Mpox Cases in California Are Rising. Where Can You Find a Vaccine?

After a summer of very low case rates, public health officials are warning that cases of mpox — formerly known as monkeypox — are rising around California, including in the Bay Area.

The initial outbreak of the virus hit the United States in the summer and fall of 2022, particularly affecting gay and bisexual men as well as trans and nonbinary people who have sex with men. After a mass vaccination effort led by organizers from the LGBTQ+ community and public health officials, the rate of mpox infections dropped to virtually zero in California — but now, the average number of cases reported every week around the state has more than doubled from the summer months.

Keep reading for what we know about the recent rise in mpox cases in the Bay Area and across the state, recommendations from local public health officials, and where you can find an mpox vaccine in the Bay Area.

Jump straight to:

• Where can I find an mpox vaccine?
• How does mpox spread, and what are the symptoms?

What are mpox cases like around the state and in the Bay Area right now?

Bay Area health officials had originally been concerned about the potential for a resurgence of mpox, a viral disease which spreads mainly from close physical contact, much earlier this year ahead of Pride festivities in June. Fears of a 2022-style outbreak did not materialize, and case counts stayed very low: From February to August 2023, the average weekly case number across California was approximately 1 to 7 cases,  according to data from the California Department of Public Health (CDPH).

But on Oct. 31, CDPH Director Dr. Tomás J. Aragón announced that the agency was now “beginning to see an uptick in mpox cases across the state.”

According to CDPH data, the number of mpox cases in California has “significantly increased,” up from this summer’s low to “approximately 17 cases per week in the most recent three-week period” (with available data being from Sept. 20 to Oct. 10).

CDPH also noted a rise in the number of California counties reporting mpox cases: 15 counties in that most recent three-week period, compared to 11 counties in the three weeks before that. Similar increases, said the agency, are also being seen nationwide in states “including Washington, North Carolina and Hawaii.”

What about the Bay Area? In a statement, the San Francisco Department of Public Health (SFDPH) said that mpox cases in the city have risen too, from only 7 cases in August to 20 cases in September and at least 20 cases in October. SFDPH noted that “some Bay Area counties have seen increased incidence rates in the last several months,” too, as had other large cities around the United States, albeit at slightly different times compared to San Francisco’s rise. Los Angeles said SFDPH saw its mpox increase in June, and mpox cases increased in Chicago in May. The latter was the outbreak that initially prompted Bay Area health officials to urge renewed vigilance against mpox ahead of Pride.

How much should I worry about this rise in mpox cases?

“While the average number of weekly cases remains low compared with last year at this time, mpox continues to circulate in California, and recent data indicate that transmission levels are increasing,” CDPH said. SFDPH also stresses that their count of October cases is still being completed, and this number may rise further.

CDPH noted two important things about this latest rise in mpox case numbers. The first: This latest increase appears to be fueled more by “ongoing transmission within sexual networks” than by people traveling to or from specific areas.

“Importantly, most cases did not report travel or attending any specific event,” CDPH said.

SFDPH has been more open to the notion that travel and event attendance could have played at least some role in this latest mpox rise, noting that during this outbreak, transmission “is primarily related to intimate contact during oral or anal sex” and that “when people are connecting more frequently or with new sexual partners, there are more opportunities for mpox to spread.”

“Things like late summer travel, gatherings, and events may be associated with changes in sexual practices that can lead to increases in cases,” SFDPH said.

The second highlight from CDPH was the role of the two-dose mpox vaccine and what it does (and doesn’t) do.

CPDPH said that since early September, over 40% of people with a documented case of mpox had at least one dose of the vaccine. A lower proportion of people, 31%, had two doses. This, said CDPH, highlights that “while mpox vaccine is effective at reducing infections and disease severity, infections after vaccination are possible and testing is warranted among vaccinated persons.”

“With this, we are reminding and encouraging all Californians to be aware of the signs and symptoms of mpox and to take preventive measures, including vaccination, to protect against severe illness,” Aragón said.

SFDPH said that more than 50,000 doses of the mpox vaccine had been administered to date, but “more than 40% of those who received their first dose” are due for their second dose. If case rates are lower in people with two shots of the mpox vaccine than those with one shot, is there a reason people are not seeking out that second shot?

Joe Hawkins, CEO and co-founder of the Oakland LGBTQ Community Center, which offers mpox shots at its clinic, said that the “huge number of people out there who received their first dose and who never came back for the second dose” might have something to do with this summer’s low case rates — which stayed low at least in part because of vaccinations.

“I think that when people see that the news reports show that the cases have dropped dramatically, I just think … and this is obviously me just assuming, that people don’t feel that the risk is still out there,” Hawkins said.

“But people are still contracting mpox, and this will continue,” he stressed. “Because where there’s smoke, there’s fire, and the opportunity to spread mpox is still very high.”

