2022-07-29 09:51:58 By : Ms. Mandy Green

Looking for facts about monkeypox, information on monkeypox symptoms or monkeypox case numbers? Read our full guide to monkeypox in the Bay Area.

Due to a lack of adequate supply from the federal government, finding a monkeypox vaccine in the Bay Area is not easy right now. But there are still providers across the region offering the vaccine to eligible residents, including those without health insurance.

Anyone can get monkeypox. Right now, the monkeypox outbreak in the United States is particularly affecting communities of gay and bisexual men, and men who have sex with men. The World Health Organization notes that trans people and gender-diverse people "may also be more vulnerable in the context of the current outbreak." You'll see this reflected in who's currently eligible to get the monkeypox vaccine in the Bay Area.

We know this process can be full of frustration and even some fear, 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 a monkeypox vaccine near you whenever we get new information.

Please be aware that because supply and availability change fast, the locations or organizations we've listed below as offering monkeypox vaccines may not have vaccines at a given time.

The monkeypox 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 monkeypox virus is related to the smallpox virus (although it’s generally less severe and far less contagious than smallpox). You might also assume monkeypox is related to chickenpox — it isn't.

Right now, Jynneos is only available for people age 18 and older.

The vaccine is administered in two doses, 28 days apart. San Francisco Health Officer Dr. Susan Philip has confirmed 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."

If you're eligible for the monkeypox vaccine, there are two scenarios in which you can get the vaccine:

If you have a confirmed or suspected exposure to monkeypox

In this case, the vaccine is given in the hope of preventing onset of the disease, or at least reducing the symptoms. This approach is called post-exposure prophylaxis, or PEP. Read more about when the monkeypox vaccine is most effective as PEP.

If you haven't necessarily had a confirmed or suspected exposure to monkeypox, but you're still considered high-risk for contracting it

In this case, the vaccine is given in the hope of preventing onset of monkeypox. Initially, Jynneos was only offered to people with a confirmed or suspected exposure, so this approach is a recent update to the CDC's strategy for monkeypox vaccination. This approach is being called outbreak response monkeypox vaccine post-exposure prophylaxis, or PEP++.

Lab workers who frequently handle monkeypox samples are also being offered the monkeypox vaccine. In this case, the approach is called pre-exposure prophylaxis, or PrEP.

Keep reading for who is currently eligible to get the monkeypox vaccine.

Originally, the San Francisco Public Health Department was following the CDC in only offering the monkeypox vaccine to people with a confirmed or suspected exposure. But on July 19, the agency announced they've expanded eligibility criteria to offer the Jynneos vaccine to San Franciscans who:

The vaccine is also being offered to SF lab workers who routinely handle monkeypox virus samples or any clinician who has a high risk of occupational exposure.

Eligibility for the monkeypox vaccine currently differs from county to county. For example, on July 19 Santa Clara also expanded its guidelines beyond people with a suspected or confirmed exposure to monkeypox. By contrast, as of July 25 Alameda County was still limiting vaccine availability to people who have a confirmed or suspected exposure.

Check your county's current monkeypox vaccine guidelines, but bear in mind that some counties have more robust information and resources available around monkeypox than others:

No, you do not need to test positive for monkeypox to get a monkeypox vaccine.

Testing for monkeypox is limited right now, and you may need to meet certain criteria to get a monkeypox test — San Francisco, for example, says that SF residents must have a rash or spots present to get a monkeypox test.

The CDC recommends that the monkeypox vaccine be given to a person within four days of the date they were exposed to monkeypox, for the best chance of preventing onset of the disease.

If a person gets the vaccine between four and 14 days of being exposed, the vaccine may reduce the symptoms of monkeypox, but may not prevent the disease altogether. Timeliness is thus another reason it’s important to stay vigilant for possible exposure to monkeypox 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 monkeypox exposure.

Getting a first shot of the monkeypox 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.

Supplies of the monkeypox vaccine in the Bay Area are distributed directly from the California Dept. of Public Health, who get their supply from the federal government. And right now, availability is still limited and demand is high.

If you’re experiencing the symptoms of monkeypox, or you’ve been informed you could have been exposed to monkeypox, 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 monkeypox treatments currently available.

If you have health insurance, reach out to your provider as soon as you can.

Kaiser Permanente has received monkeypox vaccines and is currently offering them only to Kaiser members. 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 monkeypox 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:

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 Zuckerberg San Francisco General (ZSFG) Learning Center at 1001 Potrero Avenue. 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.)

If you're visiting the ZFSG site on a day it's open, look for Building 30; the clinic will be on the second floor. As of July 20, it will be open 8 a.m. to noon and offer appointments to patients identified as high-risk. A limited number of drop-in slots will also be available while supplies last.

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.

Steamworks Bathhouse in Berkeley has also been hosting a pop-up monkeypox vaccination clinic, as vaccine supply from the City of Berkeley allows. Their next walk-in clinic is 12 p.m. on August 3. Check Steamworks' Instagram account for updates.

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 monkeypox, given that the monkeypox 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 monkeypox," 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 monkeypox."

But if you got your smallpox vaccine pre-1972, would you still have some immunity against monkeypox? Right now, that still seems uncertain. Andrea McCollum, the poxvirus epidemiology team lead in the CDC’s division of high-consequence pathogens and pathology, says "this is something we really haven’t teased out in individuals who had [smallpox] vaccination 50 years prior, 60 years prior."

Philip stresses that since a historic smallpox vaccine "may not be full protection" against monkeypox, 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 a monkeypox vaccine if you're exposed to monkeypox, to get "the fullest protection possible."

The monkeypox 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 says. "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 monkeypox 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,” says 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 monkeypox 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 says. Those who develop the disease extensively in the rectal area or near the eyes also can receive treatment.

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 monkeypox 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.

Something else patients should consider is talking to their physician about any pain they may be feeling, and where. Some monkeypox patients have described the pain from the rashes as "inescapable."

There are many options available that can alleviate, or at least reduce, the pain you may be feeling if you have monkeypox. 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 says. "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."