TPOXX = Tecovirimat = antiviral treatment for Monkeypox. This is not a vaccine.

The reason why this drug might be difficult to access in the community is that it requires a lot of paperwork on the part of the treating physician submitted to the FDA (because while largely safe and effective based on what we know now, the drug has not previously been studied for Monkeypox). While the community resources are ramping up, you may have difficulty getting access to it outside certain centers.

TPOXX is not for everyone with Monkeypox. It is indicated for patients with the following (pay special attention to

points 6 and 7 since >75% of cases will fall into these categories):

  1. Severe disease requiring hospitalization

  2. Immunocompromise (HIV/AIDS, cancer, autoimmune diseases, inborn immunodeficiencies, or on medicines that suppress the immune system)

  3. Patients <8 years old or who are breastfeeding

  4. Patients with a history of exfoliative (pealing) skin diseases such as eczema, severe acne, current herpes or chickenpox, impetigo, psoriasis, Darier disease

  5. Patients with diseases that are known to cause fistulas (abnormal connections from one place in the body to another) such as Crohn’s disease or ulcerative colitis

  6. Patients with a complication of Monkeypox, such as an overlying bacterial infection, severe nausea, vomiting or diarrhea, pneumonia, phimosis, severe pain, or other complications

  7. Patients with disease affecting their anus, genitals, eyes or mouth

According to this news article. TPOXX is available in the following locations:

  • Alameda: Kaiser Oakland, Kaiser San Leandro

  • San Francisco: San Francisco General Hospital, UCSF, San Francisco City Clinic, Kaiser San Francisco, San Francisco Veterans Affairs Medical Center

  • Santa Clara: Santa Clara Health System, Stanford Healthcare Pharmacy, Kaiser Santa Clara, Kaiser San Jose

  • Sonoma: Kaiser Santa Rosa

Anecdotally, it is more difficult to access in some locations than others. Please do not be discouraged by difficulty to access. If you are in pain in sensitive areas, you can find it. Advocate for yourself and let friends who are not suffering advocate for you.

San Francisco city clinic is known for prescribing TPOXX, but they have limited appointments.

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