| The number of people getting their first dose of a Covid-19 vaccine is declining in at least 47 of 50 U.S. states. Many have made significant progress rolling out the shots, but other states are still far behind. In some places, the decline is the mark of a successful campaign. Ten states have started vaccinations for more than half their residents. But in places that have struggled, the slide has been going on for weeks. In some of those states, the number of new recipients has turned into a trickle. There is one consistent message, though, whether states had made good progress or were still short: Everyone who was enthusiastic about getting a shot has already gotten one. The confluence of trends leaves the U.S. campaign at a crossroads. Enough people have been vaccinated to cover more than half the adult population. Covid cases are on the wane, likely beaten back by the combination of vaccines and existing immunity from previous infections. Warm weather is letting people socialize outside, where risks are lower.  A mass-vaccination site in Eagan, Minnesota. Photographer: Anthony Souffle/Star Tribune/AP But it will take weeks or months to know whether the gains are real and permanent, or whether the inoculation effort will fall just short enough to see new pockets or widespread infection break back out. In response, health officials are beginning to change tactics. Some are trying incentives: New Jersey is offering a free beer at local breweries after people get vaccinated. Maryland is giving state workers $100 if they get the shot. Illinois hopes to lure people with free target practice at a shooting range. Others are loosening up guidance on wasted doses. Early on, the message to health workers giving vaccines was not to waste a dose at any cost. Now, with supply more plentiful, officials are telling them that if the price of vaccinating people is a few unused doses in a vial at the end of the day, to do it. Others are hoping for single-dose packaging for vaccines, so they can be distributed to people's primary-care providers. One lingering question is how big of an impact there was from the safety-related pause of Johnson & Johnson's vaccine, after rare reports of dangerous blood clots. There's a correlation between the downturn in new doses and the J&J warning. But other states were already in decline before the warning. In the weeks ahead, the slowdown is likely to moderate as the vaccine campaign enters the long tail of getting doses to the parts of the country that didn't participate in the mass-vaccination part of the rollout. The big question is whether that long tail will be long enough to finish the job.—Drew Armstrong | 
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