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(INDIANAPOLIS) – Indiana COVID vaccinations are at their lowest level since the first week the vaccine was available.

Indiana peaked at 56,000 vaccinations a day in mid-April, two weeks after the state made anyone 16 or older eligible for the vaccine. Even the final expansion a month later to kids 12 and up didn’t boost vaccinations much.

There have been slight increases since, when the Delta variant became the dominant strain and when the FDA replaced the Pfizer vaccine’s emergency authorization with full approval, but the trend has been steadily downward. The state is now averaging fewer than 5,800 shots a day, barely a tenth of the April peak. The last time vaccinations were that low was before Christmas, when the vaccine was available only to health care workers and first responders.

Even a growing number of employers requiring the vaccine hasn’t moved the numbers. Community Health Network chief medical officer Ram Yeleti notes the vaccine still isn’t mandatory for thousands of workers. And even where it is, if two-thirds of the workforce is already vaccinated, requiring the vaccine doesn’t gain much ground toward the state and national goal of 70% vaccination. While there are still some new vaccinations, he says most people who want the vaccine have probably gotten it by now.

56% of eligible Hoosiers are vaccinated, with kids under 12 still not eligible. Yeleti says the point of the 70% target isn’t so-called “herd immunity” so much as erecting a barrier against the next mutation. He notes the Delta variant provided a vivid illustration this summer, when infections and hospitalizations were near all-time lows before Delta supercharged the virus again. The more people are vaccinated, Yeleti says, the fewer hosts are available for the virus to do its R&D work on new, more dangerous mutations.

Yeleti says he’d prefer to see a broad vaccine requirement. He acknowledges a vaccine mandate is controversial, with people arguing vaccination should remain their personal choice. He argues that’s offset by the strain being placed on hospitals, where 90-percent of patients admitted for COVID are unvaccinated. Yeleti says that’s denying space for people with other ailments. And he says the unrelenting flood of patients also threatens to drive up health costs.