For a population still suffering through the coronavirus pandemic and with lasting memories of HIV/AIDS, the monkeypox outbreak is triggering memories of a U.S. government unable to respond quickly to the emergence of a new disease — and many who see mistakes being repeated are giving lackluster and even negative reviews of the Biden administration’s handling of the issue.

Criticism has emerged from voices in the LGBTQ community, where monkeypox has primarily spread, especially among gay and bisexual men, as well as among public health experts amid the perception the Biden administration has fallen short in vaccine distribution as only two cities — New York and D.C. — are offering vaccines on a pre-emptive basis and immediate distribution is halted despite reports that 1 million vaccines are in reserve overseas.

Lindsey Dawson, associate director of HIV Policy and director of LGBTQ Health Policy for the Kaiser Family Foundation, acknowledged Monday in an interview with the Blade there’s “certainly been criticism the administration was slow to act” in the past six weeks, although she tempered her remarks in hopes the Biden administration would ramp up efforts in time to curb the virus.

“The amount of vaccinations available right now, it’s really quite limited,” Dawson said. “As of last week, about 40,000 vaccines have either been shipped out or are being processed for allocation to jurisdictions. That isn’t nationwide; that was for about 15 jurisdictions, and the supplies that we’re getting are fairly limited. And so, that means that only in certain places, will there be vaccinations available.”

Dawson added the Centers for Disease Control & Prevention has promoted vaccines as a kind of post-exposure prophylactic for those who think they may have been exposed to monkeypox, stopping short of guidance making vaccines more generally recommended for populations that may be at risk, such as gay and bisexual men. New York City and D.C. are two jurisdictions that are giving vaccines out on a more general basis.

The Biden administration late last month unveiled a multi-step plan to take on monkeypox, which included the distribution of 296,000 vaccine doses with plans to distribute at total of 1.6 million in the coming months, which is enough to vaccinate 800,000 people because they are a two-dose series. Although HHS announced the purchase of an additional 2.5 million vaccines, the timeline completing the distribution isn’t until 2023 — which critics say is far too late for a disease already beginning to spread.

One prominent point of contention is the failure to distribute 1 million doses of monkeypox vaccine owned by the United States and in freezer storage at a Bavarian Nordic facility in Denmark, according to a June 28 letter to the White House from PrEP4All and Partners in Health. The medication has yet to be deployed fully despite concerns about the spread of monkeypox, which is transferred by skin-to-skin contact. The reason for the delay is the Food & Drug Administration dropped the ball and failed to conduct a timely review of vaccines and refuses to distribute the agency’s counterpart the European Union has approved, the letter says.

Josh Barro, a gay political commentator and journalist, called the failure of the U.S. government to distribute the vaccines “absolute insanity” and more evidence of failure by the FDA to meet speedy deadlines in approvals.

“Literally we have bought these doses already and they’re sitting in a freezer in Denmark until some bureaucrats decide to allow them into the US,” Barro wrote.

The FDA, CDC and FDA didn’t respond Wednesday to the Blade’s request to comment on the slow rollout of vaccines and the 1 million doses reportedly in storage in Denmark.

Evidence of the Biden administration falling short on monkeypox is already leading observers to make comparisons to HIV/AIDS and the coronavirus, when the U.S. government was criticized for inaction. President Trump was accused of dropping the ball on coronavirus with delays in testing and erratic messaging — as well as even lying to the American public about its seriousness — as President Biden  faced early criticism for a vaccine-only approach and failing to make good on campaign promises to shut down the virus. During the HIV epidemic in 1980s, activists with the grassroots group ACT UP held die-in protests at government offices and the Food & Drug Administration because the U.S. government was too slow in approving and distributing potential treatments.

Dawson said COVID is different from monkeypox for many reasons, but lessons could be applied to the new outbreak in terms of messaging, testing, and vaccine distribution based on COVID demonstrating “how challenges with mounting a quick response and COVID likely impacted transmissions.”

“And certainly it took a while for vaccinations to be widely available at COVID,” Dawson said, “And so, I think the important lesson there with all infectious diseases be that COVID or monkeypox is that getting out in front of an outbreak and preventing future transmission is essential.”

