evidence: An illuminating example of the difficulties of the current national stockpile model is the response to the 2022 outbreak of mpox (formerly known as monkeypox), a viral disease that produces skin lesions and is related to the smallpox virus. In May 2022, the Biden administration stated that vaccines for smallpox were effective against mpox and available for deployment, if necessary.9 The 2 available vaccines effective against mpox in the SNS were JYNNEOS® and ACAM2000® (a third, unapproved vaccine, Aventis Pasteur Smallpox Vaccine, was also available in the event of a declared emergency if no doses of ACAM2000 were available). However, only JYNNEOS was US Food and Drug Administration (FDA) approved for mpox. ACAM2000 was not approved for mpox due to its more severe side effects, including pain, redness, and even myopericarditis and contraindications in infants and pregnant persons, but it was available via compassionate use programs.10,11 The SNS had large stores of ACAM2000, but not JYNNEOS. [...] HHS orders 2.5 million more doses of JYNNEOS vaccine for monkeypox preparedness. News release. US Department of Health and Human Services; July 1 , 2022. Accessed March 3, 2022. https://www.hhs.gov/about/news/2022/07/01/hhs-orders-2-point-5-million-more-doses-jynneos-vaccine-for-monkeypox-preparedness.html 14. J. How the US let 20 million doses of monkeypox vaccine expire. New York Times. August 1 , 2022. Accessed September 25, 2023. https://www.nytimes.com/2022/08/01/nyregion/monkeypox-vaccine-jynneos-us.html#:~:text=At%20several%20points%20federal%20officials,its%20three%2Dyear%20shelf%20life.Google Scholar 15.