children under 8 who test positive for MPX would be considered for treatment. (Yuki Iwamura/AFP via Getty Images)
TPOXX has only been approved by the Food and Drug Administration to treat smallpox infections. The CDC, however, does allow for physicians to prescribe TPOXX for MPX treatment through a process called “expanded access investigational new drug protocol.” A physician will need to submit an application to the FDA and the patient must be willing to sign an informed consent form.
San Francisco’s Dr. Philip says city health officials are partnering with health providers to “expand access for people throughout the city, whether they’re affiliated with the health system or not” but adds that it is up to the CDC to streamline the process for physicians to request TPOXX.
There are many options available that can alleviate, or at least reduce, the pain you may be feeling if you have MPX. Physicians can prescribe treatment that can respond to the pain associated with lesions, which may show up on a patient’s face, arms, mouth, or genital or rectal area, says UCSF’s Dr. Chin-Hong.
“Treatment is not only about vaccines and drugs. Treatment is also about what specific symptoms the patient’s having,” he said. “So make sure that you ask your health care professional to help you because there may be things that can help make you feel less pain.”
You can use the box below to submit your question. What you send us will make our reporting on MPX stronger, and help us decide what to cover here on our site and on KQED Public Radio.
Please know that we can’t reach back out directly to everyone who asks a question, and we can’t give out individual medical advice. If you’re concerned about MPX or another health matter, we urge you to reach out to your health care provider, or a local community clinic if you don’t have insurance. (See our list of community clinics in your county.)
Sponsored
lower waypoint
Stay in touch. Sign up for our daily newsletter.
To learn more about how we use your information, please read our privacy policy.
