The most recent wave of the COVID-19 pandemic appears to be waning in Alabama, with hospitalizations and new cases falling rapidly in the past month, but the state could face another round of illness without additional vaccinations and precautions, health experts said Wednesday.

While statewide hospitalizations are less than half of what they were in early September and fewer people are contracting the illness, the combination of another virus variant and a slowdown in vaccinations could worsen the state’s predicament yet again, said two officials from the University of Alabama at Birmingham.

“I really am very careful to say that we’ve won when I don’t feel that way right now,” said Dr. Rachael Lee, an epidemiologist with UAB Medicine.

Russell Griffin, an associate professor of public health at UAB, said around 90% of COVID-19 patients are unvaccinated, and the average age of people hospitalized with the illness is about 10 years younger than those treated early this year.

“Younger people are dying and that is what is scary to us,” he told a news briefing.

More than 14,600 people in Alabama have died of COVID-19 since last year, and more than 800,000 have tested positive for the virus that causes it. Alabama has the nation’s fourth-worst death rate for the illness, with about 298 per 100,000 people, according to researchers at Johns Hopkins University.

But the rolling average number of daily new cases has declined about 51% over the past two weeks, and the state is no longer dead-last nationally in its vaccination rate. Nearly 43% of residents are now fully vaccinated.

After months of watching patients die, including many who contracted COVID-19 after refusing to get vaccines, health officials are glad to see some improvement.

“It’s exciting that we are starting to see these numbers go down, but this is now the time more than ever to continue to wear masks, to get vaccinated if you haven’t been vaccinated yet,” said Lee.