New Jersey recommended Wednesday that all residents, regardless of vaccination status, resume wearing masks in public indoor settings, effectively extending Centers for Disease Control and Prevention guidance issued for certain areas Tuesday to the entire state.

Warning that a statewide mask mandate or other restrictions could become necessary if case numbers spike, Gov. Phil Murphy was one of many officials in the region and nation Wednesday to urge those who haven’t been vaccinated to get their shots now.

» READ MORE: Philly officials say even fully vaccinated people should again wear masks inside public spaces

The recommendations, which urge even vaccinated residents to wear masks indoors if the setting is crowded or if unvaccinated or immunocompromised people are present, reflects the danger posed by a nationwide resurgence of the virus driven by the highly contagious delta variant. It also heightened calls Wednesday for unvaccinated people, who are largely the ones getting sick, being hospitalized, or dying in places with outbreaks, to get immunized.

“There are still large swaths of people who are unvaccinated, and those people are putting the rest of us at risk. That’s the long and the short of it,” said Herb Conaway, a physician and director of the Health Department in Burlington County, one of 10 counties in New Jersey with substantial or high transmission.

The handful of New Jersey and Pennsylvania counties that fell under the CDC’s guidance as of Wednesday morning were taking action. Burlington County was working to spread the word about the new recommendations. Officials in Monroe County, north of Allentown, said they would mandate masks in county buildings and encouraged residents to wear masks and get shots.

“There is vaccine in abundance in Monroe County — we just need arms to put it into,” said emergency management director Maryellen Keegan, who said misinformation has caused the county’s vaccination rate to stagnate. “We need folks to step up and get it. Because in the end, they have the power to stop this.”

Moderate spread in Philly region

The virus’ spread is less severe in the nation’s Northeast than in many other sections of the country, sparing all but six Pennsylvania counties from the CDC mask recommendation for now. Still, transmission levels can change quickly, and the number of new cases reported each day in Pennsylvania and New Jersey continues rising.

The spread in Pennsylvania has erased the progress in lowering case counts made over the course of June and July. And the 14-day case trend was rising in every county in the Philadelphia region, as well as most other counties in the state.

Though Philadelphia imposed indoor masking guidance regardless of vaccine status last week, Pennsylvania has not made such a recommendation. California followed New Jersey’s lead on Wednesday afternoon.

Pennsylvania health officials said Tuesday the state was not considering reinstating the statewide mask mandate, which was lifted in late June, but encouraged residents in counties with substantial or high transmission to follow the CDC guidance.

That agency’s recommendation also tells all vaccinated people who live with immunocompromised or unvaccinated household members — including parents with children who haven’t been immunized, which includes all kids under 12 — to wear masks in public indoor places, even in areas that have moderate or low spread.

Statewide, Pennsylvania currently has moderate transmission by the CDC’s definition, with 30 new cases per 100,000 people and a low test positivity rate in the last week. A county or state is considered to have substantial transmission if that case rate has reached 50 or higher or the positivity rate reaches 8% or higher in the last seven days. At 100 or more new cases or 10% positivity, it moves to high transmission.

Philadelphia and its four collar counties were all in the moderate transmission range Wednesday, but Philadelphia’s rate was up to 45, nearly into the substantial range.

The collar counties all have positivity rates in the 2% range and case rates in the 30s, except Chester County, which has a case rate of 21.

New Jersey’s 56 new cases per capita in the last week tipped the state into the substantial category. Its positivity rate was 3% to 5%. Gloucester County was close to the substantial range, with a case rate of 49.

“Our metrics are trending in the wrong direction,” Murphy and Health Commissioner Judith Persichilli said in a statement. “We feel the best course of action is to strongly encourage every New Jerseyan, and every visitor to our state, to take personal responsibility and mask up indoors when prudent.”

‘It’s a grind’

In Monroe County, officials were already concerned about case numbers going up — especially after they saw a spike two weeks after the Fourth of July, said Keegan, the emergency management director. The county had substantial transmission earlier this week and officials said they’d follow the CDC guidance, but on Wednesday evening its rating dropped to moderate transmission.

“It’s concerning but not unexpected that we’ve reached this level,” Keegan said Wednesday afternoon, “when we have been sitting at vaccination percentages of only 51.5% partially vaccinated. We need folks to go out and get vaccinated.”

Demand for the vaccine has stagnated in the county, which is tucked in the Pocono Mountains and has a population of about 170,000. A drive-through clinic on four weekends in May and June saw no more than 50 takers, Keegan said, and the area’s two major hospital networks — which still offer walk-in vaccinations for anyone who wants one — both pared back schedules because enough people weren’t showing up.

» READ MORE: How to wear a mask and not fog up your glasses

At Wind Gap Community pharmacy in neighboring Northampton County, patrons have seemed “unfazed” by the increasing spread of the coronavirus that has put Northampton in the substantial range, said pharmacy technician Brittany Walters.

The pharmacy’s progress with vaccinations has largely stalled, she said, and those who do get shots haven’t cited concerns about the national outbreaks.

“A lot of people say, ‘I want to travel. I want to be able to go and do things without restrictions,’” Walters said. “I haven’t heard anybody say anything about the delta variant.”

Crawford, Lawrence, Adams, Cameron, and Wyoming Counties also have substantial or high transmission, although rural Wyoming County’s emergency management director, Eugene Dziak, said he thought the CDC’s data incorrectly put the county in that category.

In Burlington County, the Health Department has had canvassers and phone bankers targeting places like Maple Shade, where they know that only 200 more vaccinations are needed to reach the state’s 70% immunization goal for each municipality, Conaway said.

Similar efforts were happening across the state Wednesday.

“Today we’re in 33 different communities, literally slogging door-to-door,” Murphy said Tuesday on Wharton Business Daily, a SiriusXM Business Radio show. “It’s a grind. We’ll stay at it. We cannot relent, and again, we’ve made a lot of progress.”

Avoiding restrictions

If a majority of people get vaccinated fast enough, doctors and scientists have said, the virus will have little ability to mutate further and the pandemic could be suppressed.

While vaccinated people may be able to catch and spread the variant, severe illness, hospitalization, or death is extremely rare in this group. The vast majority of COVID-19 hospitalizations and deaths occur in unvaccinated people.

It remains to be seen whether that, the CDC’s guidance, or the idea that masking — or potentially other restrictions — may return will also lead people to get the shot. The number of new coronavirus vaccinations has been rising slowly in Pennsylvania and New Jersey over the last several days, reflecting a national trend and possibly spurred by the delta variant.

Now health officials hope Tuesday’s mask guidance will also spark a tipping point for some of the unvaccinated.

“I hope things don’t have to get worse before people move to a position of compliance,” Conaway said. “It shouldn’t take that. School closures, business closures, economic dislocation, death, and disease — that should be present in the minds of people who are alive today. They’ve seen this story. Having viewed that film, I’d think people wouldn’t want to see a repeat of it.”