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Louisiana has stopped asking the federal government for its full allotment of COVID-19 vaccine. About three-quarters of Kansas counties have turned down new shipments of the vaccine at least once over the past month. And in Mississippi, officials asked the federal government to ship vials in smaller packages so they don’t go to waste. As the supply of coronavirus vaccine doses in the U.S. outpaces demand, some places around the country are finding there’s such little interest in the shots, they need to turn down shipments. (Willingham, Hollingsworth and Smith, 4/23)

The pace of vaccinations in California has declined for the first time in weeks, mirroring a national trend that has experts worried about slowing demand for the life-saving vaccine. On average last week, just over 360,000 doses were administered daily across California, an 8% drop from mid-April when the seven-day average peaked at about 391,000 doses, according to data compiled by this news organization. Nationwide, doses have dipped about 11% over the past week. (Kelliher, 4/22)

Officials are shifting their attention to people who have yet to sign up for shots in an effort to reach vaccination levels needed to control the virus. Maryland has launched a “No arms left behind” initiative, with expanded walk-up options, mobile clinics and direct outreach to the elderly and college students. D.C. opened 10 walk-up clinics this week and is organizing a May 1 day of service that will focus on encouraging unvaccinated residents to get the shots. (Fadulu and Portnoy, 4/22)

Having made its way through those who lined up eagerly to get vaccinated for Covid-19, the campaign to inoculate every American is now slowing down with surplus supply and open appointments appearing in pockets nationwide. While 3 million shots a day are being administered, that’s down from a peak of 3.4 million. And only 75% of about 28 million doses being shipped out weekly will be used at the current pace. All of this suggests the vaccine effort is evolving, from the megasites that inoculated thousands a day toward a slower grind designed to reach the half of Americans who haven’t yet received a dose. (LaVito and Armstrong, 4/22)

Although there's a growing sense that normalcy is within reach after the devastating Covid-19 pandemic, experts are continuing to push for more vaccinations -- particularly as new research details the long-term consequences for those who are diagnosed with the virus. In what the authors say is the largest study to date of the long-term impact, researchers from Washington University in St. Louis found that people who had Covid-19 seem to face a much greater risk of death and need more medical care in the six months after their diagnosis, even if they had a milder form of the disease. "We have to think about the burgeoning health crisis this is going to cause for years to come," CNN Chief Medical Correspondent Dr. Sanjay Gupta told Anderson Cooper on Thursday. (Holcombe, 4/23)

Holly Elgison and Len Schillaci are a mixed vaxxed couple, and they are far from alone. “I was always going to get the vaccine, 100 percent,” said Ms. Elgison, a medical claims auditor in Valrico, Fla. Her husband, a disaster insurance adjuster, said he will pass. “To be honest with you, I think that the worst of Covid is behind us,” Mr. Schillaci said. “I’m good.” As the Biden administration seeks to get 80 percent of adult Americans immunized by summer, the continuing reluctance of men to get a shot could impede that goal. (Steinhauer, 4/22)

The thrust of a new campaign to persuade mostly white born-again and evangelical Christians who have been unwilling to get Covid-19 vaccinations is a variation on the Golden Rule — do it for others if you won't do it for yourself. And the main driver behind the Christians and the Vaccine project backs up his contention that that is what Jesus would do by both citing the Bible and tapping the expertise of secular public health experts like Dr. Francis Collins, who heads the National Institutes of Health. (Siemaszko, 4/23)

Cigna on Thursday joined other major corporations looking to coax workers into getting the COVID-19 vaccine by offering its roughly 65,000 U.S. employees $200 each and paid time off to get the shots. Fully vaccinated workers will get $200 in their health-spending accounts, along with emergency PTO to get vaccinated, according to the health insurance company, which is not requiring employees to get immunized. (Gibson, 4/22)

Four out of five Houston Methodist employees are vaccinated against COVID-19. The sliver who are not will be suspended or fired if they refuse the shot, according to company policy. The hospital required managers to be vaccinated by April 15 and all other employees — about 26,000 workers in total — by June 7, said Stefanie Asin, a Houston Methodist spokesperson. With 84 percent of the staff vaccinated, the hospital is close to herd immunity, CEO Marc Boom wrote in a letter to employees this month. (Wu and Garcia, 4/22)

The University of California and California State University announced Thursday that they will require COVID-19 vaccinations for all students, faculty and staff on campus properties this fall once the Food and Drug Administration gives formal approval to the vaccines and supplies are sufficiently available. The directive is the largest of its kind in U.S. higher education, affecting more than 1 million members of the two public university systems. More than five dozen colleges nationwide have already announced they will require vaccination for enrollment this fall, including Yale, Princeton, Columbia and, in Claremont, Pomona and Claremont McKenna. (Agrawal, Watanabe and Shalby, 4/22)