I'm surprised and incredibly impressed at this announcement. It seems trivial, but the general feeling in the industry has been that SF would fight tooth and nail against robotaxis at SFO.
What likely happened now is that SFO got a kick up their backside from the Mayor after the press started asking why it was still dragging its feet, while SJC approved Waymo swiftly.
They should be able to get to SFO from Millbrae Ave and San Bruno Ave without getting on the highway proper, although it'll likely be a lot slower unless you're getting a ride from nearby. While SJC can serve downtown SJ and Santa Clara without getting on a highway.