Nurse Kayla Mitchell, left, of Maine Medical Center’s COVID ICU unit in Portland, becomes the first person in the state to receive the Pfizer-BioNTech COVID-19 vaccine, Tuesday, Dec. 15, 2020. Credit: Derek Davis / Portland Press Herald via AP

Every day, Russell Kaye wakes up and thinks about how long the COVID-19 vaccine will protect him from the virus.

The 59-year-old photographer from Brooklin has been fully vaccinated practically since the option became available for his age group in Maine. He got a booster in October with the same kind of urgency, but he still checks new case numbers daily.

“I think if I do get COVID, [the vaccine] will keep me out of the hospital,” Kaye said. “But I’m not ready to test it.”

It is a strange place to be on the first anniversary of the state’s vaccine rollout. While the shots have proven remarkably effective at preventing serious illness from the virus, a combination of factors — including the highly contagious delta variant that arrived in the summer — are allowing the virus to spread at record rates, far higher than when vaccines first arrived.

Although Maine is one of the most highly vaccinated states at 74 percent of residents, overall case rates over the past month are nearly three times higher than they were ahead of initial vaccine approval in December 2020. Unvaccinated people continue to account for a wide majority of cases and hospitalizations despite comprising roughly a quarter of the population.

Between Nov. 12 and Dec. 10, nearly 19,000 Mainers contracted COVID-19, according to state data, including more than 13,000 unvaccinated people and just shy of 6,000 vaccinated people. The data show about 1 out of every 160 vaccinated people tested positive for the virus compared with about 1 out every 34 unvaccinated people.

During the same period in 2020, a time that marked the beginning of Maine’s winter COVID-19 surge just before the first vaccine was approved, about 6,800 Mainers — or about 1 out of every 200 people in the state — tested positive for the virus.

Gov. Janet Mills noted the anniversary in a Wednesday statement, pointing to the state’s high vaccination rates and booster efforts. But with hospitalizations hitting another record high on Wednesday, she said the state’s work is “far from done” and pressed holdouts to get vaccinated.

Those figures show the vaccines are still providing good levels of protection, and cautioned that risk can vary widely across demographics, said Dr. Dora Mills, the chief health improvement officer at MaineHealth and the governor’s sister. An older vaccinated person is still likely safer than a younger unvaccinated person due to the potency of the delta variant, she said.

She remembered the first shipments of vaccines arriving at Maine Medical Center with a police escort, and her team crying when initial doses were administered. They could not have imagined then being in a surge now because the public did not realize how much the virus can mutate or anticipate the resistance to vaccines in some areas.

“It’s very discouraging, it’s a dark time right now,” she said. “Right now everyone needs to take care of their families and loved ones.”

For Jordan Netzer, 49, of Princeton, that means still avoiding restaurants and keeping a mask on in public. He had relaxed doing the latter after getting a Johnson & Johnson shot in April, but started again with the delta surge. He was not sure what it might take to feel normal again.

“It’s been going on for so long it feels like a fact of life,” he said of the pandemic.