Black men are less likely to receive the vaccine than other groups, according to new data released by New York City.

Black New Yorkers, who make up 31 percent of the population, received only 12 percent of the doses so far.

Hispanic residents were more likely to receive vaccine They made up 16 percent of the population that was at risk. The majority of monkeypox patients are Hispanic men.

Some people with better access to the health care system have a better chance of getting a vaccine than others. A new method of administering the vaccines favored by the federal government, which uses only a fraction of the current dose, may inadvertently deepen the disparity.

More people in New York City have been shot for monkeypox than anywhere else. Of the 130,000 people it deems most at risk, 64,000 have gotten the first dose. According to a 2020 city health survey, 134,000 men who have sex with men are at higher risk of getting an STD.

Public health experts and activists are frustrated that lessons from the Covid-19 response aren't being learned. Black and Hispanic New Yorkers were more likely to be hospitalized and die from Covid than whites were. They were less likely to get vaccinations early on and less likely to get early treatments.

The appointments for the monkeypox vaccine were doled out on a first-come, first-served basis, just as they were in the early stages of the Covid vaccine drive. Public health experts say that because vaccine recipients are more likely to have flexible schedules, they are more likely to be able to find a vaccine appointment in less time.

Matthew Rose, a Black H.I.V. and social said, "We went back to vaccine cattle calls, even though we know that if we do broad-based, top- down, no-nuance messaging, it is not going to reach everyone who needs it." This was something that was going to happen. We have done the same play before.

The first batches of vaccines were given to a mostly white crowd at a sexual health clinic in Manhattan. The internet appointment system was used to offer later vaccine offerings.

The people who came to the clinic were mostly white. The decision to exclude neighborhood residents from getting shots was criticized by community members who felt excluded. Some black men say the city didn't do enough to warn them about the disease.

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Monkeypox is what it is. The symptoms of monkeypox are not as severe as those ofpox. There was an outbreak in monkeys kept for research. Most of the people who have sex with men who have the virus are from Central and West Africa.

What does it do? The monkeypox virus can be spread by coughing or sneezing, or by touching items that have previously touched the rash, or by touching items that have not touched the rash. During and after birth, monkeypox can be transmitted from the mother to the fetus.

I'm afraid I might have a disease. I don't know what to do. You can't test for monkeypox if you only have flu symptoms. You can get a monkeypox test from an urgent care center or your primary care doctor. If you have to come in contact with other people for medical care, you should be isolated at home.

I live in the city. Is it possible to get the vaccine? Adult men who have sex with men and have had multiple sexual partners in the last 14 days are eligible for a vaccine in New York City. People with conditions that weaken the immune system or have a history of allergies are encouraged to get the vaccine. There is a website that people can use to book an appointment.

Dominic Faison, 35, a Bronx resident who got monkeypox in early July, said that the information should have been promoted more to black and brown people.

In recent weeks, the city health department has shifted tactics and given priority to high-risk patients. The effort hasn't fully corrected the problem. Jynneos is a vaccine that is administered in two courses.

The city health commissioner said that black men are underrepresented in the vaccine effort.

Dr. Vasan thinks that we need to advance equity. There are sometimes trade offs in terms of speed and our ability to go deep, build relationships, and get the people who need it most access to immunization.

There are indications that the spread of monkeypox is slowing. Between 60 and 70 new cases of monkeypox were reported per day by the end of July. They have fallen to an average of 54 cases per day in the last few months.

Many cases are not being reported in communities of color with less access to health care, which is a concern for city health officials.

According to federal data, about 20 percent of the nation's cases were in New York City.

The data that have been released about recipients reveal worrying trends.

In North Carolina, 70 percent of monkeypox cases have been in Black men and 19 percent in white men, but 24 percent of vaccines have gone to Black recipients, and 67 percent to white recipients, according to an August report from the North Carolina Department of Health. The focus of national vaccine campaigns has been on men who have sex with men because of the spread of the virus.

Black people make up just 17 percent of the 233 patients who received Tpoxx, though they make up 26 percent of the total number of patients.

The federal government has more than 1.7 million courses of Tpoxx, but it's not easy to get it.

ImageA line of men wait to preregister for monkeypox vaccinations in Chelsea. Public health experts and activists were dismayed that appointments for the monkeypox vaccine have been doled out largely on a first-come, first-serve basis.
A line of men wait to preregister for monkeypox vaccinations in Chelsea. Public health experts and activists were dismayed that appointments for the monkeypox vaccine have been doled out largely on a first-come, first-serve basis.Credit...Hiram Durán for The New York Times
A line of men wait to preregister for monkeypox vaccinations in Chelsea. Public health experts and activists were dismayed that appointments for the monkeypox vaccine have been doled out largely on a first-come, first-serve basis.

The vaccine Jynneos has been hard to get since the start of the outbreak. A new way of administering the vaccine has been approved by the federal government to increase the supply. The vaccine can be administered between layers of skin instead of under the skin.

The strategy allows federal officials to say that they have solved the vaccine supply problem and now have enough vaccine to cover all 1.6 million people.

The gay community is worried that the new strategy may compound the equity problem.

The vaccine can be effective. One study looked at the safety and efficacy of the vaccine. There was a greater chance of side effects at the site of the injection, such as redness, swelling and firmness, even though the manufacturer didn't note significant safety concerns.

Training is required to switch over to fractional doses. Most providers don't know how to give shots under the skin. The fractional dose won't be as effective if it's given too deep. The need for training may make it hard for marginalized groups to get small community clinics.

The city's health commissioner said that New York and other localities were under pressure from the federal government to switch to the new method quickly, but the city planned to implement the change gradually. The White House's announcement that the next phase of vaccine distribution will only be given to jurisdictions that adopt the new approach intensified the pressure.

He said that every jurisdiction felt like it was a fast switch. The time is needed to do this right. I don't want to do something that the community won't accept.

Gay rights advocates have been talking with city and state health officials about a hybrid plan that would give everyone a full dose of the vaccine and then give them a second dose.

Doctors could collect data on side effects and effectiveness during a pilot stage if the city and state agree to the idea. All options were on the table.

Joseph Osmundson, a researcher at New York University, said he was concerned that the federal government's approach would push jurisdictions to move quickly even if they have concerns. Health advocates said it might be hard to sell Black men on the new approach, which could make them skeptical.

Many Black New Yorkers distrust the medical establishment due to a long history of racism in medicine and past medical experimentation on Black people.

"Now that a critical mass of white gay men in the biggest U.S. cities have been able to get a whole dose, they just need to do something to us."

He said that it would undermine the point of having to shift to this strategy if a large amount of people felt that way.