Andy Stone is one of the fortunate. The New Yorker saw a tweet from a local AIDS activist stating that monkeypox vaccines would be available that day at a Manhattan clinic. Stone, 35, and his husband immediately scheduled appointments online and received their shots last month.

“I want to do everything I can to protect myself and others,” Stone, a marketing consultant in Brooklyn, said, adding that his primary care doctor advised him to get the vaccine as soon as possible.

Hundreds of men who arrived without appointments and queued around the Chelsea Sexual Health Clinic that day were not so fortunate. According to New York City Council member Erik Bottcher, whose district includes the Chelsea neighborhood, the 200 shots available went quickly, and many people were turned away. When people tried to make online appointments for the following days, none were available, he said in a letter to state officials pleading for more vaccine doses.

In mid-May, the first case of monkeypox in the United States was confirmed. As the number of monkeypox cases nationwide reached 605 on July 6, some public health experts detected echoes of COVID-19 in the government’s halting response.

Monkeypox is not a COVID disease. Although COVID has killed over a million Americans, no one has died from monkeypox infection in the United States during the current outbreak. People cannot contract monkeypox simply by entering a room and breathing the same air as an infected person.

The monkeypox virus, which is related to smallpox, causes painful, pimple-like sores on people’s faces, hands, feet, chest, or genitals, as well as fever and swollen lymph nodes. People can infect others through close physical contact or by touching items such as bedding that have been in contact with the rash until the lesions scab over and heal. Monkeypox usually heals within two to four weeks.

So far, the majority of infections have been identified in men who have sex with men, with many of the cases occurring in Europe. However, the World Health Organization reported on July 1 that cases are emerging among other groups, including household members, heterosexual contacts, and children in some cases. According to the WHO, up to 10% of patients have been hospitalized.

Jynneos and ACAM2000 vaccines are available to protect against monkeypox. Federal officials are focusing on providing Jynneos, which is administered in two doses 28 days apart, because it has fewer side effects and can be administered to immunocompromised patients, whereas ACAM2000 cannot. To date, the federal government has distributed over 800 doses of the ACAM2000 vaccine.

At the moment, however, vaccine distribution is barely a trickle, and front-line health care providers say they need more doses right away. In recent days, federal officials announced a three-pronged response to the monkeypox outbreak, including increased vaccine deployment, easier access to testing, and a campaign to educate the public and providers about the disease and promote vaccinations among those most vulnerable, particularly those in the LGBTQ+ community.

Initially, the federal Centers for Disease Control and Prevention advised people to get vaccinated only if they had been exposed to monkeypox. The federal guidelines have been expanded to include men who have sex with men who have recently had multiple sex partners in a location where monkeypox has been reported.

New York City received an initial 1,000 doses from the Chelsea clinic, but then received nothing for nearly two weeks. In Washington, D.C., 300 vaccine appointments were reportedly filled in minutes after they were made available at the end of June. As of July 1, 800 vaccine doses had been distributed in Los Angeles to people who have close contacts with people who have the disease. In a news release, the Los Angeles County Department of Public Health stated that as vaccine supplies increase, it will provide more doses to high-risk groups.

Epidemiologists said that speed bumps in testing for the disease are also hampering the nation’s ability to get in front of the monkeypox outbreak. Without widespread testing and contact tracing, the extent of the outbreak is not clear.