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.
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.
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.
And with COVID-19 cases, hospitalizations and deaths subsiding across the U.S., people who are against getting vaccinated don't see much reason to change their minds.
"People are just over it. They're tired of it," said Judy Smith, administrator for a 12-county public health district in northwestern Alabama.
The bottoming-out of demand for the first round of vaccinations is especially evident in conservative areas around the country.
On most days in Idaho, the number of people statewide getting their first shot rarely surpasses 500.
In Wyoming, a total of about 280 people statewide got their first shot in the past week, and the waiting area at the Cheyenne-Laramie County Health Department stood empty Tuesday morning. The head of the department fondly recalled just a few months ago, when the lobby was bustling on Friday afternoons after school with children getting their doses. But they aren't showing up anymore either.
"People heard more stories about, well, the omicron's not that bad," Executive Director Kathy Emmons said. "I think a lot of people just kind of rolled the dice and decided, 'Well, if it's not that bad, I'm just going to kind of wait it out and see what happens.'"
Marion County, along the Mississippi line, is part of a band of Alabama counties where most people aren't fully vaccinated more than a year after shots were rolled out. Just to the east, Winston County has the state's lowest share of fully vaccinated residents, at 26%, according to the Centers for Disease Control and Prevention. About 42% are fully immunized in Marion County.