A nurse opens a monkeypox vaccine kit at SF General Hospital.
A nurse opens a monkeypox vaccine kit at SF General Hospital. Photo by Carolyn Stein.

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Monkeypox cases have been steadily rising in California since late May. As of last Friday, the San Francisco Department of Public Health has recorded 514 cases.

Here’s the lowdown on everything you need to know about monkeypox in the city: Who is eligible for vaccines, where you can get tested, and what options are available for treatment.

Who is being affected?

So far, the vast majority of monkeypox cases in the U.S. have involved men who have sex with men. According to the Department of Public Health, 97.5 percent of San Francisco cases have been in men, and 77.4 percent of people affected are gay or bisexual.

People aged 25 to 44 have been hit disproportionately hard, making up approximately seven in every 10 cases in the city.

Latinx people have been more likely to test positive for the disease, while transmission has been disproportionately low in the Asian community. The Department of Public Health is using a survey to collect responses from the public to help ensure that access to tests and vaccines is equitable.

Jake Scott, an infectious diseases specialist from Stanford University, said that it is important to acknowledge that gay and bisexual men are at a greater risk of disease, and that sexual contact is the major means by which it spreads. But that needs to be balanced with an understanding that the disease is not solely sexually transmitted, and can affect any demographic.

“Obviously, we have to be cautious not to exacerbate stigmas and shame,” he said. “We need to make sure people are comfortable seeing their doctor with monkeypox. We need to make sure people don’t feel judged.”

How many cases are there in California?

Check back every day for an update on California’s monkeypox cases:

Where can I get tested and vaccinated?

In order to test, you must have active symptoms (a bump or a rash). If you have a healthcare provider, they should be able to help schedule your test. If not, there are free facilities available for testing.

Eligible San Franciscans can get tested and vaccinated at the sites below. It is recommended that you call ahead to check your eligibility.

Who is eligible for a vaccine?

There are currently six groups in the city who are eligible for the monkeypox vaccine:

Men or trans people who have sex with men, if they had more than one sexual partner in the past 14 days

People who have been in close contact with a suspected or confirmed case in the past 14 days

People who received notice of potential exposure from a venue or event in the past 14 days

Sex workers (of any gender or sexual orientation)

Clinicians who have had a "high-risk occupational exposure," like checking lesions.

Laboratory workers who routinely perform monkeypox testing

Starting Tuesday, Sept. 6, the two-dose Jynneos vaccine will become available to men who are gay or bisexual, trans people, as well as all men or trans people who have sex with men or trans people.

What are my options for vaccines?

There are two vaccines being administered for monkeypox: the two-dose vaccine Jynneos, and the single dose vaccine Acam2000. 

Due to limited supply, only first doses of the Jynneos vaccine are currently available. On Sept. 6, vaccine sites will begin providing second doses to people who are beyond 28 days from receiving their first dose.

One dose of the Jynneos vaccine still provides significant protection against the virus. Unlike with Covid-19 vaccination, a person can go six months to a year without having to restart the vaccine process. 

People who are immunocompromised may be eligible for an additional vaccine dose to strengthen immunity. Immunocompromised people should consult with their healthcare provider about getting an additional dose.

Contact your healthcare provider or visit sf.gov/mpx to find locations and schedule an appointment.

Can I get treated for monkeypox?

There is only one treatment available for monkeypox at the moment: tecovirimat, or TPOXX for short.

Unlike the monkeypox vaccines, TPOXX does not have emergency-use authorization, meaning that clinicians need to fill out lots of paperwork in order to prescribe it. Only those with severe pain or symptoms can receive access to TPOXX.

Do I need to isolate?

The California Department of Public Health is now recommending that people with confirmed or suspected monkeypox should isolate at home.

People living with others should take care to cover any lesions, to use separate facilities where possible, and to clean and disinfect frequently used items. If an uninfected person in the household is "at high risk of severe disease," it is recommended that they do not stay in the same household as the infected person.

The department's guidance states that limited activities can resume outside the home if symptoms have been gone for at least 48 hours, if no new lesions have appeared in 48 hours, and if any lesions that cannot be covered up are fully healed. A return to work is possible if the work does not involved physical contact, it is not a "high-risk setting," and remote work is not possible.

Normal activities can start up again once all skin lesions have entirely healed and any other symptoms have been resolved for at least 48 hours.

For detailed guidance, see the California Department of Public Health website.

If you have more questions about monkeypox that you'd like answered, please let us know in the comments.

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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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DATA REPORTER. Will was born in the UK and studied English at Oxford University. After a few years in publishing, he absconded to the USA where he studied data journalism in New York. Will has strong views on healthcare, the environment, and the Oxford comma.

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  1. Thanks for this.

    What recommendations is the City giving for people with monkeypox who must use shared laundry facilities? Is any guidance being given around that?

    Incidentally, Nigeria’s Centre for Disease Control has excellent, detailed, informative guidelines on monkeypox that are so much more comprehensive than what’s available on the CDC’s Web site. You can access that document here: https://ncdc.gov.ng/themes/common/docs/protocols/96_1577798337.pdf

    1. Thanks for the question Miriam. Here is the California Department of Public Health’s current laundry-related advice:

      “Persons with MPX should handle their own laundry, if possible, and shaking of linens should be avoided. If laundry is done by someone other than the person with MPX, that person should not shake laundry, and, at a minimum, should cover arms, and use disposable gloves and a respirator.”

      Hope that is of some help!

      1. Thanks. I do wish they included more recommendations on the use of shared facilities, specifically. Can MPX be transmitted via shared machines, for instance? So many people don’t have their own washer/dryer. It would be good to have guidance provided on that.

  2. really wish they’d use a name that’s not “monkeypox” it makes people think it is no big deal when it IS a big deal