COVID-19 cases in New Jersey are rising again, and Governor Phil Murphy is urging residents to continue wearing masks and social distance while the state ramps up its vaccination efforts.

Over the last week, the state has averaged about 4,100 cases a day, a trend that some public health experts say could be an early sign of a coming third wave.

“If there's a sustained 7- and 14-day trends of case increases and a commensurate increase in positivity rate, you're pretty much in another wave,” said Shereef Elnahal, CEO of University Hospital in Newark. New Jersey currently leads in the nation in case rate, with more than 47 per 100,000 residents.

Dr. Elnahal said his hospital saw a 25% increase in COVID-19 hospitalizations over the last week. None of the patients had been vaccinated, and most were Latino—a group that leads the state in per capita cases, hospitalizations and deaths. Statewide, hospitalizations are also inching upward. For the first time in a month, total hospitalizations are hovering above 2,000 and climbing with 300 admissions per day.

“There is definitely a collective mindset that we have already crossed the finish line or [are] very near crossing the finish line. And unfortunately, that's not the case,” he said. While New York City sits next door to New Jersey, with a similar-sized population and a daily caseload plateauing around 3,400, it is only experiencing about 150 hospitalizations per day, and this number is shrinking. . This rate and the pace of COVID deaths in the Big Apple continue to decline, though some elected officials and public health experts worry the variants may stymie this progress as businesses reopen in April.

Read More: As New COVID Variants Spread, Concerned NYC Officials Call For A Pause On Reopening

The difference may be due to vaccine disparities. About 14% of the state’s 8.8 million residents have been fully vaccinated in New Jersey, and more than 3.6 million doses have been administered. But Black and Latino residents in the state are getting inoculated at much lower rates—5% and 7%, respectively—compared to white residents. Latinos make up about 21% of the population and Black residents about 15%.

New Jersey’s vaccine disparities are more pronounced than in New York, where 12% of the vaccines have gone to Hispanic residents who make up 18% of the population and 10% have gone to African American residents, who make up 17% of the state population. The Garden State also shows starker disparities than New York City’s vaccine campaign and demographic makeup.

Experts say that means the communities hit hardest by the pandemic will be least protected amid a new surge.

New Jersey COVID-19 hospitalizations, as of March 25th, 2021

“We have to step our game up. We have to focus on high-density areas and also in diverse neighborhoods... areas that have less accessibility to the vaccine,” said Dr. Rey Panettieri, professor at Robert Wood Johnson Medical School and Rutgers University.

In Hudson County, U.S. Sen. Bob Menendez, a Democrat, asked the governor to send more vaccines, writing in a letter, “I respectfully ask your administration to examine this disparity in doses administered per capita and to make certain that Hudson County residents receive an equitable allocation of vaccines.”

Read More: ‘The Perfect Storm:’ Why COVID-19 Overwhelmed NJ’s Latino Cities

Hudson County is one of the state’s most diverse counties but has administered the lowest doses per capita among all the counties, the state’s data show.

“It’s very frustrating,” said David Drumeler, deputy administrator in Hudson County. “We’re all very frustrated by it.”

He said 400-500 appointments fill up in 10 to 15 minutes at the county’s drive-thru site at the USS Juneau Center in Kearny. Drumeler said state health officials acknowledged this week that Hudson needed additional shots. Hudson County is also reporting the third highest quantity of variant cases, including the largest abundance of the New York variant B.1.526.

Coronavirus variant cases in New Jersey, as of March 25th, 2021

New Jersey State Health Department

Health commissioner Judy Persichilli said equity is top of mind as officials decide how to allocate doses to more than 600 vaccination sites. During a press briefing on Wednesday, Persichilli gave the clearest explanation yet of the formula the state uses every week to distribute doses.

Second doses and booster shots are automatically matched to sites where individuals received their first dose. The rest are allocated based on deaths per capita, poverty rates, a site’s inventory, and ability to move through its supplies.

But Governor Murphy acknowledged that the state still needed to work on ensuring equitable access to vaccines through increased community sites and more mobile van units.

“We are not where we want to be in terms of equity,” he said Wednesday.

The state recently purchased three vehicles that will be deployed to harder-to-reach neighborhoods where residents may not have high-speed internet access to book appointments or cars to get to vaccination sites.

Essex County Executive Joseph DiVincnezo Jr. also sent a letter this week requesting more vaccines but from the federal administration.

“I believe our sites are grossly underutilized. We have the capacity to be vaccinating between 25,000 and 30,000 people per week,” he wrote. “If New Jersey received a larger allocation from the federal government, then more could be earmarked for Essex County."

Murphy said he expects the state’s vaccine allocation to grow by 19% next week—to half a million doses. On Monday, other essential workers like those in food production and warehouses will be newly eligible for the vaccine.

Editor’s note: This story was updated to clarify the growth of COVID-19 hospitalizations in New Jersey.