With fresh COVID-19 cases bubbling up in some parts of the country, health officials are setting course for a fall vaccination campaign.

The Centers for Disease Control and Prevention on Thursday recommended new shots for all Americans this fall.

Officials acknowledged the need for shots is not as dire as it was only a few years ago. Most Americans have some degree of immunity from being infected, from past vaccinations or both. COVID-19 deaths and hospitalizations last month were at about their lowest point since the pandemic first hit the United States in 2020.

But immunity wanes, new coronavirus variants keep emerging and there are still hundreds of COVID-19-associated deaths and thousands of hospitalizations reported each week.

What's more, health officials have reported upticks this month in COVID-19-associated emergency room visits and hospitalizations, and a pronounced increase in positive test results in the southwestern U.S.

It's not clear whether that's a sign of a coming summer wave — which has happened before — or just a blip, said Lauren Ancel Meyers of the University of Texas, who leads a research team that tracks COVID-19.

“We'll have to see what happens in the coming weeks," she said.

Earlier this month, the Food and Drug Administration — following the guidance of its own panel of expert advisers — told vaccine manufacturers to target the JN.1 version of the virus. But a week later, the FDA told manufacturers that if they could still switch, a better target might be an offshoot subtype called KP.2.

At a Thursday meeting at the CDC in Atlanta, infectious disease experts unanimously recommended the updated vaccines for Americans age 6 months and older. The CDC director signed off on the recommendation later in the day. The shots are expected to become available in August and September.

Health officials have told Americans to expect a yearly update to COVID-19 vaccines, just like they are recommended to get a new shot each fall to protect against the latest flu strains.

But many Americans aren't heeding the CDC's advice.

As of last month, less than one-quarter of U.S. adults and 14% of children were up to date in their COVID shots. Surveys show shrinking percentages of Americans think COVID-19 is a major health threat to the U.S. population, and indicate that fewer doctors are urging patients to get updated vaccines.

CDC officials on Thursday presented recent survey information in which about 23% of respondents said they would definitely get an updated COVID-19 shot this fall, but 33% said they definitely would not.

Meanwhile, the CDC's Bridge Access Program — which has been paying for shots for uninsured U.S. adults — is expected to shut down in August because of discontinued funding. The program paid for nearly 1.5 million doses from September to last month.

"It is a challenge with this program going away,” said the CDC’s Shannon Stokley.

About 1.2 million U.S. COVID-associated deaths have been reported since early 2020, according to the CDC. The toll was most intense in the winter of 2020-2021, when weekly deaths surpassed 20,000. About 1 out of every 100 Americans ages 75 and older were hospitalized with COVID in the last four years, CDC officials said Thursday.