(KRON) – As the number of monkeypox cases continues to rise, changes were just announced on Friday regarding vaccine priority. San Francisco has the highest number of confirmed cases in the state at 197.

The San Francisco Department of Public Health says it’s prioritizing first doses and deferring second doses until it receives a sufficient supply of vaccines. Before Friday, every time someone got their first Jynneos vaccine shot, a second dose was set aside for them to get 28 days later. That won’t be the case moving forward.

By Friday, the long wait times at monkeypox vaccine sites seemed to improve, but the wait list for shots at the Magnet Sexual Health Clinic hasn’t stopped growing.

“We have over 5,000 individuals in the queue who we have deemed eligible for vaccination, but are awaiting enough supply here in the area,” said Dr. Tyler TerMeer, the CEO of the San Francisco AIDS Foundation. 

TerMeer says the clinic received 200 doses of the Jynneos Vaccine this week, but its wait list has 5,000 people on it. Dr. Peter Chin-Hong, an infectious disease specialist at UCSF, says one way to solve the vaccine supply issue is by doling out the second doses that are sitting in waiting to those who have yet to receive their first dose. The department of public health agrees, announcing a deferment of second doses to provide vaccines to more at-risk populations.

“If you’re able to prioritize first shots that means all of a sudden all those people who had appointments to get their Day 28 shots would have that deferred, and that doubles the amount of people that you can treat,” Dr. Chin-Hong said. 

He says the second dose acts as a booster and some research questions if it’s needed at all. He described the rise in cases as the tip of the iceberg.

“I still think we’re in the middle of rising very quickly, so we may see many, many more cases in the next few weeks before it starts to come down,” Dr. Chin-Hong said.

At Magnet, more than 50 people with symptoms have been tested for monkeypox. According to Dr. TerMeer, the majority of those tests came back as positive — only adding to the argument that more vaccines are needed to prevent continued spread.

“We’re also having to make very difficult decisions with a very limited amount of supply while the spread in communities like San Francisco just continues to be so fast,” Chin-Hong said.

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The San Francisco Department of Public Health will send out notifications when enough vaccine supply is available to offer second doses. They say the second dose will still be effective, even if it’s given after the minimal interval of four weeks.