Mpox FAQ

I have been exposed to mpox. What should I do?  

• Seek out a vaccine

  • If you are told by your partner that they have mpox, or someone contacts you to tell you that you were exposed, you should seek out a MPX vaccine to prevent an infection.  

  • Getting a vaccine soon after exposure – ideally within 4 days but up to 14 days after – can help prevent you from becoming infected with the mpox virus.

  • More information on vaccine eligibility can be found here: https://sf.gov/information/mpox-vaccine

• Monitor for symptoms 
   
• Let partners know you have been exposed 
   
• Talk to your health provider if you have questions 
   
• See a doctor or health provider as soon as possible if symptoms develop
   
  • People who are not connected to medical care can get care through Strut 

I know how mpox spreads, but how does it not spread?  

• Mpox is not nearly as contagious as COVID-19.
• It does not spread by casual conversation, or walking by someone with mpox in a grocery store. 
• You need to have prolonged, physical contact or share bedding or clothing with someone who has the virus.

Will wearing a condom prevent people from getting mpox?

• Condoms during sex are an important way to protect yourself and others from HIV and other STIs like gonorrhea, chlamydia and syphilis.  

• Condoms (latex or polyurethane) may protect your anus (butthole), mouth, penis, or vagina from exposure to mpox. However, condoms alone may not prevent all exposures to mpox since the rash can occur on other parts of the body and because mpox can be spread through skin-to-skin touching of sores and through direct face-to-face contact like licking or kissing or coughing in someone’s face.  

Should I wear a condom after sores and spots have healed?

If you or your partner(s) have any of the following conditions, you should consider wearing a condom for 8 to 12 weeks after you’ve been diagnosed with mpox:   

• You or your partner(s) are undergoing fertility treatment or planning pregnancy   

• You have an immunocompromised sexual partner(s) (including a pregnant partner)    

• Talk to your healthcare provider if you are undergoing planned semen storage (for example prior to chemotherapy)   

• You are concerned about transmission to a sexual partner or partners for any other reason  

• Talk to your healthcare provider if you are concerned 

And keep in mind that:  

• It’s still not clear for sure yet whether the mpox virus found in semen can actually cause infection, and   

• using a condom by itself will not prevent the spread of mpox when a person has symptoms (before skin lesions have healed)  

If I had the smallpox vaccine, am I protected from mpox? 

• The smallpox vaccine can protect you from getting mpox, however the immunity does wane over time. Most people have not gotten the smallpox vaccine recently enough to be considered protected.   
• If it has been more than 3 years since your smallpox vaccine, you should think about getting vaccinated again with Jynneos.

Who is eligible for a Jynneos vaccine in San Francisco?

Anyone who wants protection from mpox infection may receive the mpox vaccine

There is no shortage of mpox vaccine now, and so the San Francisco Department of Public Health (SFDPH) and many other health departments in California have removed all the eligibility criteria.  Anyone who may be at risk of getting mpox can now receive the JYNNEOS vaccine to prevent mpox. There is no need to prove eligibility for the vaccine.  

Some people are still at higher risk of getting mpox than others, and those persons are now considered priority groups that are recommended to get the JYNNEOS vaccine.

SFDPH recommends mpox vaccination with JYNNEOS for these priority groups:  

• Persons who have had a known exposure to mpox and need post-exposure prophylaxis (PEP)
• People with occupational (job-related) risk, including
  • Healthcare workers likely to collect laboratory specimens from patients with mpox
  • Persons working in sexual health clinics
  • Persons working in clinical settings that serve at-risk populations
  • Any occupational group recommended by Advisory Committee on Immunization Practices (ACIP) to get the vaccine
• Any person living with HIV, especially those with risk of complications of mpox, such as persons with a CD4 count <350/mm3, an unsuppressed viral load, or who have had an opportunistic infection
• Any man, trans person, or nonbinary person who has sex with men, trans persons, or nonbinary persons
• Persons who are taking or are eligible to take HIV PrEP
• Sex workers
• Sexual contacts of any persons included above
• Persons who have had close contact, within the past 6 months, with someone with suspected or confirmed mpox
• Persons who had sex or close contact, within the past 6 months, at a venue or event, or within a social group, with a suspected or confirmed mpox case. This includes persons who received notice from a venue or event of a potential exposure.
• Persons diagnosed, in the past 3 months, with a bacterial sexually transmitted disease (for example: chlamydia, gonorrhea, syphilis)
• Persons who expect to experience any of the above

Two doses of JYNNEOS should be received, with at least 4 weeks separation between doses. This helps ensure longer-term protection against mpox.

