We Need More Monkeypox Vaccines

Scott Wiener
5 min readJul 14, 2022

After more than two years of a global pandemic — with so much death and illness — one would hope our nation would be more attuned to, and have a greater sense of urgency around, yet another emerging health threat.

Sadly, as monkeypox is spreading throughout the country, San Francisco has the most cases in California (more than Los Angeles County, which has ten times our population). This is yet another public health failure currently harming gay and bisexual men, as well as transgender people. But if this failure continues, it will spread beyond the LGBTQ community. Indeed, if this outbreak is not quickly contained, monkeypox may become endemic in our country. This is a huge and preventable public health problem.

I’m committed to fight for our community’s health, as are so many. I’m in regular communication with state and local health officials and experts and am advocating for a stronger, more focused response, for expanded vaccine eligibility (San Francisco’s eligibility criteria are currently way too narrow), and for a greater allotment of vaccines for our community. Working together, we will protect ourselves and make it through this.

The good news is that, unlike COVID, monkeypox is a known virus with known treatments and vaccines. We’re not starting from scratch as we were two years ago with COVID. Monkeypox was discovered in the 1950s in animals and identified in humans in West Africa in the early 1970s. With the world moving away from universal smallpox vaccines (smallpox and monkeypox are related viruses and the smallpox vaccine is effective against monkeypox), monkeypox gained fertile ground to spread.

In 2010, health experts began warning that it was just a matter of time before monkeypox spread beyond West Africa, and in 2019 a safe and highly effective monkeypox-specific vaccine was approved by the FDA. Sadly, however, federal health authorities badly dropped the ball by ordering very few doses — 56,000 doses, translating to a two-dose regimen for 28,000 people — for our national vaccine stockpile. It’s hard to overstate what a disaster it was for the federal government to order so few doses for its stockpile. Had the federal government ordered the millions of doses needed, we would currently be able to quickly vaccinate everyone at risk and contain this outbreak.

This spring, as monkeypox, as predicted, spread beyond West Africa — to Europe, North America, and elsewhere — our nation was caught flat-footed. With a tiny supply of the monkeypox vaccine, a large majority of the people at risk are struggling to get vaccinated. We’re seeing huge, chaotic lines at vaccination sites, with no assurance there’s enough vaccine supply, and vaccine clinics are being canceled due to lack of supply. Yesterday, the San Francisco Department of Public Health announced it was suspending its San Francisco General Hospital vaccine clinic due to lack of vaccine supply. The San Francisco AIDS Foundation, through its Strut clinic in the Castro, has an allotment that it will use for its massive waiting list — 500 doses for more than a 2,000-person waitlist.

To add insult to injury, the FDA — the same agency that bans gay and bi men from donating blood (contrary to science) and the same agency that screwed up COVID testing in 2020 — temporarily stranded one million U.S.-owned vaccine doses. Those doses, instead of being administered in people’s arms immediately, were in storage in Denmark because the FDA did not promptly inspect a new production facility, showing a profound lack of urgency.

It’s not too late to fix this mess, and I’m committed to working with community and government partners to do so. More vaccine doses are coming our way, and as noted above, I’m in regular communication with state and local health authorities to increase San Francisco’s allotment, given how significantly our city is being hit. I’m also advocating to expand eligibility criteria to cover all at-risk people, not just people who happened to receive notifications that they were at a party where someone was positive.

We also need to beef up access to testing and treatment. People have struggled mightily to get tested, and not all health providers are aware of monkeypox symptoms, resulting in misdiagnosis and delayed isolation and care. Sewage monitoring also needs to be ramped up, as it helps us know the prevalence of the virus in a given community.

Since monkeypox infection or exposure can lead to extended quarantine/isolation — as long as 21 days and possibly longer — we will need to ensure workers don’t have to choose between staying home and paying rent. Paid sick leave is incredibly important for a virus whose isolation is longer than for COVID.

State and local health officials will need to evaluate whether, in addition to the newer monkeypox vaccine in short supply, we also mobilize the older smallpox vaccine, which is believed to protect against monkeypox. The federal government has a massive stockpile of this vaccine — amassed in the event of a biological warfare attack — and states and counties are allowed to access it. This older vaccine has more side effects and is complicated to administer. Moreover, it is not recommended for people with compromised immune systems, since it contains a live virus. But it is an option to help contain this outbreak, and I’m confident health officials will evaluate whether it makes sense to activate this option.

We’re also advocating at the federal level. I want to thank our representative in Congress, Speaker Nancy Pelosi, for once again pushing hard for our community’s health. Speaker Pelosi was there for us during the worst parts of the HIV crisis, and she’s there for us again today.

Here are monkeypox resources from the City of San Francisco.

Information about how to look out for symptoms and where to go for treatment here.

Information about vaccine clinics here.

Information about getting on the Strut vaccine waitlist here.

As always, do not hesitate to reach out to my office for more information, at (415) 557–1300 or senator.wiener@senate.ca.gov.

It’s a deep honor to represent this amazing community. You have my commitment to always fight for our community’s health.



Scott Wiener

CA State Senator. Urbanist. Environmentalist. Advocate for transit, housing, clean energy, criminal justice reform, health, ending poverty. Democrat. 🏳️‍🌈