About 76% of the U.S. population has received at least one shot. Less than 65% of all Americans are fully vaccinated. Vaccination incentive programs that gave away cash, sports tickets, beer and other prizes have largely gone away. Government and employer vaccine mandates have faced court challenges and may have gone as far as they ever will.

A handwritten log kept by nurses tells the story of the losing battle to get more people vaccinated against COVID-19 in this corner of Alabama: Just 14 people showed up at the Marion County Health Department for their initial shot during the first six weeks of the year, AP reports.

That was true even as hospitals in and around the county of roughly 30,000 people filled with virus patients and the death toll climbed. On many days, no one got a first shot at all, while a Mexican restaurant up the street, Los Amigos, was full of unmasked diners at lunchtime.

The vaccination drive in the U.S. is grinding to a halt, and demand has all but collapsed in places like this deeply conservative manufacturing town where many weren’t interested in the shots to begin with.

The average number of Americans getting their first shot is down to about 90,000 a day, the lowest point since the first few days of the U.S. vaccination campaign, in December 2020. And hopes of any substantial improvement in the immediate future have largely evaporated.

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