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Vermont is also one of 14 states that have seen an increase of about 10% or more in hospital admissions over the last week, the ABC News analysis found. About two-thirds of hospitalized COVID-19 patients in Vermont are unvaccinated, with those in the intensive care unit also largely unvaccinated, state officials said this week. COVID-19 patients make up between 10-15% of ICU patients; if that number increases to around 25%, \"then the system could be in jeopardy,\" Levine said.

Regarding the recent case surge, Vermont may also be a \"victim of our success,\" Levine said Tuesday, pointing to a lack of natural COVID-19 immunity among unvaccinated residents \"because we kept the virus at such low levels throughout the entire pandemic.\" Vermont has one of the lowest levels nationwide of people who have developed natural immunity to the virus, CDC data shows.

By the same token, waning immunity among residents who were \"efficiently and effectively\" vaccinated early on is also likely contributing to rising cases, Levine said. Breakthrough cases among vaccinated residents are up 31% over the past week, according to state data.

The COVID-19 vaccines have proven to be highly effective at preventing serious illness, hospitalization and death. No vaccine is 100% effective, and the waning immunity among residents, especially those who may not have mounted a robust immune response, may be tested by high community spread, experts say.

\"You still have pockets of unvaccinated people, even in a highly vaccinated state,\" said Dr. John Brownstein, an epidemiologist at Boston Children's Hospital and ABC News contributor. \"Unvaccinated individuals are the primary host by which the virus will spread and continue to allow for transmission to take place in the community and ultimately create challenges for those that are vaccinated.\"

Changes in behavior, including more travel and indoor gatherings, and Halloween festivities have also helped fuel the surge, state officials said. At Saint Michael's College in Colchester, Halloween parties were blamed for causing an outbreak on campus that led school officials to briefly move classes online and suspend in-person social gatherings through Thanksgiving. Post-Halloween, 87 students have tested positive for the virus, compared to just 11 between Aug. 27 and Oct. 22, according to school data.

\"We were doing really well as a community up to the point where there were numerous Halloween parties where students were unmasked and in close contact,\" the college's president, Lorraine Sterritt, said in a letter to students earlier this week.

Statewide, COVID-19 cases are not expected to decrease over the next four weeks, state modeling shows, as hospitalizations are on the rise. Vermont has among the lowest COVID-19 hospitalization rates in the country \"thanks to vaccines doing their jobs,\" Gov. Phil Scott told reporters Tuesday. But ICU capacity is the \"biggest concern at this point\" as hospitals are currently \"under stress from an increase in patient care for health issues that are not related to COVID,\" he said.

Health officials are stressing vaccination and urging residents to get booster shots and vaccinate newly eligible children. Nearly 50% of Vermonters aged 65 and older have gotten a booster dose, while over 30% of children between the ages of 5 and 11 have made an appointment to get vaccinated or already started the process, state officials said Tuesday.

Reaching the remaining unvaccinated adults will also be key, Carney said.

\"If there are people who have not yet decided to get vaccinated, I strongly urge them to talk to whoever they seek for their health care and have a conversation,\" she said. \"Vaccinating as many people as we can who are eligible for the vaccine will help us -- in the short-term and in the long-term.\"

\"PHOTO:
Ed Jones/AFP via Getty Images
PHOTO: An employee receives a vaccination against Covid-19 from a National Guard soldier at a pop-up vaccination stand at the Vermont Creamery in Websterville, Vt., June 29, 2021.
>

Maintaining high levels of testing will also help, Brownstein said. \"Testing is such an important way for us to identify those who have been exposed and infected and to limit transmission,\" he said.

Scott said he isn't reissuing a mask mandate amid the increase in cases, saying he feels it would be an \"abuse of power,\" but encouraged residents to \"take a few extra precautions,\" including wearing masks indoors while in public and getting tested before gatherings.

\"If we make smart decisions in the coming weeks, and make an extra effort to protect the vulnerable, we can help reduce hospitalizations,\" Scott said. \"But it takes all of us committing to these smart, practical choices, starting with getting vaccinated.\"

\"None of us wants to step backwards,\" he added.

ABC News' Arielle Mitropoulos contributed to this report.

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