SAN FRANCISCO (KGO) -- Public health departments around the Bay Area are grappling with limited testing, limited supply of vaccine and lack of data around monkeypox, which is making it difficult to understand the full picture of the outbreak.
"Monkeypox has been detected in the wastewater of Northern California, suggesting that there is more transmission than meets the eye. And I think what we are seeing now in the number of cases is just the tip of the iceberg," says Dr. Peter Chin-Hong, a professor of medicine and an infectious disease specialist at UCSF.
Dr. Chin-Hong says the high rates of transmission are being meet with a slow response and not enough vaccines.
The FDA recommends two doses of the monkeypox vaccine to be most effective. But because of the lack of supply, he says the new strategy is to just administer one dose.
"There is some laboratory data suggesting that one dose can actually have up to two years of protection," explains Chin-Hong.
California State Senator Scott Wiener (D-San Francisco) is concerned that, like other infectious disease outbreaks, monkeypox could become endemic. Currently, the virus is most impacting gay and bisexual men.
"I hope it doesn't spread more broadly, but it definitely could. And if does, then we see a much broader swath of the population seeking vaccines. That will quickly swamp the system," says Sen. Wiener.
He is calling for emergency funding from the state before the August recess, to provide funding to local counties, especially for more testing.
"Most counties have not seen a lot of monkeypox so far, but that's starting to change. So we have a lot of countries that are not going to have the resources to respond," he says.
Wiener says Governor Gavin Newsom addressed monkeypox with the White House during his recent trip to Washington, D.C., and that other senior California state health officials have held high level talks with their federal counterparts.
"We all are putting a lot of pressure on our federal partners because they are the ones who are best positioned to turn this around on vaccinations. I do believe they now have a much greater sense of urgency," says Wiener.
Currently, there is only one lab that manufacturers the monkeypox vaccine in the world. But Wiener says it has agreed to license it. He adds, it is up to the Biden administration to pressure U.S. manufactures to step up.
"We have been trying to light a fire to say that you need to do everything humanly possible to accelerate and expand the production of these vaccines. Anything that you can. Working with the European Union. Working with the World Health Organization. Making sure that other manufacturers are stepping in, providing financial incentives," says the senator.
The Biden administration has ordered several million doses of the monkeypox vaccine, but most of it won't be available until the end of the year.
San Francisco has requested 35,000 vaccines to treat people who are at high risk of the virus, but has only received several thousand.
Even if U.S. companies start production immediately, extra vaccines are still months away.
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