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Monkeypox Vaccine Allocated to Local Health Jurisdictions in California

August 3, 2022

Of the total monkeypox vaccines provided to California by the federal government, to date CDPH has allocated most of the doses to local health jurisdictions (LHJs) based on formulas described below, and LHJs can order up to that number. In addition, CDPH holds 15% of doses in reserve for special situations and urgent needs.

Formulas for Allocating Doses That LHJs Can Order, to Protect the Greatest Number of People at Risk

The below represents the formulas used to allocate the limited number of monkeypox vaccines to LHJs. To estimate populations at highest risk of monkeypox transmission, the formulas include the number of early syphilis cases among men as a proxy.

Formula for Phase 0 (end of June)

  • A base of 6 doses was allocated to each LHJ with

    • At least 1 monkeypox case as of 6/27/2022, and/or

    • More than 400 early syphilis cases among men in 2019

  • Additional doses were allocated to LHJs based on their share of

    • Monkeypox cases (50% weight), and

    • Cases of early syphilis among men (50% weight)

  • Number of LHJs meeting criteria and allocated doses: 9

Formula for Phase 1 (early July)

  • Similar to Phase 0, using proportion of early syphilis cases among men and monkeypox cases weighted equally.

  • Additional vaccines were allocated to LHJs that had venues or events with large exposures that had already happened or were likely to happen in the coming weeks

  • LHJs with populations >100,000 that had not yet reported a monkeypox case were allocated 20 doses each for possible exposed contacts of cases.

  • Unused Phase 0 allocations were rolled into Phase 1 allocations.

Number of LHJs meeting criteria and allocated doses: 35

Formula for Phase 2a (mid-July)

  • Similar to Phase 0 and 1, using proportion of early syphilis cases among men and monkeypox cases weighted equally.

  • To prioritize vaccine to the highest risk areas, the limited doses were allocated to jurisdictions with cases; local health jurisdictions without cases were not allocated vaccine.

Number of LHJs meeting criteria and allocated doses: 16

Formula for Phase 2b (late July)

LHJs were eligible for Phase 2b allocation if the three criteria below were met:

  • The LHJ has had at least one monkeypox case reported

  • The LHJ has ordered at least 95% of their allocated vaccine doses between Phase 0-Phase 2a

  • The LHJ submitted a plan to CDPH detailing how doses would be administered to priority populations

LHJs deemed eligible were then allocated doses using the following formula:

  • 75% based on monkeypox cases in the past two weeks (7/12/22-7/25/22)

  • 25% based on early syphilis cases among men

Number of LHJs meeting criteria and allocated doses: 23

Formula for Phase 3a (early August)

The formula for Phase 3a was the same as the formula for Phase 2b.

Future Phases

Phases 3b and 3c are forthcoming from CDC, and may be allocated to states and territories based on demonstrated doses administered in each jurisdiction.  Once released by CDC, CDPH will continue to assess the situation to determine how to distribute vaccine to the LHJs to best reach the population at highest risk of infection and transmission. 


Federal Distribution:

For more information on Federal JYNNEOS monkeypox vaccine distribution, visit the U.S. Department of Health & Human Services website

​​Originally published on July 22, 2022
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