If it has been more than 4 weeks since the first dose, the second dose can be administered as soon as possible, and the series does not need to be restarted.    

If you have received your second dose, there is no need for a third dose at this time.

Since no vaccine is 100 percent effective, it is important for individuals to reduce the risk of potential exposures to mpox both before and after vaccination. Learn more about mpox infections after vaccination.

How does San  Francisco administer the mpox vaccine?

You can get a subcutaneous method of injection if you prefer this over the intradermal method of injection. A subcutaneous injection is when a needle is used to inject the vaccine into the tissue layer between the skin and the muscle. This is a more common way to get a vaccination. Intradermal administration means injecting the vaccine under the topmost layer of the skin. People can request to receive the intradermal injection on the back below the shoulder blade, or on the upper arm. Read more information from the CDC on alternative locations for intradermal administration.

How do you test for mpox?  

• You must have a rash, or spots, to get a mpox test.  
• The mpox test is done on your skin with a swab at a clinic or health care provider. The swab is rubbed against spots on your skin, or parts of your rash, and then sent to a specialized lab for MPX testing.
• When testing for mpox, your health care provider may recommend testing for other sexually transmitted infections. Syphilis and herpes are much more common than mpox – they appear similar and should be treated too.  
• A preliminary lab test result should be available in a few days. While you are waiting, be sure to take steps to care for yourself and others: 

  • Stay home and away from others 

  • Avoid public transportation if possible, and if you must leave your home, wear a well-fitting mask and be sure to cover all lesions, including on your hands. You may use soft bandages for lesions that are not covered by clothes or gloves

  • Call, text, or contact your sex partners and people you have had close contact with since the start of your symptoms 

Is there treatment for mpox?

• Most people get well from mpox without needing any medicines or other treatment.
   
• There is no medicine that the FDA has approved for mpox infection treatment.
    
• However, there is one medicine that is used for severe mpox, called tecovirimat, or TPOXX. It is allowed as an “investigation” drug for special circumstances for people who have severe MPX.
   
• Talk to your doctor if you think you might need TPOXX because of a special condition or severe disease. 
   
• If you need TPOXX, your doctor will work with the health department, or other providers to get you TPOXX.

What is severe mpox and who is at risk?

Most people get well from mpox without pills or treatment of any kind. But for some people mpox can be serious.    

Here is what to look out for:   

• any mpox blisters or spots on or near your eyes

• spots that spread all over your body or blend together

• problems with bleeding or bruises all over

• any trouble breathing, or thinking, or continuing to feel worse and not improving over time   

The groups of people who may be at higher risk for getting severe mpox include: 

• children under age 8  

• people who are pregnant 

• people whose immune system is not as strong because of a disease, an infection or from taking medicines 

• people with a history of eczema and other skin conditions  

• If you are one of these groups of people, it is important to see your doctor early. You should call your doctor or clinic if you are worried you are getting severe mpox.  And you should seek care by calling 911 or going to a hospital emergency room in a health emergency. 

If I get infected, how long will it take me to get sick?   

• After a person is infected with mpox, it may take up to 3 weeks for a person to have symptoms of mpox.
• People are not spreading mpox during the time before symptoms appear.

How long is an infected person contagious?

• You are able to spread mpox to other people from the start of your symptoms (like feeling like you have the flu) or the start of a rash, until all scabs have fallen off and new skin covers all the mpox spots 
• This can take 2 to 4 weeks 

Can I get mpox over and over again?

• If you have been sick with mpox, your body may be able to prevent you getting sick with mpox again.
• We are learning more, but we do not know how long your body’s protection, or immunity might last.

If I recently recovered from mpox but was not able to get vaccinated, should I get vaccinated once I have recovered?

• If you have been diagnosed with mpox recently and are generally healthy, at this time it is not recommended by CDC nor by CDPH to get vaccinated.   

