October 20, 2022



San Francisco, CA – The San Francisco Department of Public Health (SFDPH) today announced that the public health emergency declaration on MPX will end on October 27. MPX cases have slowed to less than one case per day and more than 27,000 San Franciscans are now vaccinated against the virus.

Additionally, SFDPH advanced its public health response to other sexually transmitted infections (STIs) today by issuing the first guidance in the nation on how to use doxycycline, a common antibiotic, to prevent infections of chlamydia, gonorrhea, and syphilis. These types of bacterial STIs are also of public health concern, and rates have risen in recent years within communities of gay and bisexual men, trans people and others who also have been most affected by MPX (see more below).

The public health emergency declaration on MPX, the first of its kind in the nation, served its purpose to reflect the immediate urgency of the MPX threat to the health of those most affected in the gay, bisexual and trans communities. It also gave public health officials tools, such as collection of critical data, needed to respond effectively.

The overwhelming community support and advocacy for critical resources such as vaccines from the federal government, coupled with early and strong action, drove San Francisco's successful public health response and enabled the city to reach this milestone. First and foremost were San Franciscans themselves, who have been exceedingly proactive about their health and have sought out vaccines and taken other steps to become informed and protect themselves and others. SFDPH and community partners directed resources toward people most impacted by MPX in the gay, bisexual, and trans communities, and with a goal of lowering health disparities and barriers to care.

While much has been accomplished in the nearly three months of the emergency declaration, it is important to note that MPX is still circulating in communities and remains a public health concern. The work must continue.

San Franciscans should continue to do their part by getting vaccinated against MPX if they are eligible and, critically, completing the two-dose Jynneos series; maximum protection against the virus occurs only after the vaccine series is completed. If there are concerns about receiving an intradermal injection on the forearm, the vaccine can be administered in ways that are less visibly noticeable, for example on the back.

SFDPH will continue efforts to prevent MPX by focusing public health resources where they can be most effective, and by addressing health disparities in BIPOC communities. SFDPH will also remain vigilant in responding to outbreaks as needed, monitoring disease trends, and keeping the community informed when new issues arise that require a public health response. Health systems, community clinics such as SF City Clinic and Strut, and SFPDH-affiliated sites will continue to offer vaccines, tests and other MPX resources.

New tool to prevent STIs

SFDPH also encourages people to be generally proactive about sexual health screenings, as other infections like syphilis can present similarly to MPX and also require medical care. New tools to prevent disease, such as doxycycline post-exposure prophylaxis (doxy-PEP), should also be considered when appropriate.

A recent clinical trial conducted by SFDPH, UCSF, and University of Washington researchers found that a single dose of doxy-PEP taken within 72 hours after sex (oral, anal, or vaginal) significantly reduced infections of chlamydia, gonorrhea, and syphilis. Doxy-PEP is the first biomedical prevention drug that has been shown to be effective and well-tolerated to reduce these infections.

In particular, doxy-PEP holds promise to decrease rates of syphilis in San Francisco, which are among the highest in the country. Syphilis is also the STI with the highest potential for severe disease, particularly involving the eyes and nervous system.

SFDPH’s new guidance is for doxy-PEP to be used among cis men and trans women who have had a bacterial STI in the past year and have reported condomless anal or oral sexual contact with at least one cis male or trans female partner in the past year. The guidance also recommends that anyone with a history of syphilis receive doxy-PEP. SFDPH will continue to support and participate in research that promotes the sexual health of the communities we serve.


More information about MPX in San Francisco can be found here:

More information about doxy-PEP can be found here: