San Francisco deferring 2nd dose of monkeypox vaccine until supply increases

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Monkeypox vaccine.

SAN FRANCISCO - San Francisco Department of Public Health on Friday announced they will defer the second dose of the Jynneos monkeypox vaccine in order to inoculate as many people from broader at-risk populations as demand outweighs supply.

The number of monkeypox cases in the city makes up more than half of California's 266 cases at last count. San Francisco currently has 141 confirmed cases, health officials said.

In a news release, the health department said they lack supply for people who need the vaccine most and those second shots will be deferred until supply increases. The Jynneos doses are to be taken about one month apart.

San Francisco health officials this week procured about 4,000 additional doses of the vaccine, which allowed Zuckerberg San Francisco General Hospital to restart their vaccine clinic midweek. The clinic had to shut down the previous week due to a lack of supply.

Long lines for monkeypox vaccine in San Francisco

Long lines for monkeypox vaccine in San Francisco.

On Friday's daily update on social media, the hospital said 600 people got their first shot and that everybody who came on a walk-in basis received a vaccine. A day earlier, hospital officials said they served 500 people in line.

The monkeypox vaccine clinic at SF General is available Monday through Friday from 8 a.m. to noon. We have reported on long lines down the block and some confusion and criticism over the response to the outbreak.

Many in the LGBTQ+ community are frustrated with the lack of resources and the mismanaged and disorganized response. Supervisor Rafael Mandelman has been one of those vocal critics. He participated in a board of supervisors hearing on the response as well as a rally at San Francisco's Federal building this week. State Senator Scott Wiener has been another, seeking an expansion to access the vaccine, testing, treatment and education and outreach.

Others are saying the delayed response, or lack thereof, reminds them of the HIV/AIDS crisis from the previous generation and how they had to be self reliant. Organizations like Alice B Toklas LGBTQ Democratic Club are posting on social media about appointment openings for UCSF's monkeypox vaccine clinic, held where prior infrastructure from COVID remains in place.

The health department said their strategy to hold off on second doses until they have supplies is endorsed by the state health department and consistent with the approach in New York, the United Kingdom and Canada.

The virus is generally spread through skin-to-skin contact or bodily fluids via kissing, breathing at close range, sexual activity and sharing bedding or clothing. Local, state and federal health officials have stressed that the virus is not airborne like COVID-19 or the flu.

The outbreak has, for the most part, seen a higher concentration of cases impacting gay, bisexual, and men who have sex with men. The virus is not exclusive to these groups, anyone can contract monkeypox via close contact with an infected person.

On Friday, Centers for Disease Control and Prevention said two children were diagnosed with the virus, including a toddler in California. The children are described as being in good health and receiving treatment. Officials think they might have gotten the virus through household transmission.

The health department said since no vaccine is 100% effective, it is important to take precautions and reduce risk of potential exposures both before and after receiving the vaccine. The Jynneos vaccine is FDA approved for prevention of smallpox and monkeypox in adults. Preventative measures include; avoiding close physical contact if sick, especially if you have a new, unexpected rash or sore. Health officials said for those who do choose to have sex while sick, that they should avoid kissing and other face-to-face contact. Sores should be covered with clothing or sealed bandages. Many are describing flu-like symptoms at the onset of their illness, followed by lesions.

A San Francisco man who quarantined due to monkeypox described his experience and said doctors told him he may have to isolate for a month or more because people can be contagious as long as they have the lesions. He said he was told you have to wait two to four weeks for the sores to crust and fall off in order to emerge.

Amid pressure to respond to the outbreak more urgently, city health officials have requested 35,000 doses to begin to meet the need. Gov. Gavin Newsom said he expected 60,000 doses in the state by next week. Meanwhile, the federal government has requested 7 million doses of the vaccine, but isn't expected to receive that amount until 2023.

Those eligible to get the vaccine at the clinic are:

Gay, bisexual, and other men or trans people who have sex with men, who have had more than 1 sexual partner in the past 14 days
Sex workers of any sexual orientation or gender identity
Persons who have had close contact within the past 14 days with someone with suspected or confirmed monkeypox
Persons who had close contact with others at a venue or event or within a social group in the past 14 days where a suspected or confirmed monkeypox case was identified. This includes persons who received notice from a venue or event of a potential exposure within the past 14 days
Laboratory workers who routinely perform monkeypox virus testing
Clinicians who have had a high-risk occupational exposure (e.g., examined monkeypox lesions or collected monkeypox specimens without using recommended personal protective equipment)