The number of suspected monkeypox cases in New York City ballooned again Monday to 48, a 60% increase in just four days as health officials scramble to shore up a vaccine that appears woefully equipped at this point to accommodate demand.

The health department announced the latest case count in a Monday tweet that was notably bereft of reference to new appointments opening up at the lone Manhattan clinic the city has prepared to offer the monkeypox vaccine. New York City began offering vaccination against monkeypox Thursday to at-risk groups, with the outbreak primarily linked at this point to men having sex with men, according to officials, but demand was so high walk-ins were closed within hours.

After once again running out of vaccines over the weekend, the city’s health department said it was in continued talks with the Centers for Disease Control to get more inoculations. The amount and timeline were not clear, however. “This is yet another example of a public health failure. And consider what we just went through with COVID-19, we should be much more preapred,” said NYC Council Member Erik Bottcher, one of the local leaders who say that the CDC is failing the city and its comparatively larger LGTBQ population.

Read more at NBC News