Cyclists and pedestrians enjoy a foggy morning along the Great Highway at Ocean Beach in an undated image. (Photo courtesy of San Francisco Recreation and Parks)

San Francisco officials declared a local public health emergency Thursday for monkeypox as the city has roughly one-third of the reported cases statewide.

The declaration, which will formally take effect Aug. 1, will enable the city to expedite emergency planning, staffing and public agency coordination as San Francisco attempts to slow the virus’ increased spread.

The San Francisco Department of Public Health has reported 281 confirmed and probable cases of monkeypox, almost exactly 33 percent of the 799 cases that have been reported statewide.

To date, only the larger Los Angeles County has more reported monkeypox cases. As of Tuesday, no other county in the state had reported more than 45.

“Our COVID-19 response has taught us that it is imperative that we mobilize city resources,” city Health Director Dr. Grant Colfax said in a statement. “The declaration helps us ensure we have all the tools available to augment our outreach, testing and treatment, especially to the LGBTQ+ (community) who remain at highest risk for monkeypox.”

Unlike the early days of the COVID-19 pandemic, a vaccine to prevent monkeypox does exist in the form of the two-dose Jynneos vaccine, which was originally developed to prevent both monkeypox and smallpox.

However, vaccine doses remain in extremely short supply, even with U.S. Health and Human Services Secretary Xavier Becerra announcing Thursday that the federal government will disperse 786,000 doses of the vaccine across the country.

State health officials said in a letter sent last week to the U.S. Centers for Disease Control and Prevention that California alone would need at least 600,000 to 800,000 vaccine doses, a figure they called a conservative estimate.

San Francisco officials said they expect the city to receive 4,220 vaccine doses this week, bringing the city’s total allocation to date to roughly 12,000 doses. San Francisco Department of Public Health officials had initially requested a conservative estimate of 35,000 vaccine doses.

As a result of the lack of doses, the city has limited their eligibility to mostly close contacts, sex workers and men who have sex with men who have had more than one sexual partner in the prior 14 days.

The city has focused on administering the first of the vaccine’s two doses to as many residents as possible to ensure that those at highest risk of contracting the virus have at least a modicum of protection.

Monkeypox is generally spread through prolonged skin-to-skin contact or bodily fluids. State and federal health officials have stressed that the virus is not airborne like COVID-19 or the flu.

Symptoms can include a rash or sores on the skin anywhere on a patient’s body. Contraction of the virus often begins with flu-like symptoms, with a rash or sores often appearing within one to three days.

While many cases have been confirmed among men who identify as gay or bisexual, health experts have stressed that the virus is not exclusive to men who have sex with men, and anyone can contract monkeypox regardless of their sexual orientation.

“We know that this virus impacts everyone equally — but we also know that those in our LGBTQ community are at greater risk right now,” Mayor London Breed said in a statement. “Many people in our LGBTQ community are scared and frustrated. This local emergency will allow us to continue to support our most at-risk, while also better preparing for what’s to come.”

San Francisco officials have worked with local LGBTQ community groups like the San Francisco AIDS Foundation and San Francisco Pride both to provide vaccinations and general information about the virus.

The city has also distributed thousands of posters and flyers about the virus in English, Spanish, Chinese and Filipino in the Castro and South of Market neighborhoods, according to SFDPH officials.

Sen. Scott Wiener, D-San Francisco, praised city officials for the declaration, which came one day after he called for both the city and state to declare states of emergency over the ongoing outbreak.

“San Francisco was at the forefront of the public health responses to HIV and COVID-19, and we will be at the forefront when it comes to monkeypox,” Wiener said in a statement. “We can’t and won’t leave the LGTBQ community out to dry.”

To date, monkeypox cases have also been reported in Alameda, Napa, Contra Costa, San Mateo, Monterey, Santa Cruz, Santa Clara, Solano and Marin counties.

Information from state public health officials about the monkeypox outbreak, including prevention methods and eligibility criteria for vaccination, can be found at

San Francisco-specific information regarding monkeypox testing, treatment and other resources can be found at