How mpox cases are tracked around the country:

• Mpox case data for California via the California Department of Public Health (CDPH)
• Mpox case data for San Francisco via SFDPH
• Mpox case data for the United States via the Centers for Disease Control and Prevention (CDC)

• Tell us: What else do you need to know about right now?

Who is most at risk from mpox?

Anyone can get mpox, but SFDPH said that the 2022 mpox outbreak predominantly affected communities of gay and bisexual men and men who have sex with men (MSM), as well as trans and nonbinary people who have sex with men.

This 2022 outbreak was “unique compared to what had been known about mpox previously,” Dr. Stephanie Cohen, director of HIV prevention for the Population Health Division at SFDPH, told KQED earlier this year. That’s because the virus “really seemed to spread through sexual transmission and [was] associated with sexual activities,” she said. Read more about how mpox spreads. 

“When you look at our national data [from 2022], almost 97% of cases in the U.S. were in people who are cis men,” Cohen said. “There were very, very few cases in cisgender women and also very few cases — about 0.08% — in children under the age of 16.”

Should I get the mpox vaccine?

The mpox vaccine is a two-dose series, with roughly a month between doses, and public health officials are urging people to seek vaccination in light of this most recent rise in cases. So …

If you got both doses of the mpox vaccine in 2022:

You’re all up to date — and you don’t need to get another mpox vaccine in 2023. There’s no recommendation at this time to get an mpox booster, SFDPH’s Cohen said.

If you didn’t get the mpox vaccine in 2022:

Go ahead and get your first dose as soon as possible, and get your second dose around 28 days later.

If you got only your first dose of the mpox vaccine in 2022, or more than 28 days ago:

Get your second dose as soon as possible, Cohen said. “Getting both doses of the vaccine is very critical for protection,” she said.

Reminder: The mpox vaccine is available for everyone.

In 2022, public health officials were initially only offering vaccines to people exposed to mpox or were categorized as being in a specific group more at risk from mpox. Those eligibility criteria are no longer in effect, and anyone who wants an mpox vaccine can get one in San Francisco and in many other areas of California.

“There is no shortage of mpox vaccine now,” the SFDPH website said, and there is “no need to prove eligibility for the vaccine.”

Remember, getting your mpox vaccine won’t 100% prevent you from getting mpox, as the CDPH data show. But being vaccinated could also help reduce your symptoms — which can be painful — if you do get infected, SFDPH’s Cohen said.

“That’s, of course, really a good outcome of the vaccine — because we did see some pretty severe cases of mpox last summer in unvaccinated individuals,” Cohen said. “And we really don’t want people to experience the distressing and painful symptoms that occurred at the same time.”

Where can I find the mpox vaccine?

Your mpox vaccine will be 100% free, and you don’t need health insurance to receive one. As with the COVID vaccine, receiving an mpox vaccine won’t make you a public charge or affect any future immigration processes you may enter into, and you won’t be asked about your immigration status to receive the mpox vaccine.

You can schedule an appointment for an mpox vaccine, or choose a walk-in clinic.

If you live in or near San Francisco:

See a full list of mpox vaccine sites near you in San Francisco. SFDPH’s Stephanie Cohen confirmed that you don’t have to be a city resident to get vaccinated for mpox in San Francisco.

Mpox vaccination sites elsewhere in the Bay Area and California:

• Find an mpox vaccine clinic near you using the CDC’s Vaccine Locator.
• Find an mpox vaccine clinic near you using the state’s myturn.ca.gov site.

What you need to know about mpox

How does mpox spread?

Mpox is a disease that is caused when a person is infected with the mpox virus. As the name might suggest, the virus is related to the smallpox virus but is generally less severe and “much less contagious” than smallpox, according to CDPH.

Mpox spreads through “prolonged skin-to-skin contact,” said SFDPH, which notes that transmission during this latest 2023 rise in cases “is primarily related to intimate contact during oral or anal sex”. It can also spread through kissing and sharing bedding or clothing. 

What are the symptoms of mpox?

The symptoms of mpox often start as flu-like symptoms, said SFPDH, but the virus also appears as a rash or sores or spots that can resemble pimples or blisters on the skin anywhere on the body, especially around your genitals. These spot often start as “red, flat spots, and then become bumps,” said SFDPH, before the bumps become filled with pus, and turn into scabs when they break. See the full list of mpox symptoms from SFDPH.

“It’s really important that if someone develops a rash that they think might be related to pox, even if it’s subtle, to come in and see their doctor and get checked out and get tested,” urged Cohen. “And that can help us prevent the spread of transmission in the community.” See more on what to do if you suspect you have mpox.

Is mpox the same as monkeypox?

Yes. In 2022, the World Health Organization announced it would adopt the new, preferred term “mpox” as a synonym for monkeypox, in the light of the “racist and stigmatizing language online, in other settings and in some communities” that the agency said it had observed during the outbreak earlier that year.

You may have also seen the virus referred to as MPX, which was the name originally adopted by SFDPH.

KQED’s Carlos Cabrera-Lomelí contributed to this story.

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