Thousands of tiny vials of a rare and valuable vaccine are about to be sent to health clinics across Israel for the country's first blitz to control an outbreak of monkeypox.
Despite having recorded only 125 cases of disease, Israeli health authorities have taken the unusual approach of securing 10,000 monkeypox vaccines for its residents.
They have also expressed a desire to get more supplies in the future.
Gal Wagner — an LGBT medical specialist in Tel Aviv — said he had been "flooded with requests" for the vaccine since the World Health Organization (WHO) declared monkeypox a global emergency, the agency's highest level of warning.
"People are afraid of the virus and they really want to protect themselves," Dr Wagner said.
"When we started talking about having vaccination in Israel and the Ministry of Health declared they had bought vaccinations for Israel, we saw many, many patients who were really happy and wanted to get the vaccination right away."
Israel's swift response to monkeypox is the second time in recent years that the nation has mobilised quickly against a health threat.
'There is simply no room for complacency'
Dr Wagner's clinic will be among the first to offer the vaccine to high-risk patients in Israel, including men born after 1980 who have HIV, men on HIV pre-exposure meds or men who have contracted a sexually transmitted disease this year.
Monkeypox — which has been found in more than 70 countries — is not a sexually transmitted disease.
However, this global outbreak has, so far, mostly been detected in the sexual networks of men who have sex with other men.
The WHO has cautioned that no-one should assume the outbreak will remain only within this community.
"There is simply no room for complacency … with its fast-moving outbreak that — with every hour, day and week — is extending its reach into previously unaffected areas," the WHO's regional director for Europe, Hans Henri P Kluge, said.
The WHO said the illness — which belongs to the same family of viruses as smallpox — is spread through close contact with an infected person.
It can also be transmitted through infected particles on items such as bedding or towels.
Those infected with monkeypox usually come down with a fever and body aches before a blistery rash appears on their body.
While it can be quite painful, the vast majority of patients make a full recovery.
Israel wants to be a world leader in fighting infectious diseases
Going hard and fast on vaccination is a technique Israel relied upon when COVID-19 emerged.
Early on in the pandemic, the government cut a deal with Pfizer to get supplies of the vaccine in exchange for giving the pharmaceutical company access to Israeli's personal health data.
When vaccines became widely available in early 2021, the country was credited with having the world's fastest rollout.
It was also the first country in the world to introduce third and fourth vaccine doses.
Sheba Medical Centre researcher Itzchak Levy said the country was trying to position itself as one of the most prepared nations at the start of an emerging problem.
"The most important thing when you fight an infectious disease is to prevent it," Dr Levy said.
"And any disease that you can prevent by vaccination, I think it's a miracle."
Health authorities have hailed Israel's COVID-19 vaccine response a huge success, and credited the approach with the country lifting restrictions before others, including Australia.
Fears that stigma will slow global response
The WHO has voiced concerns that countries will not move quickly enough against monkeypox because of "the stigmatisation of men who have sex with men".
One of the world's largest outbreaks of monkeypox has been in the United States, where LGBTQ activists have voiced frustration with what they feel has been a sluggish and apathetic response.
Earlier this week, Australia's Chief Medical Officer, Paul Kelly, declared the increasing presence of monkeypox in the country a "communicable disease incident of national significance".
The Australian Health Department said it had secured a small supply of monkeypox vaccines for high-risk cases, but didn't specify the number of vaccines.
Australia hasn't announced a rollout of a wider vaccination program.
Israeli LGBT activist George Avni said some people in his community had started changing their behaviour, to protect themselves before the vaccine was available.
"Some people are afraid and concerned about it," he said.
"Some people have stopped going to hook-ups, or to gay saunas or clubs, because they were worried to get infected."
However, Mr Avni said, he was not sure if he was going to get the vaccination at this stage.
"If I have to have decrease my sexual partners for some time, or just going back to condoms, it may decrease the chance that I will get infected," he said.
"So I think I'd rather do that than get vaccinated."
