For many, a nationwide return to normalcy from the Covid-19 pandemic is expected to accelerate into the summer as more businesses and state governments prepare for a large-scale reopening. Sports stadiums are filling up, mask mandates are being shed, and travel and tourism industries anticipate a rebound with cruise lines planning for passengers once again.
Health officials have pointed out, however, that such successes are largely contingent on getting the US fully vaccinated as quickly as possible. And right now, the rate of vaccination is slowing.
The average daily pace of coronavirus vaccinations is down almost 50% from its April peak, according to US Centers for Disease Control and Prevention data published Thursday.
Over the past week, about 1.8 million vaccine doses have been administered each day, a 46% drop from the peak rate of nearly 3.4 million per day in mid-April.
One expert told CNN that the health community is worried about what lies ahead. Clusters of unvaccinated people may become infected with Covid-19 as they move indoors to beat the summer heat, particularly in the South, noting that a similar situation happened last year.
"If we have large numbers of unvaccinated people in those states, we may very well see a surge in those states, so I think a lot of us are worried about that," Dr. Ashish Jha, dean of the Brown University School of Public Health, told CNN's Chris Cuomo on Thursday.
Roughly 48% of Americans of all ages have received at least one dose of vaccine and 38% are fully vaccinated, according to the latest data from the CDC. The country is closing in on half of those ages 18 and up being fully vaccinated.
Yet the rate of inoculations nationwide is uneven, with some states far outpacing others.
The eight states with the fewest vaccine doses administered per capita are Mississippi, Alabama, Louisiana, Arkansas, Wyoming, Idaho, Georgia and Tennessee, according to the CDC.
The states with the most administered per capita are Vermont, Massachusetts, Connecticut, Hawaii, Maine, Rhode Island, New Mexico and New Jersey. Washington, DC has a rate of vaccination that would qualify in the top eight if it were a state, according to the CDC.
Good news continues to emerge from places ahead of the national vaccination average. For the first time since March 2020, there are no Covid-19 patients at San Francisco General Hospital, the largest primary care facility in the city, hospital spokesperson Cristina Padilla told CNN.
San Francisco celebrated its one millionth dose of the vaccine this week. As of May 19, 76% of the eligible San Francisco population has been vaccinated, according to the city's department of public health.
"There is no doubt we still have a long road of recovery ahead, and we will tackle each phase with the same dedication and care that we always do," Padilla said.
How some states are fighting vaccine hesitancy
The importance of getting vaccinated was demonstrated in additional CDC data, which showed less than 1,400 hospitalized or fatal Covid-19 cases in fully vaccinated people as of May 10, a miniscule percentage given 115 million people at that time had completed their vaccinations. Only 223 of the severe breakthrough cases were fatal, the CDC said.
With the successes seen in high-vaccinated areas as well as the efficacy of the vaccines, states are pulling out all the stops to get more people on board.
The Washington State Department of Health announced Thursday that two of its four Covid-19 mass vaccination sites will close on May 28 and that the focus will be on mobile vaccine clinics for greater outreach.
"This transition isn't closing a door to vaccine opportunity but opening several new ones that will allow for more equitable vaccine access in the future," Washington Secretary of Health Dr. Umair Shah said in a statement.
Other states are offering potential financial windfalls in the form of a lottery.
New Yorkers who get vaccinated next week from Monday to Friday will be given a lottery ticket with a chance to win as much as $5 million, said Gov. Andrew Cuomo, who described declining vaccination rates as "troubling news."
Starting on Tuesday, the Maryland Lottery will randomly select a vaccinated Marylander for a $40,000 prize every single day, Gov. Larry Hogan announced.
Those states are following Ohio's example. Gov. Mike DeWine last week was the first state leader to announce lottery drawings in a bid to get more people inoculated, and vaccination rates have since picked up, the Ohio Department of Health said on Thursday.
Ohio will hold five drawings with a prize of $1 million each for people 18 and older, and will hold five drawings for full college scholarships for people under the age of 18 who are vaccinated.
A give-and-take with masks at school
The relaxations of restrictions continued this week, yet the reaction has varied regarding rules for schools.
Rhode Island, with one of the highest rates of vaccinations per capita, announced many reopening measures effective Friday.
"The number of Rhode Islanders fully vaccinated and those with at least one dose -- more than 400,000 Rhode Islanders -- puts the Ocean State in a strong position to reopen safely on May 21, a week earlier than originally planned," Gov. Dan McKee said. Mask requirements at schools and youth sports, however, remained intact and subject to change at a later date.
In Florida's Miami-Dade County, a decision to relax outdoor masking rules for the rest of the school year was subsequently paused after backlash from the teachers' union, which claimed that any changes needed to be agreed upon by them first.
Dr. Jha told CNN's Cuomo on Thursday that masks are an excellent way to get unvaccinated children back in school buildings, and questioned the latest decisions this week by those in places such as Texas and Iowa that prohibited mask mandates on school grounds.
"Kids thankfully don't get as sick as adults, but kids do get sick. We've seen a lot of hospitalizations and unfortunately even a few deaths in kids from this disease," Jha said.
"We are in the middle of the worst pandemic in a century. We actually have a ticket out," he said. The answer was getting people vaccinated and wearing a mask indoors if you're not vaccinated, he said.
"Let's move on with our lives. And the fact that we're fighting these things is incredibly frustrating, because we're fighting ourselves, not just the virus anymore," Jha said.
Differing expectations for booster timeline
Meanwhile, to combat the threat of variants as well as the general decrease in one's immunity over time, booster shots may be required in the future. But experts are split on if and when that will happen.
In the US, people should prepare to have a booster shot within a year, US Surgeon General Dr. Vivek Murthy said Thursday.
"We have to see how long the protection lasts. We know it lasts at least six months," Murthy told CNN's Wolf Blitzer, adding that the most important thing right now is for people to get vaccinated and help those around them do the same.
"I really believe that this is our time to rise again, and we're going to do that by getting vaccinated, protecting ourselves and stepping up to protect one another," Murthy said.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Thursday the timeline for needing a booster shot is currently unclear.
"We're preparing for the eventuality that we might need boosters, but I think we've got to be careful not to let the people know that inevitably, X number of months from now, everyone's going to need a booster. That's just not the case," Fauci said to The Washington Post at a live event. "We may not need it for quite a while."