• Importantly, a mpox infection itself confers immunity and provides protection against future infection. 

What if my job involves touching people?

• People with jobs or professions that have skin-to-skin contact with customers or clients should look at or visually inspect the area of skin that they are treating for signs of mpox
   
• It is also important to ask your customer/client about whether they have any flu-like symptoms (such as a fever)
   
• Do not touch anyone with flu-like symptoms or a rash that might be mpox.  (Flu-like symptoms can also be associated with COVID-19, which is another reason to ask your customers about how they are feeling before providing services.)   

What kind of cleaning products work against mpox?

The U.S. Environmental Protection Agency (EPA) has a list of approved cleaning solutions, or disinfectants for mpox. The list includes popular products that many people already use, such as Lysol and Clorox. In addition, the EPA has approved special product labeling for cleaning solutions to prevent MPX. The list of approved products can be found on the EPA website.

According to the CDC, if you have mpox you should clean and disinfect the spaces you are in regularly to prevent the spread of mpox to your family or household when you are staying home and staying away from others. This includes washing your bedding and towels. Do not shake them out.

Once you have gotten well from mpox and new skin has grown over all your mpox sores or spots, you should wipe down and clean your home as thoroughly as you can. The virus can live on surfaces such as bedding for as long as 15 days. More information and tips about cleaning during and after mpox can be found here.

Can kids get this infection?

• Anyone can get mpox
   
• Do not share a bed if you are feeling flu-like symptoms or you have a rash or spots
   
• If you or others have symptoms and live in a household and/or share close, small spaces like a bedroom or a shared bed with a child, please contact your doctor right away 
   
• Stay home, and stay away from other people in your home as much as you can, wear a mask and avoid close physical contact like kissing or hugging other people 

I have pets in my home and I have mpox or mpox symptoms.  How can I protect them? 

• You should take steps, whenever possible, to protect everyone in your home, including your pets or companion animals 
   
• We know that rodents can get mpox, and we do not know enough yet about whether dogs and cats can get mpox
     
• If you must take care of animals in your home, you should wear a mask, especially when you are touching or caring for your pet
   
• You should also wear clothes that cover your skin (such as long sleeves and long pants)
   
• You should wear gloves as much as possible, especially when feeding, petting or changing bedding, and you should thoroughly wash your hands before touching them
   
• Try to avoid being face-to-face with your pets including licking or kissing, until you are healed, even if you are wearing a mask
   
• More information about protecting animals in your home can be found online at https://www.cdc.gov/poxvirus/monkeypox/specific-settings/pets-in-homes.html.   

How can we protect ourselves while traveling?

At this time, mpox is rare and considered a low threat to the general public. Almost everyone who gets mpox gets infected from having a lot of skin-to-skin or face-to-face contact, such as kissing and sex with someone who has mpox at a time when that person has symptoms and can spread it.

However, you should not sleep inside a hotel room that has not been cleaned after the previous people left.

The CDC recommends that travelers avoid close contact with sick people, as well as dead or live wild mammals. If you are traveling on a plane, avoid prolonged skin-to-skin contact, while sharing an armrest, for example. The good news is that mpox is not nearly as contagious as COVID-19.

How to get help if you don’t have a doctor:

If you do not have a provider, or have difficulty scheduling an appointment, you can be seen at Strut located 470 Castro Street (415-581-1600).

For more information, go to: cdc.gov/monkeypox

Can I get the mpox vaccine at the same time as other vaccines?

Yes. You can get the mpox vaccine before, after or at the same time as most vaccines. Find where you can get vaccinated here.

Mpox and flu vaccines

You can get both the mpox and flu vaccine at the same visit. You may want to get each vaccine in a different arm.

Mpox and COVID-19 vaccines

You can get the mpox and COVID-19 vaccines at the same time. If you are a man or trans person between ages 12-40 and got the mpox vaccine first, you may want to wait 4 weeks to get the COVID-19 vaccine due to a rare risk of myocarditis (heart inflammation). If you were recently exposed to mpox, do not wait to get the mpox vaccine, even if you recently got a COVID-19 vaccine. Speak with your doctor if you have questions about when to get vaccinated.