A few days after Adam Fuller attended a large party over Pride weekend, he got a worrying text in a group thread. It was a screenshot from party organizers, alerting attendees that someone at the event had tested positive for monkeypox.
Fuller got to work. “There were so many people there it’s almost impossible to know if I had contact with this person or not,” he said. He researched the disease, learning that it’s in the smallpox family, is transmitted through skin-to-skin contact and that there’s a vaccine that’s effective even after exposure. His doctor directed him to Strut, a health center in the Castro District operated by the San Francisco AIDS Foundation. But when he reached out, Fuller was told he wasn’t eligible.
The reason: a limited supply of vaccines. Despite months of advance warning that monkeypox cases were growing, and a 40% increase in cases citywide in just one week, Strut has just 60 doses of the Jynneos vaccine.
It’s an eerily familiar scenario, and an infuriating one. Two and a half years into a global pandemic, how are we so deeply unprepared for monkeypox?
Many saw this coming. Tyler TerMeer, CEO of the AIDS Foundation, said they were concerned to only receive a few dozen doses of the vaccine before Pride. The disease has largely impacted people in the gay community, which through its many programs, the organization is well-prepared to serve.
“We knew that there were limited cases in the US at that point, but that it was growing, and that the number of cases could likely spike here in the Bay Area following Pride events,” TerMeer told me.
That prediction turned out to be true. The alert that Fuller went received out to thousands of people. Outrage has ensued, with many taking to Twitter to lambast the vaccine shortage.
The city is drastically unprepared for even a small outbreak of monkeypox. Once again, we find ourselves reacting to a public health crisis that we had ample time to prepare for.
According to the city Department of Public Health’s guidelines, anyone at two parties where cases were recorded are eligible for the shot. But the city’s immunization clinic, which is offering vaccines on a first-come, first-serve basis, is so swamped it’s suspended all COVID and low-cost vaccines due to monkeypox demand, and notes on its website that due to staffing shortages it can ‘t keep up with voicemails.
The AIDS Foundation is facing a similar surge. Within one day of setting up a monkeypox vaccine hotline, it received 500 calls. As of Wednesday afternoon, it had 300 people exposed to monkeypox on the waitlist for a vaccine.
The Department of Public Health told me Thursday they’d just received 2,000 doses and are figuring out where to deploy them. But that still may not be enough, and supply is low. Last week, the US Department of Health and Human Services said it planned to distribute just 56,000 doses across the country. An order of 2.5 million doses from the Danish manufacturer of Jynneos is not expected to arrive for months.
In the meantime, the lack of preparation and attention from the federal government and drugmakers is reviving deep trauma for queer people from the early years of the AIDS epidemic.
“I’m a person who’s been living with HIV for 18 years and have a lot of concern about how woefully unprepared we are in this country to respond to this,” TerMeer said. “It feels like that urgency is not there, which is hard to digest when you are someone who is queer identified and knows the history of what’s happened to our community.”
Next week, the AIDS Foundation plans to hold a town hall on monkeypox, and Supervisor Rafael Mandelman, who represents the Castro, has called for a hearing on the city’s response. But for the thousands of people who received exposure notifications after Pride, who are seeking timely testing and vaccines, a hearing is too little too late.
As for Fuller, he’s quarantining at home, but not out of a fear of transmitting monkeypox. Sometime during the Pride festivities, he contracted COVID-19. The irony is not lost on him. “My challenge right now is figuring out if my symptoms are related to monkeypox, or is it just COVID?” he said.
Until San Francisco catches up, he can’t test to find out.
Nuala Bishari is a San Francisco Chronicle opinion columnist and editorial writer. Email: nuala.bishari@sfchronicle.com
