Extremely weak to monkeypox, San Francisco is ‘actually begging’ feds for vaccine

San Francisco’s LGBTQ community, led by a city supervisor, is calling on the federal government to greatly step up distribution of vaccines against monkeypox, a highly infectious virus now spreading mostly through male-to-male sex.

The city is home to more gay, bisexual and transgender men than anywhere in the country, Supervisor Rafael Mandelman said Tuesday, which makes residents among the most vulnerable to the virus. He introduced a resolution urging the US Centers for Disease Control and Prevention to prioritize vaccine distribution based on risk.

“Gay and bisexual men are once again being failed by our federal government,” Mandelman said on the steps of City Hall, invoking memories of the AIDS crisis in the 1980s. He was joined by the city’s top health officials, Dr. Grant Colfax and Dr. Susan Philip, and representatives of other communities at heightened risk for monkeypox, including transgender people and sex workers.

“Would monkeypox receive a stronger response if it were not primarily affecting queer folks?” Mandelman asked rhetorically as supporters hissed.

He and other speakers drew comparisons not only to the early years of the HIV epidemic — when the government was slow to respond to the public health emergency hitting primarily gay men — but to the COVID-19 pandemic, where federal officials have made the coronavirus vaccine as easy as possible for everyone to get.

dr Grant Colfax, director of health, joined public health officials during a press conference outside City Hall calling for more support from the federal government to combat monkeypox.

Bronte Wittpenn/The Chronicle

San Francisco’s public health experts said they aren’t seeing the feds prioritizing monkeypox the same way.

“We are literally beginning our federal partners to provide more vaccine,” Colfax said, noting that the city’s health department has received only 2,888 vaccines from the state since early June — and it took until this week to get 2,300 of them.

Yet the monkeypox hotline at the San Francisco AIDS Foundation is ringing off the hook, “getting one to two calls per minute,” said Tyler TerMeer, chief executive at the agency, which held a monkeypox virtual town hall Tuesday evening.

Across the country, 866 monkeypox cases have been reported, including 148 in California, according to the CDC. Of the state’s cases, 40% are in San Francisco — up sixfold in the past month, to 60.

OnTuesday, Dr. Erica Pan, state epidemiologist with the California Department of Public Health, revealed that scientists have detected monkeypox in Bay Area wastewater surveillance systems, the first such occurrence in the country.

“This implies there’s a lot more disease there than we realize,” she said in an online health update.

Pan said the state is giving a vaccine, called Jynneos, mainly to people who have been exposed to monkeypox: lab workers who do testing, doctors and others who treat infected patients, and people who have attended an event where someone had a confirmed case.

A cousin of smallpox, the disease generally is not deadly, and most people recover without treatment. But its painful lesions can last for weeks. Other symptoms include fever, headache, muscle aches and chills.

Children and people with medical conditions that make them more vulnerable can have more severe cases.

Two patients are hospitalized for monkeypox at UCSF, one of only four or five hospitals in the state with Tpoxx, a drug to treat smallpox, said Dr. Peter Chin-Hong, a UCSF infectious disease expert who appeared with Pan.

Unlike COVID-19, monkeypox is not generally transmitted through respiratory droplets, although it can be caught through kissing and breathing at close range. It spreads mainly through intimate contact, and most cases so far have been reported among male-to-male partners.

The White House announced its vaccine strategy on June 28, and said it will allocate 296,000 doses “over the coming weeks,” and 1.6 million doses “over the coming months.”

People stood in long lines to receive the monkeypox vaccine at San Francisco General Hospital.

Jessica Christian/The Chronicle

Noting that the US Department of Health and Human Services has said it will buy enough additional vaccine to fully vaccinate about 2 million people through 2023, Mandelman said that’s not enough.

More than 4.5 million men in the US say they have sex with other men, the supervisor said, citing a 2016 study in the journal JMIR Public Health and Surveillance. The same study indicates that in San Francisco, 18.5% of men have sex with other men.

Having to wait five to seven days to get monkeypox test results is also a problem because people may pass along the virus before they know they have it, Paul Aguilar, HIV chair of the Harvey Milk LGBTQ Democratic Club, said from the City Hall steps, where he joined Mandelman.

Philip, the city’s health director, blamed the testing problem on a bottleneck at the state level but said new labs are opening, and “we’re hoping to speed up the process.”

Mandelman’s resolution would require the Board of Supervisors to urge the CDC to release a vaccine prioritization plan “based on the risk of contracting the virus and medical vulnerability.”

The board would also call on the Department of Health and Human Services to buy and distribute enough vaccine for every at-risk person to easily get it.

The board is expected to vote on the resolution next week.

Chronicle staff writer Catherine Ho contributed to this report

Nanette Asimov is a San Francisco Chronicle staff writer. Email: nasimov@sfchronicle.com Twitter: @NanetteAsimov