(CNN) — As federal officials weigh a national public health emergency declaration surrounding the monkeypox outbreak, San Francisco and New York state began sounding the alarm Thursday.

San Francisco became the first major city in the United States to declare a local health emergency for monkeypox in an effort to strengthen the city’s preparedness and response amid high demand for the vaccine.

The declaration, which takes effect Monday, is a legal action that allows city departments to mobilize and coordinate more effectively, Mayor London Breed’s office said in a statement. It also allows for future reimbursements by the state and federal governments.

“We need to be prepared and this declaration will allow us to better serve the city,” said Dr. Grant Colfax, Director of Health. “Our response to COVID-19 has taught us that it is imperative that we mobilize the resources of the city. The declaration helps us ensure that we have all the tools available to increase our outreach, testing and treatment, especially for LGBTQ+ people who continue to have increased risk of contracting monkeypox.

Dr. Susan Philip, public health officer for San Francisco, added, “We have always been at the forefront of advocacy and action for LGBTQ+ health and I am issuing this statement to reaffirm our commitment to the well-being of these communities and to allow us move more quickly to obtain and distribute the necessary resources to help those disproportionately affected.”

The San Francisco Department of Public Health has confirmed 261 cases of monkeypox in the city, while California has a total of 799 cases.

Clarifications on sex between men and monkeypox 1:21

In New York, the state Health Commissioner, Dr. Mary T. Bassett, declared an imminent threat to public health, citing the rapid spread of the virus.

“This declaration means that local health departments involved in response and prevention activities will be able to access additional state reimbursement, after other federal and state funding sources are maximized, to protect all New Yorkers and, ultimately, limit the spread of monkeypox in our communities,” he said in a statement.

New York has 1,247 probable or confirmed cases of monkeypox, according to data from the US Centers for Disease Control and Prevention (CDC). The state has received more than 60,000 doses of the jynneos vaccine against monkeypox, says the Department of Health and Human Services (HHS).

The San Francisco health department requested 35,000 doses to meet the overwhelming demand, but said it had only received 12,000 doses as of Thursday. About 4,220 more are expected this week, the mayor’s office said.

In Seattle, King County health officials say they have received just 4,720 doses of the Jynneos vaccine. That is only 6% of the 80,000 doses they would like to have to cover the 40,000 people at high or high risk for monkeypox.

The Jynneos vaccine works best when given in two doses at least four weeks apart, but with increasing demand and limited supply, some jurisdictions have focused on getting the first doses now and determining the second doses later.

HHS says 338,000 doses of vaccine have been delivered nationwide. The US Food and Drug Administration (FDA) has authorized an additional 786,000 doses of the Jynneos vaccine, and jurisdictions can place orders starting Friday.

In Washington, the federal government continues to monitor the response to monkeypox and will use it to consider whether to declare the outbreak a public health emergency, HHS Secretary Xavier Becerra said Thursday.

“What I can tell you is that we continue to monitor the response to monkeypox across the country,” he said. “We have made vaccines, tests and treatments available to all jurisdictions running their public health systems well beyond the numbers currently needed.”

“We will weigh any decision about declaring a public health emergency based on the responses we are seeing across the country. The bottom line is that we need to get ahead of ourselves and be able to end this outbreak,” he added.

CNN’s Virginia Langmaid contributed to this report.

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