building 30 at Zuckerberg General Hospital for monkeypox story
Building 30 at Zuckerberg San Francisco General Hospital, the same building where monkeypox vaccines are being distributed. Photo by Carolyn Stein.

Community advocates blamed a lack of vaccine supplies, poor language-based services and unclear communication from the San Francisco Department of Public Health as the primary reasons why the city’s Latinx community has been hardest hit by the monkeypox virus. 

Latinx individuals represent 15 percent of the city’s population but, as of July 18, comprised 30 percent of monkeypox cases, Department of Public Health officials said at a Thursday hearing at City Hall on monkeypox in San Francisco. 

“It feels like there’s less urgency and less communication, compared to Covid-19,” Santiago Garzon, who works for the Instituto Familiar de la Raza, told Mission Local. Garzon, a youth advocate at the nonprofit dedicated to promoting and enhancing the health and well-being of San Francisco’s Latinx community, has personally witnessed the impact of the city’s poor communication and vaccine shortages. 

“We have a lot of people coming and asking us where we can get the vaccine,” Garzon said, noting that some of the people coming in are also sex workers or immunocompromised. “Not having enough information is one of the largest challenges we face.”

Misinformation and a lack of educational materials in Spanish and other languages, combined with pre-existing stigma, has had a “snowball effect” on those who are Latinx and identify as LGBTQ+, Garzon said. 

The Latinx community has also suffered disproportionately during the Covid pandemic, representing more than 50 percent of all cases at different times.

Garzon wasn’t the only one dismayed by the messaging and language barriers in the health department’s communications. 

Valerie Tulier-Laiwa, who is on the executive committee of the  Latino Task Force, told Mission Local that she has not seen nearly as much outreach in Spanish as she has seen in English. 

She also suggested that a city official should go on a local Spanish-language radio station to spread information about the virus, something she has yet to see the city do. 

Connie Chan, District 1 Supervisor, expressed similar disappointment in the lack of language-based services at the hearing. “I think folks who have cultural or language challenges always end up getting left behind, especially in this case, with public health information.” Chan said. 

Throughout the hearing, District 8 Supervisor Rafael Mandelman also discussed how many people in the LGBTQ+ community are relying on “gay twitter” to get their information on the monkeypox virus, further underscoring a failure to adequately communicate with the public. 

“If that’s the only place people are getting information, then that’s very dangerous,” Chan said, echoing Mandelman’s sentiments. 

Monkeypox is a disease from the monkeypox virus that spreads through close contact. The virus is part of the same family as smallpox. Monkeypox was discovered in humans in 1970, but this is the largest outbreak of the virus to date, with more than 13,000 reported cases worldwide. Symptoms of monkeypox include large rashes or lesions on the skin, as well as flu-like symptoms such as fever, headache, swollen lymph nodes or muscle aches. Vaccines have been difficult to access in the U.S., but are effective in preventing infections. 

Garzon says that the monkeypox crisis is a personal problem, too.

“A couple weeks back I was told I might’ve been exposed to the monkeypox virus. After calling a primary care doctor I was told that there was a shortage of vaccines,” Garzon said during public comment at the hearing. “Almost a week later, I was able to receive my first vaccine. And yet, it took two weeks for me to receive a monkeypox PCR lab result. And still, I don’t have a second appointment for my second dose.” 

As monkeypox cases rise in San Francisco, with 55 new confirmed cases as of Wednesday, vaccine supplies continue to be limited. Earlier this week, San Francisco received a shipment of more than 4,000 vaccine doses from the federal government, far short of the 35,000 the city requested. The city has provided the vaccine to various partners in the city, and currently has only one drop-in clinic at Zuckerberg San Francisco General Hospital.

“Each day, people are having to get up earlier and earlier to get the vaccine,” Mandelman said at the hearing. The drop-in clinic is currently only open from 8 a.m. to noon on Mondays and Fridays, but people are lining up as early as 5 a.m., with no guarantee that they will receive the vaccine.

Making appointments to get the vaccine has also been difficult: “I explored the website, I went through the clinics at SFGov, I made calls and they all redirect you back to voicemail,” public commenter Joe Wise said.

At the hearing, Department of Public Health representatives said the city is focused on providing first doses. Currently, the city is supplying the Jynneos vaccine, a two-dose series vaccine. According to the U.S Centers for Disease Control and Prevention, two doses of Jynneos are required, because people are considered to reach maximum immunity 14 days after their second dose. 

It should also be noted, however, that the CDC does not know if the Jynneos vaccine will fully protect recipients against monkeypox. It is unclear when second doses will be scheduled in San Francisco. 

Latino Task Force

When the city stumbled in response to Covid, The Latino Task Force and doctors and researchers at the University of California, San Francisco, stepped up to test and later vaccinate the city’s Latinx community at low-barrier neighborhood sites that developed into hubs.  Tulier-Laiwa said the sites could be used to distribute the monkeypox vaccine. 

“The hubs would be a great place for Latinos to get monkeypox vaccines,” Tulier-Laiwa told Mission Local. “We are culturally and linguistically competent. We are also discreet, which means that some community members who may not be ready to come out as gay or bisexual will have a safe place to go.” 

So, why hasn’t the city used the Latino Task Force’s hubs as a way to reach the Latinx community? Lack of vaccine supplies, according to Tulier-Laiwa. 

“It’s clear, right now, that we need more supply,” UCSF’s Carina Marquez said in a phone interview with Mission Local. “For those of us that remember the beginning of the Covid-19 pandemic, it’s clear that equity should be at the forefront.”

This article was updated to clarify that 1970 refers to the year monkeypox was discovered in humans.

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Intern reporter. Carolyn grew up in Los Angeles. She previously served as a desk editor for her college newspaper The Stanford Daily. When she's not reporting, you can find her going on an unnecessarily long walk.

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  1. Wait, wasn’t it Supervisor Rafael Mandleman that fought tooth and nail to reopen the bath houses during the early days of Covid19? Anyone with knowledge of San Francisco history knows why they had to be closed. Now with monkey pox spreading in San Francisco he is outraged. Some of the exposures are a direct result of unbridled partying in June. We can’t blame the federal government for everything. Supervisor Mandelman needs to get on the sidewalk and hand out information pamphlets on how to slow the spread of monkey pox. Stop complaining and do something!

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  2. History repeats itself. It took, if I remember correctly, fully 7 months into the pandemic before the City opened a testing site in the Mission, which was the epicenter and which had by far the most cases.
    San Francisco, is so corrupt now, so uncaring about anyone who’s not rich, white, and living in the “right” neighborhoods.
    We have one of the worst departments of public health of any large city in the U. S., thanks to London Breed and her henchman, Grant Colfax.

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  3. Covid redux. How long will it take for Breed to wake up and make the community hubs an integral part of the City’s public health infrastructure?

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  4. Here are the current options / real advice as of Friday:
    1. If you have Keiser, call them and make an appointment
    2. Go to the UCSF MyChart site, create an account if you don’t have one, login, and make an appointment online
    3. If you can’t do either of the above, go to the drop-in site at SF General

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  5. If language were the sole cause of the ethnic disparity then you would expect Chinese and other Asians would be similarly affected. At least Spanish shares the same alphabet as English whereas Mandarin, Cantonese etc. do not.

    Given that this disease spreads via close personal contact then another factor might be populations that often live in close quarters with each other and/or have large families in small homes. That was part of why Covid affected poorer communities more than affluent ones.

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