To be sure, the monkeypox outbreak isn’t nearly on the scale of the HIV/AIDS or COVID-19 pandemic, which have spread far and wide and claimed millions of lives. According to the Centers for Disease Control, the total number of recorded monkeypox infections in the United States as of two days ago is 767. Anthony Fauci, director of the National Institute of Allergy & Infectious Diseases, told the Blade in a conference call with reporters last month the risk of gay and bisexual men contracting monkeypox is not high, but the numbers could increase. Monkeypox generally isn’t a fatal disease.

The LGBTQ watchdog group GLAAD, which has strong connections to both media and entertainment, has teamed up with the White House in its messaging on monkeypox, with a heavy emphasis on LGBTQ influencers and a closed press meeting on Wednesday. The White House didn’t respond to the Blade’s request to comment for additional information.

Sarah Kate Ellis, CEO of GLAAD, said in a statement to the Blade the initiative would supplement ongoing efforts to combat monkeypox taken by the.Biden administration and public health officials.

“Getting accurate information out about monkeypox virus (MPV) is critically important to the LGBTQ community and all communities, and we need to continue to hear from public health leaders about what’s being done to combat the virus and inform the public,” Ellis said. “GLAAD is helping convene those who can help get the word out about this threat to public health and to ensure accurate and respectful reporting to keep everyone safe. Media must continue to hold public health officials accountable to accurate data gathering, testing, treatment, and vaccine distribution to stop the spread of MPV.”

Elsewhere, localities are stepping up efforts to implore the Biden administration to do more on monkeypox as vaccines remain in limited supply for reserved for distribution in certain jurisdictions.

In San Francisco, District 8 Supervisor Rafael Mandelman announced Tuesday his introduction of a resolution urging the Department of Health & Human Services and the Centers for Disease Control & Prevention to accelerate efforts on monkeypox vaccines, calling for a vaccine prioritization plan and streamlined testing as well as enough vaccine doses for high-risk populations, including gay and bisexual men, transgender people, and sex workers.

“This should be a preventable public health crisis – unlike COVID-19, we did not have to wait for new vaccines to be developed,” Mandelman wrote on Twitter. “It begs the question: would monkeypox have received a better response if it wasn’t primarily affecting queer people?”

Equity concerns for a population sensitive to racial disparities are also at the top of list among observers and public health experts with experience in health outreach to LGBTQ patients, especially in the aftermath of the coronavirus pandemic having a disproportionate impact on Black people.

Dawson expressed concern about localities like New York and D.C. focusing its messaging on monkeypox through social media, which she said may not be visible to workers unable to access it during the day.

“To the extent that vaccination and testing are difficult and burdensome to people, they’re going to be less likely to take it up,” Dawson said. “And people who do take it up are probably people who have more privilege, right? They can take time off work, or they are aware of these slots opening up because they’ve seen that on social media and they’re on social media in the middle of their workday, and so it does raise potential equity challenges there.”

In New York City, despite being a locality deemed a priority spot for monkeypox vaccines, officials are also demanding a better response. Lynn Schulman, a city council member, spearheaded a letter to the CDC with the LGBTQIA+ caucus declaring efforts on monkeypox to have fallen short.

“The biggest concern is the lack of vaccines,” the letter says. “New York City has recently received additional doses of vaccine from the federal government, but vaccine supplies remain low. Currently, if an individual would like to get vaccinated, DOHMH has no appointments available. At a time when we are still dealing with COVID infections, this is unacceptable.”

Dawson said to make a more comprehensive assessment of the Biden’s administration’s approach to monkeypox she’ll observe the pace at which vaccines become more readily available to the public.

“We see those appointments open up and shut down again just minutes later because the demand is just outpacing the availability,” Dawson said. “So it’ll be really important to watch. How likely are vaccines to get get to jurisdictions … Right now, certainly demand is outpacing the vaccinations available, but we could get to a point where we are with COVID vaccines now, where work actually has to be done to encourage uptake of vaccinations.”

CORRECTION: An earlier version of this article misattributed a quote about local governments to the Biden administration. The Blade regrets the error.